[ad_1]
Near-term priorities
1. Implement flavor restrictions: At the federal level, the FDA must quickly finalize and implement rules to prohibit the marketing of menthol-flavored cigarettes and flavored cigars and complete its work through the premarket tobacco product application (PMTA) process to keep non-tobacco-flavored e-cigarette and nicotine products off the market. The FDA can also issue product standards to eliminate all characterizing flavors (except for tobacco flavor) in all products. This includes concept flavors and ingredients that create a heating or cooling sensory experience to mimic menthol or other flavors. At the state and local level, communities can accelerate the elimination of flavored products by passing and implementing more comprehensive sales restrictions on flavored products (where they are not pre-empted). Federal and state/local strategies are required in tandem to mitigate industry efforts to thwart policies at all levels.
Encouragingly, these policies are gaining increasing attention across the country. Flavor policies have been implemented as sales restrictions at the state and local levels with 121 local comprehensive policies restricting the sale of flavored tobacco, and two strong state policies already in place. However, even with those in place, only 3.31% of the U.S. population is covered by comprehensive policies. It is critical to continue to expand such policies in additional states and localities as they achieve readiness for these bold steps. We recognize that some areas may be ready to take such policies on in the near future, but for others, it will take time to build the cessation infrastructure, educate the public and retailers, and build community buy-in.
At the federal level, the FDA must quickly implement product standards that prevent cigarettes and cigar products from having characterizing flavors. These standards must be finalized and implemented as soon as possible. The federal government needs to also continue to work to issue product standards that remove characterizing flavors, other than tobacco flavor, from all products, excluding FDA-approved nicotine replacement therapies (NRT) or other cessation drugs. Evaluation of these policies indicates that more comprehensive policies that include all flavors and all products have better outcomes. Further, evaluation of flavor restrictions in other countries, as well as current domestic policies, shows that such policies reduce youth use of tobacco products; increase quit attempts and successful quitting among adults who smoke; and decrease not only sales of the restricted products, but decrease overall sales of tobacco products.
2. Restrict points of sale: States and localities can limit the sales of all tobacco products to adult-only stores where youth are not allowed to enter, and more importantly, drastically reduce the number of tobacco outlets and prohibit tobacco outlets from being close to youth-sensitive areas like schools and parks.
Policies to restrict sales such as adult-only retailer requirements and capping the number of tobacco outlets are measures that states and localities (when not pre-empted) can put into place. For example, in Bloomington, MN, they passed a law to begin the process of sunsetting tobacco licenses. Starting June 30, 2022, the city no longer issues any new tobacco licenses, so when a store with a tobacco license closes, that license is eliminated. We know that retailer density is a predictor of youth and young adult smoking. As the number of tobacco retailers increase, so does exposure to tobacco advertising and promotion, and the ease of accessing tobacco and nicotine products. Further, reducing availability of tobacco retail outlets can help those who wish to quit.
An estimated 375,000 retailers sell tobacco products in the U.S. To put this into perspective that is 31 times more tobacco retailers than there are McDonald’s restaurants. The number of tobacco retailers in a given area also contributes to tobacco-related health disparities, since tobacco retailers are disproportionately located in more heavily populated areas with a greater number of minority and low-income populations. For example, in Philadelphia, one study showed that low-income areas have 69% more tobacco retailers per person and more tobacco retailers within 500 and 1,000 feet of schools than high-income neighborhoods. In Washington, DC, little cigars and cigarillos and menthol tobacco products are cheaper in Black and some young adult neighborhoods. Recently, some localities have implemented caps on the number of retailer licenses they will allow, including Philadelphia, which saw a 20.3% reduction in tobacco retailers, especially in lower-income districts. San Francisco, which capped the number of tobacco retailer licenses, saw a 24% reduction in tobacco retail licenses with a 32% reduction in the lowest-income neighborhoods. Some localities have enacted policies to restrict tobacco sales to adult-only facilities, which can be effective in reducing tobacco use.
3. Reduce nicotine levels in combustible tobacco products: Implement the planned FDA rule to reduce nicotine in cigarettes and other combustible tobacco products to non-addictive levels.
Capping the nicotine in combustible tobacco products at non-addictive levels will also make significant contributions in lowering the number of people who initiate smoking, help people quit, and reduce tobacco-related mortality. In fact, the FDA estimated that a nicotine cap in cigarettes would result in approximately 5 million additional smokers quitting smoking within one year of implementation and, by the year 2100, more than 33 million people – especially youth and young adults – would be prevented from becoming regular smokers, resulting in more than 8 million fewer tobacco-related deaths through the end of the century.
4. Improve cessation access: Federal, state, and local government agencies, as well as private insurers, should make cessation interventions as accessible as possible, including coverage for multiple quit attempts per year with no copays. Further, the FDA should quickly approve existing nicotine replacement therapies (NRT) for long-term use.
We know that other endgame policies will be less effective without improved access to cessation services. Quitting is difficult. It takes the average smoker 11 quit attempts before successfully quitting. The seven FDA-approved cessation drugs, as well as counseling and other behavioral interventions, can be very effective in helping tobacco users quit. It is important that people wishing to quit smoking have access to proven, safe, and effective drugs for the duration of their quit journey.
[ad_2]
Source link
