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U.S. oncologists are calling on federal and state officials to beef up the regulation of tobacco products, increase research funding, and ensure access to cessation treatments through the new state-based insurance exchanges.
Physicians also need to "lead by example" by not smoking, treating tobacco dependence aggressively, lobbying for tobacco-free environments, and refusing to accept tobacco industry support, according to a policy statement from the American Society of Clinical Oncology. The statement was published July 29 in the Journal of Clinical Oncology (doi:10.1200/JCO.2013.48.8932). This is the first time ASCO has updated its policy on tobacco control since 2003.
The latest report reminds physicians, policy makers, and the public that the problem of tobacco cessation and control is not solved, said Dr. Clifford A. Hudis, president of the American Society of Clinical Oncology.
"While smoking cessation efforts have been rewarded in many populations with falling rates of cigarette and tobacco use, that’s not been uniform," said Dr. Hudis of Memorial Sloan-Kettering Cancer Center in New York. "It remains a dominant health care risk in the U.S. and specifically a cancer risk,"
But Dr. Hudis said he thinks ASCO’s message will resonate on Capitol Hill where lawmakers are looking for cost-effective policies. "This is an area where doing the right thing could yield unbelievable dividends in terms of savings for the system," he said.
One of those areas is in federally sponsored research. ASCO is seeking an increased federal role in research on a range of tobacco control areas from understanding the mechanisms of tobacco use to implementing tobacco cessation in specific populations including cancer patients and survivors. ASCO also wants to see tobacco use history and status included as a core data element that is collected throughout oncology clinical trials.
ASCO also supports coverage of tobacco cessation treatment insurance coverage and increased physician payments for evidence-based tobacco cessation services, such as intensive counseling, and FDA-approved medications. Although Medicare and Medicaid both cover tobacco cessation treatments, the ASCO report expresses concerns that these services could be left out of some health plans in the state-based insurance exchanges. ASCO wants to ensure when states set their essential health benefit packages for policies sold in the exchanges that they include a range of evidence-based services and drug therapies for tobacco cessation that are consistent with the recommendations of the U.S. Preventive Services Task Force.
Regulation is another area where ASCO officials are calling for more action.
The organization continues to support policies to increase the price of tobacco products in an effort to curb use and fund state tobacco control programs, including quit lines and youth prevention programs. ASCO supports a "substantial" increase in tobacco excises taxes, the establishment of minimum price laws for cigarettes that counteract industry discounts, and an increase on retail licensing fees.
All tobacco products should be regulated in the same way, ASCO said, without exemptions for cigars and cigarillos.
The organization also supports the 2011 recommendation from the FDA Tobacco Products Scientific Advisory Committee to remove menthol cigarettes from the market.
The ASCO recommendations come on the heels of a new scientific review by the Food and Drug Administration that shows that menthol cigarettes is likely associated with increased smoking initiation by teens and young adults. Menthol use is also likely associated with greater addiction, making it harder to quit. FDA officials concluded that menthol cigarettes, while not more toxic, likely pose a greater public health risk than did nonmenthol cigarettes.
The FDA is asking the public to offer suggestions for how menthol in cigarettes could be regulated.
The agency has also commissioned additional studies on the public health impact of menthol cigarettes, compared with regular cigarettes. The three studies will look at whether genetic differences in taste perceptions for menthol cigarettes, compare the smoke-related toxins and carcinogens between menthol and nonmenthol cigarettes, and consider the impact of menthol compounds on addiction.
Physicians also have a role to play when it comes to encouraging patients to quit and lobbying lawmakers on smoking-related regulations.
"Physicians are just one part of this discussion, though we can be leaders and motivators more broadly in the population," Dr. Hudis said.
But a new survey published on July 29 in the Journal of Oncology Practice shows that oncologists aren’t fully promoting smoking cessation in their practices (doi:10.1200/JOP.2013.001025).
The online survey of ASCO members conducted in 2012 shows that the vast majority of oncologists are asking patients about tobacco use at least initially. About 90% of the 1,197 respondents said they routinely asked patients about tobacco use at the initial visit and 84% advised patients to stop using tobacco.
But there was a significant drop off when it came to following up with treatment options. Only 44% routinely discuss medication options and only 39% provide other cessation support. The respondents cited inadequate training in tobacco cessation interventions and patient resistance as some of the barriers.
Dr. Hudis said sometimes tobacco cessation falls through the cracks for busy physicians. "That just reminds us that everyone in health care is stretched these days, working hard and balancing priorities," he said. "We just have to make sure that this remains front and center."
For its part, ASCO plans to help develop cessation tools and resources for providers to integrate into their practices. ASCO is also calling for a stronger focus on tobacco cessation both in medical training and continuing medical education courses. The organization is encouraging credentialing organizations to include questions about tobacco-dependence treatment in their exams. ASCO plans to partner with the American Board of Internal Medicine to make sure there is tobacco cessation content in the oncology specialty training boards.
