National Institutes of Health State-of-the-Science Conference Statement: Tobacco Use: Prevention, Cessation, and Control

Abstract

NIH Conferences5 December 2006National Institutes of Health State-of-the-Science Conference Statement: Tobacco Use: Prevention, Cessation, and ControlFREENIH State-of-the-Science Panel*NIH State-of-the-Science Panel*Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-145-11-200612050-00141 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail National Institutes of Health (NIH) consensus and state-of-the-science statements are prepared by independent panels of health professionals and public representatives on the basis of 1) the results of a systematic literature review prepared under contract with the Agency for Healthcare Research and Quality (AHRQ), 2) presentations by investigators working in areas relevant to the conference questions during a 2-day public session, 3) questions and statements from conference attendees during open discussion periods that are part of the public session, and 4) closed deliberations by the panel during the remainder of the second day and the morning of the third. This statement is an independent report of the panel and is not a policy statement of the NIH or the federal government.The statement reflects the panel's assessment of medical knowledge available at the time the statement was written. Thus, it provides a "snapshot in time" of the state of knowledge on the conference topic. When reading the statement, keep in mind that new knowledge is inevitably accumulating through medical research.Tobacco use is the leading preventable cause of premature death in the United States. Each year, more than 440 000 Americans die of tobacco-related disease, accounting for 1 in every 5 deaths. Cigarette smoking is responsible for more than 30% of cancer deaths annually in the United States. Smoking also contributes substantially to deaths from heart disease, stroke, and chronic obstructive pulmonary disease. According to current estimates, 21% of American adults (44.5 million individuals) and 22% of American high school students (3.75 million individuals) smoke. Cigarettes are the predominant form of tobacco that Americans consume, but tobacco consumption also includes smokeless tobacco, cigars, and pipes. In addition to the toll in human lives, tobacco use is an enormous economic burden on society. From 1995 to 1999, estimated annual smoking-attributable economic costs in the United States were $75.5 billion for direct medical care for adults and $81.9 billion for lost productivity.Tobacco use per capita has decreased from about 14 pounds per year in the 1950s to about 5 pounds per year in 2000, suggesting that public health interventions have been effective. Yet it is unlikely that the United States will reach the Healthy People 2010 objectives of reducing smoking prevalence to 12% or less in adults and 16% or less in youth. Further progress in reducing tobacco use is an important challenge facing the public health, medical, and political communities.For these reasons, the National Cancer Institute and the NIH's Office of Medical Applications of Research sponsored a State-of-the-Science Conference on Tobacco Use: Prevention, Cessation, and Control on 12-14 June 2006 in Bethesda, Maryland. The key questions to be addressed at the State-of-the-Science Conference were: 1) What are the effective population- and community-based interventions to prevent tobacco use in adolescents and young adults, including among diverse populations? 2) What are the effective strategies for increasing consumer demand for and use of proven, individually oriented cessation treatments, including among diverse populations? 3) What are the effective strategies for increasing the implementation of proven, population-level, tobacco-use cessation strategies, particularly by health care systems and communities? 4) What is the effect of smokeless tobacco product marketing and use on overall harm to the population from tobacco use? 5) What is the effectiveness of prevention and of cessation interventions in populations with co-occurring morbidities and risk behaviors? 6) What research is needed to make the most progress and greatest public health gains nationally and internationally?At the conference, invited experts presented information pertinent to these questions, and a systematic literature review prepared under contract with AHRQ was summarized. The evidence report (www.ahrq.gov/clinic/epcix.htm) emphasized randomized, controlled trials; systematic reviews; and other experimental or observational studies with more than 100 participants. During the conference, attendees provided both oral and written statements in response to the key questions. The panel members weighed this evidence as they addressed the key conference questions.1. What Are the Effective Population- and Community-Based Interventions to Prevent Tobacco Use in Adolescents and Young Adults, Including among Diverse populations?Never startin