Reducing Tobacco-Related Cancer Incidence and Mortality


Book Description

Tobacco use is the leading cause of preventable death in United States, causing more than 440,000 deaths annually and resulting in $193 billion in health-related economic losses each year-$96 billion in direct medical costs and $97 billion in lost productivity. Since the first U.S. Surgeon General's report on smoking in 1964, more than 29 Surgeon General's reports, drawing on data from thousands of studies, have documented the overwhelming and conclusive biologic, epidemiologic, behavioral, and pharmacologic evidence that tobacco use is deadly. This evidence base links tobacco use to the development of multiple types of cancer and other life-threatening conditions, including cardiovascular and respiratory diseases. Smoking accounts for at least 30 percent of all cancer deaths, and 80 percent of lung cancer deaths. Despite the widespread agreement on the dangers of tobacco use and considerable success in reducing tobacco use prevalence from over 40 percent at the time of the 1964 Surgeon General's report to less than 20 percent today, recent progress in reducing tobacco use has slowed. An estimated 18.9 percent of U.S. adults smoke cigarettes, nearly one in four high school seniors smoke, and 13 percent of high school males use smokeless tobacco products. In recognition that progress in combating cancer will not be fully achieved without addressing the tobacco problem, the National Cancer Policy Forum of the Institute of Medicine (IOM) convened a public workshop, Reducing Tobacco-Related Cancer Incidence and Mortality, June 11-12, 2012 in Washington, DC. In opening remarks to the workshop participants, planning committee chair Roy Herbst, professor of medicine and of pharmacology and chief of medical oncology at Yale Cancer Center and Smilow Cancer Hospital, described the goals of the workshop, which were to examine the current obstacles to tobacco control and to discuss potential policy, outreach, and treatment strategies that could overcome these obstacles and reduce tobacco-related cancer incidence and mortality. Experts explored a number of topics, including: the changing demographics of tobacco users and the changing patterns of tobacco product use; the influence of tobacco use on cancer incidence and cancer treatment outcomes; tobacco dependence and cessation programs; federal and state level laws and regulations to curtail tobacco use; tobacco control education, messaging, and advocacy; financial and legal challenges to tobacco control efforts; and research and infrastructure needs to support tobacco control strategies, reduce tobacco related cancer incidence, and improve cancer patient outcomes. Reducing Tobacco-Related Cancer Incidence and Mortality summarizes the workshop.




Understanding the U.S. Illicit Tobacco Market


Book Description

Tobacco use has declined because of measures such as high taxes on tobacco products and bans on advertising, but worldwide there are still more than one billion people who regularly use tobacco, including many who purchase products illicitly. By contrast to many other commodities, taxes comprise a substantial portion of the retail price of cigarettes in the United States and most other nations. Large tax differentials between jurisdictions increase incentives for participation in existing illicit tobacco markets. In the United States, the illicit tobacco market consists mostly of bootlegging from low-tax states to high-tax states and is less affected by large-scale smuggling or illegal production as in other countries. In the future, nonprice regulation of cigarettes - such as product design, formulation, and packaging - could in principle, contribute to the development of new types of illicit tobacco markets. Understanding the U.S. Illicit Tobacco Market reviews the nature of illicit tobacco markets, evidence for policy effects, and variations among different countries with a focus on implications for the United States. This report estimates the portion of the total U.S. tobacco market represented by illicit sales has grown in recent years and is now between 8.5 percent and 21 percent. This represents between 1.24 to 2.91 billion packs of cigarettes annually and between $2.95 billion and $6.92 billion in lost gross state and local tax revenues. Understanding the U.S. Illicit Tobacco Market describes the complex system associated with illicit tobacco use by exploring some of the key features of that market - the cigarette supply chain, illicit procurement schemes, the major actors in the illicit trade, and the characteristics of users of illicit tobacco. This report draws on domestic and international experiences with the illicit tobacco trade to identify a range of possible policy and enforcement interventions by the U.S. federal government and/or states and localities.




