Georgia Chapter, American Academy of Pediatrics: August 2013

The American Society of Clinical Oncology on Monday called for a “substantial” increase in tobacco excise taxes and urged oncologists to still counsel their patients with cancer to quit smoking. Those recommendations are among a group of suggestions designed to move people to stop smoking.

“Given that the scientific and medical evidence is indisputable that tobacco use poses a huge burden in cancer incidence and death in the United States and worldwide, it is our responsibility as health care professionals and cancer specialists to address the devastating consequences of tobacco use and to help patients with cancer quit,” said the policy statement, which was published in the Journal of Clinical Oncology. The article noted that tobacco use is linked to 30 percent of all cancer deaths and is associated with increased risk for at least 17 types of cancer.

The recommendations updated a previous set of suggestions issued a decade ago. In 2003, one of ASCO’s primary goals was the creation of an independent commission that would develop a comprehensive tobacco cessation and control plan. ASCO officials say that recommendation was achieved with the creation of the Food and Drug Administration’s Center for Tobacco Products in 2009.

Since the first set of recommendations, the article noted, evidence of the dangers of tobacco use has grown stronger and federal officials have expanded coverage of cessation benefits. Starting in 2005, federal Medicare officials have recognized the importance of quitting smoking and have covered cessation services.

In 2011, the Medicare program expanded tobacco cessation coverage to pay for up to eight face-to-face sessions in a 12-month period for all Medicare beneficiaries. The Medicare Part D program also will pay for drugs that can help people stop using tobacco.

“One of ASCO’s top priorities included in the 2013 statement is to educate oncology providers and ensure that tobacco cessation is incorporated into daily oncology practice because it is never too late for a patient with cancer to stop using tobacco,” a spokeswoman for the group said in an email. “Recent research has shown that patients who continued tobacco use even after a cancer diagnosis experienced poorer outcomes, more side effects, and an increased likelihood of the cancer coming back.”

The oncologists’ recommendations include:

• A “substantial” but unspecified increase in tobacco excise taxes.

• The creation and implementation of local ordinances to ban indoor smoking.

• Funding of comprehensive tobacco control programs, including anti-smoking quit hotlines and youth prevention programs, at the levels sought by the federal Centers for Disease Control and Prevention.

• The elimination of ads aimed at youth.

• The expansion of minimum-price laws for tobacco products that prevent deep discounts or bulk purchase price reductions, similar to laws that currently exist in 25 states and the District of Columbia.

• Increased retail licensing fees.

• Regulation of all tobacco products — including cigars and cigarillos, nicotine delivery products and all other new tobacco products — with as much rigor as for cigarettes.

• Full implementation of regulations requiring graphic warning labels on cigarette packaging.

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