The annual Society for
Research on Nicotine and Tobacco meeting, held recently in
Boston, brought together researchers, agencies, advocates, and
health care professionals for four days to learn about and share
new, cutting-edge tobacco and nicotine science.
Following are some highlights:
The growing problem of non-communicable diseases
(NCDs): Tobacco use, specifically smoking, as well as
exposure to secondhand smoke, is a key risk factor in all of the
top NCDs that are becoming an increasing burden around the world.
The top four NCDs are heart disease and stroke, cancer, diabetes,
and chronic lung disease. NCDs as a whole are the cause of death
for more than 35 million people per year globally. Specifically, NCDs are
responsible for nearly two-thirds of deaths each year, far more
than infectious disease, and as such have become more and more
prominent on the global discussion table. Although the discussion
on NCDs and strategies for combatting them are ongoing, it is
important to keep tobacco use and its control as a prominent topic.
The CDC recognizes tobacco control as a key piece in the fight
disease, and the WHO is drafting an action plan for the
prevention and control of NCDs, but we must continue to recognize
the huge role that tobacco use plays in these diseases.
The large number of health care professionals (HCPs) who
smoke: Many HCPs are aware of the health problems
associated with smoking but simply have not been able to quit. In
the United States, some health institutions such as the Cleveland
Clinic have decided that the way to reduce the number of health
care workers who smoke is to have a
smoke-free hiring policy. There is much argument on both sides
when it comes to smoke-free hiring, and there are myriad
difficulties with HCPs who smoke. Having HCPs who smoke is
problematic because, when patients are trying to quit, smelling
smoke on the hands or clothes of those caring for them can be a
smoking trigger. Meanwhile, when one is advising a patient on how
to quit, they lose credibility if they are a current smoker
Globally, many HCPs are unaware of the health risk of smoking.
Some parts of the world have rates of smoking among HCPs of up to
80 percent! We can intuit that if physicians and other HCPs aren't
even aware that tobacco use is so harmful, they are probably not
offering advice or treatment to their tobacco-using patients. As Dr. Ron Borland of the
VicHealth Centre for Tobacco Control said in a pre-conference
workshop co-sponsored by Global Bridges and Treatobacco.net, "If there's
one thing harder than getting smokers to quit smoking, it's
educating our health professionals. We can make a lot of progress
by making sure that HCPs understand the nature of the problem."
The so-called "endgame" for tobacco, on local, national
and global levels:The Policy Theme Lecture, delivered by
professor at University of California at San Francisco and editor
of Tobacco Control, offered many
intriguing developments and suggestions for how we can start to
work toward an endgame rather than simply a reduction in use.
Dr. Karl Fagerstrom, creator of the Fagerstrom Nicotine Dependence
Test, suggested raising the legal age for tobacco use to 21,
combined with an increase in enforcement. Because few people start
smoking after age 21 anyway, this would significantly reduce the
number of newly addicted young people. He also suggested the
systematic raising of the legal age for tobacco use by one year
each calendar year, effectively making a "smokefree generation." An
entire symposium was also dedicated to the topic of endgame
strategies; Dr. Neal Benowitz discussed the use of de-nicotinized
cigarettes as a means to reduce cigarette consumption by making the
tobacco less addictive, and Dr. Robert Proctor outlined his case
for the abolition of tobacco. We are poised at the brink of a huge
shift when it comes to the abolition of tobacco, so let us hope
that we continue to make strides in this direction.
The tobacco control community is a relatively small one, and
this conference pulled from the best and brightest in the field. I
encourage those with an appetite for science and a passion for
tobacco control to consider attending future meetings.