Tobacco Control & Prevention National Update Presented to Tobacco Program Grant Review Committee Dec. 16, 2011
Major Initiatives• Centers for Disease Control and Prevention –Office on Smoking & Health• U.S. Food & Drug Administration (FDA)• National Tobacco Control Strategy• Health Care Reform
CDC – Office on Smoking & Health• “Accelerating the Decline” initiative – Perception problem is solved, lack of advocacy partners, 18-24 yrs. & low SES still high, better use FDA authority.• Upcoming Surgeon General’s Report on Youth Tobacco Use – (Spring 2012)• First ever national media campaign – Spring of 2012, hard hitting, 1-800 Quitline number• Less than .02 per dollar of revenue going towards programs – big reductions in states• Federal funding cuts, OSH competitive grant?
U.S. Food and Drug Administration• Granted Regulatory Authority over tobacco products (6/09)• Restricts Marketing and Sales to Youth• Requires Disclosure of Ingredients• Regulates “reduces harm” claims (no more light, mild, or low-tar)• Bigger, bolder health warnings on packages• Requires industry to pay user fee to FDA to support efforts ($800M/yr)
U.S. Food and Drug Administration• Authority to further restrict marketing• Allows FDA to require changes in the product (cannot ban nicotine completely)• Created the Tobacco Products Scientific Advisory Committee (TPSAC) – Recommended removal of menthol cigarettes from the market) – Working on dissolvable tobacco products (3/12)
U.S. Food and Drug Administration• Industry preventing progress by: –Suing over warning labels –Suing over Menthol report – Increasing marketing and sales of dissolvable tobacco products –Suing some more about anything
National Tobacco Prevention and Control Strategy• First of its kind comprehensive national plan• “Ending the Tobacco Epidemic” –Released by HHS – Nov. 2010• Focused on Evidenced- based strategies• Includes national media campaign• Requires all HHS campuses are tobacco free• Required Medicare and Medicaid to include tobacco cessation services• Includes more funding for research
Health Care Reform• New Coverage Under Medicaid – Oct. 1, 2010 – state Medicaid programs must provide a comprehensive cessation benefit with no-cost sharing/co-pay & requires expanded private insurance coverage of cessation/treatment without cost sharing – Jan. 1, 2013 – increased federal reimbursements for cessation – Jan 1, 2014 – state Medicaid programs cannot exclude smoking cessation drugs form their prescription drug coverage
Health Care Reform• Creation of Public Health Prevention Fund to support proven prevention, wellness and public health programs in communities – Community Transformation Grants that include additional funding for tobacco programs & QuitLines – Possible 68% cut to offset impact of continued payroll tax deductions (changes by the day)
Key Opportunities• National media campaign with quit smoking call to action & QuitLine # (spring 2012)• Warning labels with QuitLine # (fall 2013)• Banning of Menthol ??• Release of Surgeon Generals report on Youth Tobacco Use (Spring 2012)• Insurance Reimbursement for cessation services and counseling• FDA – needs for input, testimony from states
Key Threats• Modified Risk Products• Dissolvable Tobacco Products• Stall in decreases of adult prevalence• Increases in use among 18-24 year olds• Competitive applications for CDC funds• Tobacco issues is solved – obesity is the problem• Low SES smokers – how to get them to quit
Always the Question• DOES SPENDING MORE ON TOBACCO CONTROL PROGRAMS MAKE ECONOMIC SENSE?
AN INCREMENTAL BENEFIT-COST ANALYSIS USING PANEL DATA Journal of Contemporary Economic Policy, Nov. 27. 2011• This paper presents a benefit-cost analysis of the ongoing, state-level tobacco prevention and control programs in the United States. Using state-level panel data for the years 1991–2007, the study applies several variants of econometric modeling approaches to estimate the state- level tobacco demand. The paper finds a statistically significant evidence of a sustained and steadily increasing long-run impact of the tobacco control program spending on cigarette demand in states. The study also shows that, if individual states follow the Best Practices funding guidelines, potential future annual benefits of the tobacco control program can be as high as 14–20 times the cost of program implementation. (JEL C2, H5, I1)