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: Looking to the Future of Tobacco Control: A Recap of 2013 SRNT Meeting

Looking to the Future of Tobacco Control: A Recap of 2013 SRNT Meeting

Project Manager

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 against non-communicable 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 themselves.

 

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 Ruth Malone, 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.

1 :

Why should HCPs be prohibited from smoking if they do so only during their spare time, and in a way that does not affect their work? Coming to work smelling like smoke would obviously be an issue in certain medical fields, but if an HCP's smoking behavior does not directly affect their work, they should have the right to smoke as long as it is legal. Alcohol is also the cause of many health problems--should HCPs be prohibited from drinking as well? The arguments touched upon in this blog post represent an attitude that is overly intrusive with respect to personal choice. The data indicates that most people in this country who smoke are aware that smoking is bad for them. They choose to do it anyway. That is their right, just as it is the right of anyone at the Society for Research on Nicotine and Tobacco's right not to smoke, and to shun friends and family who choose to do so. And if people do choose to smoke despite the risks, the solution isn't "abolition," as Dr. Proctor suggests. (What he really means by "abolition," of course, is "prohibition," and that's worked so well for us in the past!) In this country at least, smoking has become a moral issue. Some people see the risks and choose to smoke and others see those same risks and choose not to. So the argument here appears to be not so much that smoking is bad for you, but rather that it isn't morally permissible to engage in behaviors that are bad for you. I respectfully dissent, as I believe in my right to choose what behaviors I engage in, particularly when a given behavior is currently legal--I only wish that the people at the Society's meeting in Boston would grant me the same respect.
March 23, 2013 01:52

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