U.S. oncologists are calling on federal and state officials to beef up the regulation of tobacco products, increase research funding, and ensure access to cessation treatments through the new state-based insurance exchanges.
Physicians also need to "lead by example" by not smoking, treating tobacco dependence aggressively, lobbying for tobacco-free environments, and refusing to accept tobacco industry support, according to a policy statement from the American Society of Clinical Oncology. The statement was published July 29 in the Journal of Clinical Oncology (doi:10.1200/JCO.2013.48.8932). This is the first time ASCO has updated its policy on tobacco control since 2003.
The latest report reminds physicians, policy makers, and the public that the problem of tobacco cessation and control is not solved, said Dr. Clifford A. Hudis, president of the American Society of Clinical Oncology.
"While smoking cessation efforts have been rewarded in many populations with falling rates of cigarette and tobacco use, that’s not been uniform," said Dr. Hudis of Memorial Sloan-Kettering Cancer Center in New York. "It remains a dominant health care risk in the U.S. and specifically a cancer risk,"
But Dr. Hudis said he thinks ASCO’s message will resonate on Capitol Hill where lawmakers are looking for cost-effective policies. "This is an area where doing the right thing could yield unbelievable dividends in terms of savings for the system," he said.
One of those areas is in federally sponsored research. ASCO is seeking an increased federal role in research on a range of tobacco control areas from understanding the mechanisms of tobacco use to implementing tobacco cessation in specific populations including cancer patients and survivors. ASCO also wants to see tobacco use history and status included as a core data element that is collected throughout oncology clinical trials.
ASCO also supports coverage of tobacco cessation treatment insurance coverage and increased physician payments for evidence-based tobacco cessation services, such as intensive counseling, and FDA-approved medications. Although Medicare and Medicaid both cover tobacco cessation treatments, the ASCO report expresses concerns that these services could be left out of some health plans in the state-based insurance exchanges. ASCO wants to ensure when states set their essential health benefit packages for policies sold in the exchanges that they include a range of evidence-based services and drug therapies for tobacco cessation that are consistent with the recommendations of the U.S. Preventive Services Task Force.
Regulation is another area where ASCO officials are calling for more action.
The organization continues to support policies to increase the price of tobacco products in an effort to curb use and fund state tobacco control programs, including quit lines and youth prevention programs. ASCO supports a "substantial" increase in tobacco excises taxes, the establishment of minimum price laws for cigarettes that counteract industry discounts, and an increase on retail licensing fees.
All tobacco products should be regulated in the same way, ASCO said, without exemptions for cigars and cigarillos.
The organization also supports the 2011 recommendation from the FDA Tobacco Products Scientific Advisory Committee to remove menthol cigarettes from the market.
The ASCO recommendations come on the heels of a new scientific review by the Food and Drug Administration that shows that menthol cigarettes is likely associated with increased smoking initiation by teens and young adults. Menthol use is also likely associated with greater addiction, making it harder to quit. FDA officials concluded that menthol cigarettes, while not more toxic, likely pose a greater public health risk than did nonmenthol cigarettes.
The FDA is asking the public to offer suggestions for how menthol in cigarettes could be regulated.
The agency has also commissioned additional studies on the public health impact of menthol cigarettes, compared with regular cigarettes. The three studies will look at whether genetic differences in taste perceptions for menthol cigarettes, compare the smoke-related toxins and carcinogens between menthol and nonmenthol cigarettes, and consider the impact of menthol compounds on addiction.
Physicians also have a role to play when it comes to encouraging patients to quit and lobbying lawmakers on smoking-related regulations.
"Physicians are just one part of this discussion, though we can be leaders and motivators more broadly in the population," Dr. Hudis said.
But a new survey published on July 29 in the Journal of Oncology Practice shows that oncologists aren’t fully promoting smoking cessation in their practices (doi:10.1200/JOP.2013.001025).
The online survey of ASCO members conducted in 2012 shows that the vast majority of oncologists are asking patients about tobacco use at least initially. About 90% of the 1,197 respondents said they routinely asked patients about tobacco use at the initial visit and 84% advised patients to stop using tobacco.
But there was a significant drop off when it came to following up with treatment options. Only 44% routinely discuss medication options and only 39% provide other cessation support. The respondents cited inadequate training in tobacco cessation interventions and patient resistance as some of the barriers.
Dr. Hudis said sometimes tobacco cessation falls through the cracks for busy physicians. "That just reminds us that everyone in health care is stretched these days, working hard and balancing priorities," he said. "We just have to make sure that this remains front and center."
For its part, ASCO plans to help develop cessation tools and resources for providers to integrate into their practices. ASCO is also calling for a stronger focus on tobacco cessation both in medical training and continuing medical education courses. The organization is encouraging credentialing organizations to include questions about tobacco-dependence treatment in their exams. ASCO plans to partner with the American Board of Internal Medicine to make sure there is tobacco cessation content in the oncology specialty training boards.
