Bolster Policy on Tobacco, ENDS, Secondhand Smoke, Says AAFP

Letter Supports Robust Taxation and Flavor Regulation, Among Other Tactics

February 12, 2019 09:58 am News Staff – Why do certain segments of the U.S. population start smoking at younger ages or smoke more or have a harder time quitting tobacco than others? Factors might include where a person lives, their education level and/or their employment status.

The demographic and other characteristics the CDC recognizes as disparities among smokers -- including those that influence whether and how they quit using tobacco products -- are confoundingly numerous, which means there's no one-size-fits-all way to reduce the number of people shackled to the leading cause of preventable death in the United States.

But the AAFP is again reminding the Trump administration of evidence-based strategies that can reduce negative health outcomes and overall tobacco use across various social determinants of health -- strategies that regulators should reinforce.

In a Feb. 6 letter(3 page PDF) to Randi Frank of the CDC's Office on Smoking and Health that was signed by Board Chair Michael Munger, M.D., the Academy acknowledged that "the breadth and scope of tobacco-related disparities cannot be addressed with one single solution." Still, the AAFP noted, there are several evidence-based strategies to prevent smoking, particularly among U.S. youth.

Among the AAFP's recommendations:

Maintain support for evidence-based cessation methods, including OTC and prescription nicotine replacement therapy, pharmacological options and counseling.
Increase to 21 the legal sale age for tobacco products, including electronic nicotine delivery systems (ENDS) -- a move that could lower teen smoking by 12 percent, potentially preventing some 223,000 deaths among people born between 2000 and 2019.
Impose robust tax on tobacco products and ENDS.
Allot funds from the Tobacco Master Settlement Agreement and/or tobacco excise taxes to tobacco prevention, cessation, education and other elements of comprehensive tobacco control.
Impose FDA regulation on flavoring in all tobacco products, including ENDS.
Immediately stop the marketing and advertising of ENDS, especially to youth and children.

The AAFP added that it "strongly supports the prohibition of the use of all tobacco products, including ENDS, in all public places, both indoors and outdoors."

The letter was the AAFP's response to a request for information from the CDC regarding tobacco control that was published Dec. 11 in the Federal Register.

Rise of 'JUULing' Among Youth Sparks Sharp Response
Academy Offers Members Physician/Patient Resources
(8/6/2018)

Study Suggests E-cigarettes Cause More Harm Than Good
Some Adults May Quit Smoking Traditional Cigarettes, But More Teens and Young Adults Will Start
(3/30/2018)

Additional Resource
CDC: Youth and Tobacco Use