Tobacco War


Book Description

Tobacco War charts the dramatic and complex history of tobacco politics in California over the past quarter century. Beginning with the activities of a small band of activists who, in the 1970s, put forward the radical notion that people should not have to breathe second-hand tobacco smoke, Stanton Glantz and Edith Balbach follow the movement through the 1980s, when activists created hundreds of city and county ordinances by working through their local officials, to the present--when tobacco is a highly visible issue in American politics and smoke-free restaurants and bars are a reality throughout the state. The authors show how these accomplishments rest on the groundwork laid over the past two decades by tobacco control activists who have worked across the U.S. to change how people view the tobacco industry and its behavior. Tobacco War is accessibly written, balanced, and meticulously researched. The California experience provides a graphic demonstration of the successes and failures of both the tobacco industry and public health forces. It shows how public health advocates slowly learned to control the terms of the debate and how they discovered that simply establishing tobacco control programs was not enough, that constant vigilance was necessary to protect programs from a hostile legislature and governor. In the end, the California experience proves that it is possible to dramatically change how people think about tobacco and the tobacco industry and to rapidly reduce tobacco consumption. But California's experience also demonstrates that it is possible to run such programs successfully only as long as the public health community exerts power effectively. With legal settlements bringing big dollars to tobacco control programs in every state, this book is must reading for anyone interested in battling and beating the tobacco industry.




WHO Technical Manual on Tobacco Tax Administration


Book Description

Tobacco use is the single largest cause of preventable death globally, killing more than five million people each year. Tobacco use also creates considerable economic costs, from greater spending on health care to treat the diseases it brings on in users and those exposed to tobacco smoke to the lost productivity resulting from the premature deaths it causes. Of all the many interventions for reducing tobacco use, a significant increase in tobacco product taxes and prices has been demonstrated to be the single most effective and cost-effective intervention, particularly among the poor and the young. At the same time, because of the inelasticity of demand for tobacco products in most countries and the low share of tax in price in many, significant increases in tobacco taxes generate significant increases in the revenues generated by these taxes. This technical manual aims to help governments achieve both objectives by identifying a set of "best practices" for tobacco taxation. It documents governments' existing approaches to tobacco taxation, discusses barriers to using tobacco taxes to achieve health and revenue objectives, and provides case studies of effective tobacco tax administration. This manual is intended to be useful to tax administrators at the Ministry of Finance level by making them aware of the practices used and challenges faced by other countries. It will also be useful to officials in a country's Ministry of Health or similar organizations by providing them with a more thorough understanding of key issues in tax structure and administration.




Effectiveness of Tax and Price Policies for Tobacco Control


Book Description

This new volume of the IARC Handbooks of Cancer Prevention in Tobacco Control presents a critical review and evaluation of the evidence by 25 international experts from twelve countries on the economics, epidemiology, public policy and tobacco control aspects of tax and price policies. The working group draws conclusions about the effectiveness of tax and price measures to control tobacco use in the population. The Handbook covers an overview of tobacco taxation; industry pricing strategies and other industry initiatives diluting the effects of taxes on consumption; tax, price and aggregated demand for tobacco, as well as demand at the individual level in adults, young people and the economically disadvantaged; tax avoidance and tax evasion and the economic and health impacts of tobacco taxation. This body of evidence and the consensus evaluation of 18 concluding statements on the impact of interventions to increase the price of tobacco products, can assist policy makers, government officials, evaluators and researchers working in tobacco control and disease prevention, to base their decisions on the latest scientific evidence.




Curbing the Epidemic


Book Description

Annotation. Addresses important economic and social issues confronting policymakers when dealing with the issue of tobacco control and its impact on the social and economic resources of both developed and developing countries.




