|
||||||||||||||||
|
||||||||||||||||
|
||||||||||||||||
|
| ||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||
Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page R1
Erin Balogh, Margie Patlak, and Sharyl J. Nass, Rapporteurs
National Cancer Policy Forum
Board on Health Care Services
OCR for page R2
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The workshop that is the subject of this workshop summary was approved by
the Governing Board of the National Research Council, whose members are drawn from
the councils of the National Academy of Sciences, the National Academy of Engineer-
ing, and the Institute of Medicine.
This activity was supported by Contract Nos. HHSN261200900003C and 200-2005-
13434 TO #1 between the National Academy of Sciences and the National Cancer
Institute and the Centers for Disease Control and Prevention, respectively. In addition,
the National Cancer Policy Forum is supported by the American Association for Cancer
Research, the American Cancer Society, the American Society of Clinical Oncology, the
Association of American Cancer Institutes, Bristol-Myers Squibb, C-Change, the CEO
Roundtable on Cancer, GlaxoSmithKline, Novartis Oncology, the Oncology Nursing
Society, and Sanofi-Aventis. The views presented in this publication do not necessarily
reflect the views of the organizations or agencies that provided support for the activity.
International Standard Book Number-13: 978-0-309-26401-3
International Standard Book Number-10: 0-309-26401-4
Additional copies of this workshop summary are available for sale from the National
Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-
6242 or (202) 334-3313; http://www.nap.edu.
For more information about the Institute of Medicine, visit the IOM home page at:
www.iom.edu.
Copyright 2013 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Cover credit: Design by Casey Weeks.
The serpent has been a symbol of long life, healing, and knowledge among almost all
cultures and religions since the beginning of recorded history. The serpent adopted as a
logotype by the Institute of Medicine is a relief carving from ancient Greece, now held
by the Staatliche Museen in Berlin.
Suggested citation: IOM (Institute of Medicine). 2013. Reducing tobacco-related cancer
incidence and mortality: Workshop summary. Washington, DC: The National Academies
Press.
OCR for page R3
OCR for page R4
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of
distinguished scholars engaged in scientific and engineering research, dedicated to the
furtherance of science and technology and to their use for the general welfare. Upon the
authority of the charter granted to it by the Congress in 1863, the Academy has a man-
date that requires it to advise the federal government on scientific and technical matters.
Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of
the National Academy of Sciences, as a parallel organization of outstanding engineers.
It is autonomous in its administration and in the selection of its members, sharing with
the National Academy of Sciences the responsibility for advising the federal government.
The National Academy of Engineering also sponsors engineering programs aimed at
meeting national needs, encourages education and research, and recognizes the superior
achievements of engineers. Dr. Charles M. Vest is president of the National Academy
of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences
to secure the services of eminent members of appropriate professions in the examination
of policy matters pertaining to the health of the public. The Institute acts under the
responsibility given to the National Academy of Sciences by its congressional charter to
be an adviser to the federal government and, upon its own initiative, to identify issues
of medical care, research, and education. Dr. Harvey V. Fineberg is president of the
Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in
1916 to associate the broad community of science and technology with the Academy’s
purposes of furthering knowledge and advising the federal government. Functioning in
accordance with general policies determined by the Academy, the Council has become
the principal operating agency of both the National Academy of Sciences and the
N
ational Academy of Engineering in providing services to the government, the public,
and the scientific and engineering communities. The Council is administered jointly by
both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles
M. Vest are chair and vice chair, respectively, of the National Research Council.
www.national-academies.org
OCR for page R5
WORKSHOP PLANNING COMMITTEE1
ROY S. HERBST (Chair), Chief of Medical Oncology, Yale Cancer
Center and Associate Director for Translational Research, Smilow
Cancer Hospital at Yale, New Haven, CT
CAROLYN DRESLER, Tobacco Control Medical Director, Arkansas
Department of Health, Board of Directors, International Association
for the Study of Lung Cancer, and Chair, Tobacco Control
Subcommittee, American Society of Clinical Oncology Cancer
Prevention Committee, Little Rock, AR
ELLEN R. GRITZ, Professor and Olla S. Stribling Distinguished Chair for
Cancer Research, Department of Behavioral Science, The University of
Texas MD Anderson Cancer Center, Houston
THOMAS J. KEAN, President and Chief Executive Officer, C-Change,
Washington, DC
MATTHEW MYERS, President, Campaign for Tobacco-Free Kids,
Washington, DC
BRENDA NEVIDJON, Clinical Professor and Specialty Director,
Nursing & Healthcare Leadership, Duke University School of
Nursing, Durham, NC, and Past President, Oncology Nursing
Society
BENJAMIN TOLL, Assistant Professor of Psychiatry, Yale University
School of Medicine, Yale Comprehensive Cancer Center, Program
Director, Smoking Cessation Service, Smilow Cancer Hospital at Yale,
New Haven, CT
Project Staff
ERIN BALOGH, Study Director
PAMELA LIGHTER, Research Assistant
NIHARIKA SATHE, Research Assistant (until March 2012)
MICHAEL PARK, Senior Program Assistant
SHARYL J. NASS, Director, National Cancer Policy Forum
ROGER HERDMAN, Director, Board on Health Care Services
1 Institute of Medicine planning committees are solely responsible for organizing the
workshop, identifying topics, and choosing speakers. The responsibility for the published
workshop summary rests with the workshop rapporteurs and the institution.
