A remarkable public health advance is happening and has not received much attention. A recent commentary (MC Fiore. NEJM 2016; 375: 1410-12) highlights the substantial and accelerating progress in lowering the use of tobacco/smoking.
The author notes that the rate of decline in smoking is now about 0.78 percentage points per year during the Obama administration which is more than double the rate during the prior 16 years. This decline, if continued, could mean that the current rate of smoking of 15.3% of U.S. adults could be zero by around 2035.
The author notes that the current administration likely deserves some of the credit for this progress due to legislative acts and leadership. Legislation has included increases in federal cigarette excise taxes, more FDA oversight of thousands of tobacco products, and better insurance coverage of smoking cessation through the Affordable Care Act. Leadership has involved the CDC, FDA and HHS. This has led to comprehensive strategic plans which have developed effective educational campaigns, including “Tips from Former Smokers” and “The Real Cost.” More steps to build on this progress has been outlined in the 50th-annisversary of the Surgeon General’s report, The Health Consequences of Smoking (2014).
Potential Further Actions:
- Further increases in cigarette excise taxes
- Sustain high-impact national media campaigns
- Public housing mandates to make smoke-free
- Federal legislation to ban any tobacco products to persons younger than 21 years
- Extend smoke-free indoor-air protections to all Americans
My take: This is great news. Hopefully, there will be a big drop from >36 million Americans who smoke to many fewer in coming years. This can reduce premature deaths which are expected for about half of people who continue to smoke.