After Tobacco


Book Description

States have banned smoking in workplaces, restaurants, and bars. They have increased tobacco tax rates, extended "clean air" laws, and mounted dramatic antismoking campaigns. Yet tobacco use remains high among Americans, prompting many health professionals to seek bolder measures to reduce smoking rates, which has raised concerns about the social and economic consequences of these measures. Retail and hospitality businesses worry smoking bans and excise taxes will reduce profit, and with tobacco farming and cigarette manufacturing concentrated in southeastern states, policymakers fear the decline of regional economies. Such concerns are not necessarily unfounded, though until now, no comprehensive survey has responded to these beliefs by capturing the impact of tobacco control across the nation. This book, the result of research commissioned by Legacy and Columbia University's Institute for Social and Economic Research and Policy, considers the economic impact of reducing smoking rates on tobacco farmers, cigarette-factory workers, the southeastern regional economy, state governments, tobacco retailers, the hospitality industry, and nonprofit organizations that might benefit from the industry's philanthropy. It also measures the effect of smoking reduction on mortality rates, medical costs, and Social Security. Concluding essays consider the implications of more vigorous tobacco control policy for law enforcement, smokers who face social stigma, the mentally ill who may cope through tobacco, and disparities in health by race, social class, and gender.




Tobacco Control Policy Analysis in China


Book Description

This is the first book that analyzes tobacco control policies in China from the perspectives of economics and health. For readers interested in the economic aspects of tobacco control policy issues not only in China but also in other developing countries, this book provides a comprehensive analytical and empirical framework addressing key debated issues.This book covers a range of interesting topics from the prevalence of smoking in China, health and economic burden of smoking in China, demand for cigarettes and taxation in China, the role of tobacco on farming, the tobacco industry and the World Trade Organization, poverty and smoking in China, to future challenges of tobacco control for the Chinese government.




Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products


Book Description

Tobacco use by adolescents and young adults poses serious concerns. Nearly all adults who have ever smoked daily first tried a cigarette before 26 years of age. Current cigarette use among adults is highest among persons aged 21 to 25 years. The parts of the brain most responsible for cognitive and psychosocial maturity continue to develop and change through young adulthood, and adolescent brains are uniquely vulnerable to the effects of nicotine. At the request of the U.S. Food and Drug Administration, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products considers the likely public health impact of raising the minimum age for purchasing tobacco products. The report reviews the existing literature on tobacco use patterns, developmental biology and psychology, health effects of tobacco use, and the current landscape regarding youth access laws, including minimum age laws and their enforcement. Based on this literature, the report makes conclusions about the likely effect of raising the minimum age to 19, 21, and 25 years on tobacco use initiation. The report also quantifies the accompanying public health outcomes based on findings from two tobacco use simulation models. According to the report, raising the minimum age of legal access to tobacco products, particularly to ages 21 and 25, will lead to substantial reductions in tobacco use, improve the health of Americans across the lifespan, and save lives. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products will be a valuable reference for federal policy makers and state and local health departments and legislators.




E-Cigarette Use Among Youth and Young Adults: a Report of the Surgeon General


Book Description

Tobacco use among youth and young adults in any form, including e-cigarettes, is not safe. In recent years, e-cigarette use by youth and young adults has increased at an alarming rate. E-cigarettes are now the most commonly used tobacco product among youth in the United States. This timely report highlights the rapidly changing patterns of e-cigarette use among youth and young adults, assesses what we know about the health effects of using these products, and describes strategies that tobacco companies use to recruit our nation's youth and young adults to try and continue using e-cigarettes. The report also outlines interventions that can be adopted to minimize the harm these products cause to our nation's youth.E-cigarettes are tobacco products that deliver nicotine. Nicotine is a highly addictive substance, and many of today's youth who are using e-cigarettes could become tomorrow's cigarette smokers. Nicotine exposure can also harm brain development in ways that may affect the health and mental health of our kids.E-cigarette use among youth and young adults is associated with the use of other tobacco products, including conventional cigarettes. Because most tobacco use is established during adolescence, actions to prevent our nation's young people from the potential of a lifetime of nicotine addiction are critical.E-cigarette companies appear to be using many of the advertising tactics the tobacco industry used to persuade a new generation of young people to use their products. Companies are promoting their products through television and radio advertisements that use celebrities, sexual content, and claims of independence to glamorize these addictive products and make them appealing to young people.