v
OCR for page R6
NATIONAL CANCER POLICY FORUM1
JOHN MENDELSOHN (Chair), Director, Khalifa Institute for
Personalized Cancer Therapy, The University of Texas MD Anderson
Cancer Center, Houston
PATRICIA A. GANZ (Vice-Chair), Distinguished University Professor,
University of California, Los Angeles, Schools of Medicine & Public
Health, and Director, Cancer Prevention & Control Research,
Jonsson Comprehensive Cancer Center
AMY P. ABERNETHY, Associate Professor of Medicine, Duke
University School of Medicine, and Director, Duke Cancer Care
Research Program, Durham, NC
RAFAEL G. AMADO, Senior Vice President & Head of R&D,
GlaxoSmithKline-Oncology, Collegeville, PA
FRED APPELBAUM, Director, Clinical Research Division, Fred
Hutchinson Cancer Research Center, Seattle, WA
PETER B. BACH, Attending Physician, Memorial Sloan-Kettering
Cancer Center, New York, NY
EDWARD BENZ, JR., President, Dana-Farber Cancer Institute, and
Director, Harvard Cancer Center, Harvard School of Medicine,
Boston, MA
MONICA BERTAGNOLLI, Professor of Surgery, Harvard University
Medical School, Boston, MA
OTIS BRAWLEY, Chief Medical Officer and Executive Vice President,
American Cancer Society, Atlanta, GA
MICHAEL A. CALIGIURI, Director, Ohio State Comprehensive
Cancer Center, Columbus, OH
RENZO CANETTA, Vice President, Oncology Global Clinical Research,
Bristol-Myers Squibb, Wallingford, CT
MICHAELE CHAMBLEE CHRISTIAN, Retired, Washington, DC
WILLIAM DALTON, CEO, M2Gen Personalized Medicine Institute,
Moffitt Cancer Center, Tampa, FL, and Chair, American Association
for Cancer Research Science Policy & Legislative Affairs Committee
1 Institute of Medicine forums and roundtables do not issue, review, or approve indi-
vidual documents. The responsibility for the published workshop summary rests with the
workshop rapporteurs and the institution.
vi
OCR for page R7
WENDY DEMARK-WAHNEFRIED, Associate Director for Cancer
Prevention and Control, University of Alabama at Birmingham
Comprehensive Cancer Center
ROBERT ERWIN, President, Marti Nelson Cancer Foundation,
Davis, CA
ROY S. HERBST, Chief of Medical Oncology, Yale Cancer Center,
New Haven, CT
THOMAS J. KEAN, President and Chief Executive Officer, C-Change,
Washington, DC
DOUGLAS R. LOWY, Deputy Director, National Cancer Institute,
Bethesda, MD
MICHELLE M. Le BEAU, Arthur and Marian Edelstein Professor of
Medicine and Director, Comprehensive Cancer Center, University of
Chicago, IL, and President, Association of American Cancer Institutes
DANIEL R. MASYS, Affiliate Professor, Biomedical Informatics,
University of Washington, Seattle
MARTIN J. MURPHY, Chief Executive Officer, CEO Roundtable on
Cancer, Durham, NC
BRENDA NEVIDJON, Clinical Professor and Specialty Director,
Nursing & Healthcare Leadership, Duke University School of
Nursing, Durham, NC, and Past President, Oncology Nursing
Society
STEVEN PIANTADOSI, Director, Samuel Oschin Comprehensive
Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
LISA C. RICHARDSON, Associate Director for Science, Division of
Cancer Prevention and Control, Centers for Disease Control and
Prevention, Atlanta, GA
DEBASISH ROYCHOWDHURY, Senior Vice President, Global
Oncology, Sanofi Oncology, Cambridge, MA
YA-CHEN TINA SHIH, Director, Program in the Economics of Cancer,
University of Chicago, IL
ELLEN SIGAL, Chairperson and Founder, Friends of Cancer Research,
Washington, DC
STEVEN STEIN, Senior Vice President, U.S. Clinical Development and
Medical Affairs, Novartis Oncology, East Hanover, NJ
JOHN A. WAGNER, Vice President, Clinical Pharmacology, Merck and
Company, Inc., Rahway, NJ
vii
OCR for page R8
RALPH R. WEICHSELBAUM, Chair, Radiation and Cellular
Oncology, and Director, Ludwig Center for Metastasis Research, The
University of Chicago Medical Center, IL
JANET WOODCOCK, Director, Center for Drug Evaluation and
Research, Food and Drug Administration, Rockville, MD
National Cancer Policy Forum Staff
SHARYL J. NASS, Director
LAURA LEVIT, Program Officer
ERIN BALOGH, Associate Program Officer
PAMELA LIGHTER, Research Assistant
MICHAEL PARK, Senior Program Assistant
PATRICK BURKE, Financial Associate
SHARON B. MURPHY, Scholar in Residence
ROGER HERDMAN, Director, Board on Health Care Services
viii
OCR for page R9
Reviewers
This workshop summary has been reviewed in draft form by individu-
als chosen for their diverse perspectives and technical expertise, in accor-
dance with procedures approved by the National Research Council’s Report
