Growing Up Tobacco Free Preventing Nicotine Addiction in Children and Youths (1994) / Chapter Skim
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9 COORDINATION OF POLICIES AND RESEARCH
9 COORDINATION OF POLICIES AND RESEARCH
Pages 257-278
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From page 257... ...
These measures generally fall in the realm of social policy taxation of tobacco products, enforcement of youth access laws, constraints on advertising and promotion, regulation of tobacco products, and tobacco control advocacy for tobacco-free environments. Previous chapters have dealt with the addictive process, promotion of a tobacco-free social norm, preventive and cessation interventions, advertising and promotion of tobacco, pricing and taxation, youth access, and regulation of tobacco products.
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From page 258... ...
The annual reports on smoking and health have documented the health consequences of tobacco use and disseminated new research findings to broad public and scientific audiences, and substantial progress in reducing smoking prevalence has been achieved over the past three decades, since Surgeon General Luther Terry issued the federal government's first comprehensive report on the devastating health toll caused by smoking. However, the surgeon general has no direct-line authority to regulate tobacco products, provide technical assistance to states, monitor public health, conduct research, or provide service.
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From page 259... ...
Congress should repeal the law that preempts state and local regulation of advertising and promotion occurring exclusively within the state's boundaries, and should also enact comprehensive restrictions on advertising and promotion of tobacco products. Congress should also rectify its massive regulatory default by enacting a comprehensive scheme for regulating the labeling, packaging, and constituents of tobacco products, and by conferring regulatory authority on FDA or a separate tobacco control agency.
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From page 260... ...
In 1993, in its IMPACT Project, CDC initiated cooperative agreements with the non-ASSIST states to help them develop tobacco control efforts. Similarly, through the SmokeLess States program, the Robert Wood Johnson Foundation has funded 10 states to enhance their efforts.
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From page 261... ...
The inspector general monitors the functioning of the agencies with the department, and has issued reports on various aspects of tobacco control. The Office of the Assistant Secretary for Health administrator, the Public Health Service, and its Office on Health Promotion and Disease Prevention coordinate prevention activities throughout the Public Health Service, including progress toward achieving the goals set forth in Healthy People 2000.
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From page 262... ...
This includes the study of health outcome measures, clinical practice guidelines, quality assurance, and system performance indicators. AHCPR has, for example, focused on clinical use of nicotine patches in the treatment of nicotine addiction.
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From page 263... ...
to the investigation. It is important to note that not all primary studies directly or specifically targeted issues related to youth tobacco use.
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From page 264... ...
Prevention (school-based, community-based, and skills training projects, policy studies, and/or education through the media) : Twenty primary research studies on prevention of initiation were targeted directly to children and youths, representing just over half ($22.5 million)
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From page 265... ...
Only 5 studies address the wealth of social and interpersonal influences that the Committee believes are central to youth initiation. And the federal support for policy studies is extremely weak with only a single study, except to the extent that youth smoking is made part of NCI's ASSIST, CDC's states initiative, and the general service programs of the Center for Substance Abuse Prevention (CSAP)
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From page 266... ...
Policy research is usually interdisciplinary, involving the social sciences and other fields. It includes, for example, studies of how excise taxes decrease consumption, how community organization affects the effectiveness of tobacco control measures, how enforcement of youth access laws can reduce illicit sales, the impact of "tombstone" advertising on sales and use rates, and similar studies.
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From page 267... ...
In 1992, Massachusetts also passed a comprehensive tobacco control package. In 1993, 23 states passed 37 less comprehensive tobacco control laws, including excise tax increases, youth access restrictions, vending machine restrictions, indoor air controls, public smoking bans, and other measures-many of which will have an impact on youth tobacco use.
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From page 268... ...
Discussions on the tobacco excise tax at the federal level have to date focused on generating revenue for health care reform and other programs, not on the public health goal of reducing use of tobacco products. There has been little discussion of replicating this feature of the California tobacco control program.
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From page 269... ...
Joseph DiFranza edits Tobacco Access Law News, a bimonthly newsletter disseminated to tobacco control advocates. The Robert Wood Johnson Foundation has emerged as the leading source of foundation support for tobacco control, as a prominent part of its work against substance abuse.
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From page 270... ...
Office of the Inspector General, Department of Health and Human Services Office of the Assistant Secretary for Health State offices for substance abuse and health Association of State and Territorial Health Officials Office on Smoking and Health; prepare surgeon general's reports; staff Interagency Committee on Smoking and Health; coordinate federal public health efforts; monitor smoking rates; gather national health statistics; liaison with state health and substance abuse offices Reports on youth access, spit tobacco, public health agencies' tobacco control measures Healthy People 2000 objectives; coordination of Public Health Service agencies Gather state health statistics, liaison with CDC, coordinate with local governments Annual report on state tobacco control efforts
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From page 271... ...
Federal funding to state block grants for substance abuse; technical assistance for state and local government; program evaluation continued on next page
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From page 272... ...
Americans for Nonsmokers' Rights Join Together Materials and technical assistance for schools Cardiovascular research; Coalition on Smoking OR Health Lung research; Coalition on Smoking OR Health Cancer research; Coalition on Smoking OR Health SmokeLess States National advocacy National advocacy organization, funded by ACS, ALA, AHA and joined by many professional and private voluntary health organizations National volunteer organization National physician and health professional advocacy organization National advocacy organization Advocacy resource center
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From page 273... ...
At the federal level, if an increase in excise tax on tobacco products is contemplated by Congress in the near future, as part of health care reform or other legislation, Congress should ensure that some fraction of revenues raised by the federal excise tax on tobacco products be devoted to a credible tobacco control effort. This may be difficult, as the revenues and expenditures may derive from separate pieces of legislation, but to the extent possible, the Committee encourages a linkage between new taxes and an energetic federal tobacco control program.
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From page 274... ...
The Committee commends CSAP for this action, for taking steps to fill a critical gap, and notes the usefulness of including tobacco in drug abuse prevention programs. The tobacco control effort extends well beyond preventive interventions, however, and the Committee believes that similar efforts are needed at the federal level on tax policy, youth access, licensing, advertising and promotion, regulation, and other public policy domains.
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From page 275... ...
As a long-term goal, the Committee believes that prospects for a more coherent and accountable national tobacco control policy would be brighter if the various government and private organizations concerned with tobacco use pooled their resources to create such a national resource in the private sector. Regardless of whether a central policy analysis institute is possible or desirable, it will be important to broaden the base of support for tobacco control efforts at all levels, and to exhort federal, state, and local governments, private voluntary health organizations, and advocacy groups to collaborate.
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From page 276... ...
This should not be construed as calling for consolidation of functions, along the lines of a tobacco control administration as outlined above, but rather for better linkage of activities in various federal agencies, in states, and in private sector organizations. It will probably fall short of the mission of even a tobacco control institute, as discussed above, which would be a national resource for policy analysis and planning (but without implementing authority for research, public health monitoring, regulation, and services)
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From page 277... ...
The public health appears ascendant in what has been a 30-year struggle to modify social norms favorable to tobacco use. The stage is now set for aggressive action to reduce tobacco use by children and youths as a central feature of the nation's tobacco control efforts.
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From page 278... ...
The prices of tobacco products continue to drop in real terms as the industry responds to a shrinking market, making tobacco products more affordable to children and youths. The prevalence of tobacco use now appears to be increasing among children and youths.
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