U.S. oncologists are calling on federal and state officials to beef up the regulation of tobacco products, increase research funding, and ensure access to cessation treatments through the new state-based insurance exchanges.
Physicians also need to "lead by example" by not smoking, treating tobacco dependence aggressively, lobbying for tobacco-free environments, and refusing to accept tobacco industry support, according to a policy statement from the American Society of Clinical Oncology. The statement was published July 29 in the Journal of Clinical Oncology (doi:10.1200/JCO.2013.48.8932). This is the first time ASCO has updated its policy on tobacco control since 2003.
The latest report reminds physicians, policy makers, and the public that the problem of tobacco cessation and control is not solved, said Dr. Clifford A. Hudis, president of the American Society of Clinical Oncology.
"While smoking cessation efforts have been rewarded in many populations with falling rates of cigarette and tobacco use, that’s not been uniform," said Dr. Hudis of Memorial Sloan-Kettering Cancer Center in New York. "It remains a dominant health care risk in the U.S. and specifically a cancer risk,"
But Dr. Hudis said he thinks ASCO’s message will resonate on Capitol Hill where lawmakers are looking for cost-effective policies. "This is an area where doing the right thing could yield unbelievable dividends in terms of savings for the system," he said.
One of those areas is in federally sponsored research. ASCO is seeking an increased federal role in research on a range of tobacco control areas from understanding the mechanisms of tobacco use to implementing tobacco cessation in specific populations including cancer patients and survivors. ASCO also wants to see tobacco use history and status included as a core data element that is collected throughout oncology clinical trials.
ASCO also supports coverage of tobacco cessation treatment insurance coverage and increased physician payments for evidence-based tobacco cessation services, such as intensive counseling, and FDA-approved medications. Although Medicare and Medicaid both cover tobacco cessation treatments, the ASCO report expresses concerns that these services could be left out of some health plans in the state-based insurance exchanges. ASCO wants to ensure when states set their essential health benefit packages for policies sold in the exchanges that they include a range of evidence-based services and drug therapies for tobacco cessation that are consistent with the recommendations of the U.S. Preventive Services Task Force.
Regulation is another area where ASCO officials are calling for more action.
The organization continues to support policies to increase the price of tobacco products in an effort to curb use and fund state tobacco control programs, including quit lines and youth prevention programs. ASCO supports a "substantial" increase in tobacco excises taxes, the establishment of minimum price laws for cigarettes that counteract industry discounts, and an increase on retail licensing fees.
All tobacco products should be regulated in the same way, ASCO said, without exemptions for cigars and cigarillos.
The organization also supports the 2011 recommendation from the FDA Tobacco Products Scientific Advisory Committee to remove menthol cigarettes from the market.
The ASCO recommendations come on the heels of a new scientific review by the Food and Drug Administration that shows that menthol cigarettes is likely associated with increased smoking initiation by teens and young adults. Menthol use is also likely associated with greater addiction, making it harder to quit. FDA officials concluded that menthol cigarettes, while not more toxic, likely pose a greater public health risk than did nonmenthol cigarettes.
The FDA is asking the public to offer suggestions for how menthol in cigarettes could be regulated.
The agency has also commissioned additional studies on the public health impact of menthol cigarettes, compared with regular cigarettes. The three studies will look at whether genetic differences in taste perceptions for menthol cigarettes, compare the smoke-related toxins and carcinogens between menthol and nonmenthol cigarettes, and consider the impact of menthol compounds on addiction.
Physicians also have a role to play when it comes to encouraging patients to quit and lobbying lawmakers on smoking-related regulations.
"Physicians are just one part of this discussion, though we can be leaders and motivators more broadly in the population," Dr. Hudis said.
But a new survey published on July 29 in the Journal of Oncology Practice shows that oncologists aren’t fully promoting smoking cessation in their practices (doi:10.1200/JOP.2013.001025).
The online survey of ASCO members conducted in 2012 shows that the vast majority of oncologists are asking patients about tobacco use at least initially. About 90% of the 1,197 respondents said they routinely asked patients about tobacco use at the initial visit and 84% advised patients to stop using tobacco.
But there was a significant drop off when it came to following up with treatment options. Only 44% routinely discuss medication options and only 39% provide other cessation support. The respondents cited inadequate training in tobacco cessation interventions and patient resistance as some of the barriers.
Dr. Hudis said sometimes tobacco cessation falls through the cracks for busy physicians. "That just reminds us that everyone in health care is stretched these days, working hard and balancing priorities," he said. "We just have to make sure that this remains front and center."
For its part, ASCO plans to help develop cessation tools and resources for providers to integrate into their practices. ASCO is also calling for a stronger focus on tobacco cessation both in medical training and continuing medical education courses. The organization is encouraging credentialing organizations to include questions about tobacco-dependence treatment in their exams. ASCO plans to partner with the American Board of Internal Medicine to make sure there is tobacco cessation content in the oncology specialty training boards.
FROM THE JOURNAL OF CLINICAL ONCOLOGY