Review Committee. The purpose of this independent review is to provide
candid and critical comments that will assist the institution in making its
published workshop summary as sound as possible and to ensure that the
workshop summary meets institutional standards for objectivity, evidence,
and responsiveness to the study charge. The review comments and draft
manuscript remain confidential to protect the integrity of the process. We
wish to thank the following individuals for their review of this workshop
summary:
LINDA BAILEY, President and CEO, North American Quitline
Consortium
MICHAEL C. FIORE, Professor of Medicine and Director, Center
for Tobacco Research and Intervention, University of Wisconsin
School of Medicine and Public Health
THOMAS J. GLYNN, Director, Cancer Science and Trends,
International Cancer Control, American Cancer Society
DANNY McGOLDRICK, Vice President for Research, Campaign
for Tobacco-Free Kids
ix
OCR for page R10
x REVIEWERS
GRAHAM WARREN, Assistant Professor, Department of Radiation
Medicine, Department of Pharmacology and Therapeutics,
Roswell Park Cancer Institute
Although the reviewers listed above have provided many constructive
comments and suggestions, they did not see the final draft of the work-
shop summary before its release. The review of this report was overseen by
Susan J. Curry, University of Iowa College of Public Health. Appointed
by the Institute of Medicine, she was responsible for making certain that
an independent examination of this report was carried out in accordance
with institutional procedures and that all review comments were carefully
considered. Responsibility for the final content of this report rests entirely
with the rapporteurs and the institution.
OCR for page R11
Contents
INTRODUCTION, 1
CHANGING DEMOGRAPHICS OF TOBACCO USE, 5
CHANGING PATTERNS OF TOBACCO USE, 10
TOBACCO USE AND CANCER, 13
How Smoking Causes Cancer, 13
Impact of Smoking on Cancer Incidence and Treatment
Outcomes, 15
TOBACCO DEPENDENCE, 17
TOBACCO CESSATION PROGRAMS, 21
Overview of Tobacco Cessation Therapy, 21
Use of Tobacco Cessation Therapy, 26
Models for Clinician Referrals, 27
Tobacco Cessation Therapy for Cancer Patients, 29
Training Practitioners, 31
OVERVIEW OF TOBACCO CONTROL POLICY, 33
ANTISMOKING LAWS AND REGULATIONS, 39
Family Smoking Prevention and Tobacco Control Act, 39
Patient Protection and Affordable Care Act, 42
Point-of-Sale Restrictions, 43
Smoke-Free Environments, 43
Tobacco Taxes, 45
Proposed Laws and Policies, 47
xi
OCR for page R12
xii CONTENTS
SUCCESSFUL STATE AND LOCAL GOVERNMENT
ANTISMOKING EFFORTS, 48
New York State and New York City, 48
Massachusetts, 49
California, 52
EDUCATION, OUTREACH, AND MESSAGING, 53
Educational Efforts, 53
Media Campaigns, 57
Cigarette Packaging Warning Labels, 59
Message Content, Framing, and Placement, 61
ANTISMOKING ADVOCACY, 65
FINANCIAL AND LEGAL CHALLENGES, 67
Funding for Tobacco Cessation Programs, 70
Legal Challenges, 71
RESEARCH AND INFRASTRUCTURE NEEDS, 72
CONCLUDING REMARKS, 75
REFERENCES, 75
APPENDIXES
A Workshop Agenda 87
B Speaker, Moderator, and Panelist Biographies 93
OCR for page R13
Boxes, Figures, and Tables
BOXES
1 Quitlines, 22
2 Major Tobacco Control Activities at the U.S. Department of Health
and Human Services (HHS), 34
3 Successful Media Campaigns, 58
FIGURES
1 Percentage of high school students who reported current cigarette
use, 1991–2011, 8
2 Trends in per capita consumption of various tobacco products—
United States, 1880–2005, 10
3 Link between cigarette smoking and cancer through carcinogens in
tobacco smoke, 14
4 Effectiveness of and estimated abstinence rates for interventions
delivered by various numbers of clinician types, 28
5 Long-term impact of comprehensive tobacco control in
California, 38
6 State and local smoke-free restaurant and bar laws have expanded
rapidly in the United States, 2002–2012, 45
7 Real cigarette prices and per capita consumption, United States,
1970–2000, 46
xiii
OCR for page R14
xiv BOXES, FIGURES, AND TABLES
8 Impact of tobacco taxes and smoke-free laws on adult and youth
smoking prevalence in New York City, 2002–2007, 49
9 The tobacco industry outspends state tobacco prevention efforts by
23 to 1, 69
10 U.S. cancer deaths versus federal research funding per death, 74
TABLES
1 Tailoring Pharmacotherapy for Tobacco Cessation Therapy, 22
2 The 5 A’s Model for Treating Tobacco Dependence, 24
