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September 7, 2005

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Looking to the Future: Helping 33 million smokers quit

New England Journal article discusses DOJ tobacco trial, proposed national smoking cessation program

An article published in the September 8, 2005 New England Journal of Medicine sheds new light on the $130 billion smoking cessation plan proposed in the Department of Justice RICO suit against the tobacco companies.  The tobacco cessation plan was embroiled in controversy when Department of Justice attorneys reduced the amount proposed for the smoking cessation remedy from $130 billion over 25 years to $10 billion over five years. 

             “Spending $5 billion a year on tobacco cessation for 25 years would profoundly improve the health of Americans,” said Dr. Michael Fiore, author of the article and the government’s expert tobacco-cessation witness in the Department of Justice trial.  “This is why it is such a tragedy that the Justice Department backed away from their original cessation remedy.  Can you imagine what would happen if, as we projected with this plan, one million additional smokers quit each year – 33 million over time?”

            Smoking remains the single greatest preventable cause of disease and death.  A recent study in the British Medical Journal found that the life of a cigarette smoker is, on average, 10 years shorter than is the case for non-smokers.  One-half of current smokers are projected to be killed prematurely by smoking – 23 million Americans in all.   In economic terms, smoking costs billions. According to the Centers for Disease Control & Prevention (CDC), annual healthcare and lost-productivity costs for smoking exceed $167 billion.  In contrast, the CDC estimates that the total state investment in tobacco control is under $862 million a year.            

           The cessation plan presented at the trial included offering free medications and counseling to the 33 million smokers who want to quit (70 percent of current smokers) with the goal of helping one million additional smokers quit each year (see figure), at a cost of $5.2 billion per year to be paid by the tobacco companies.  The program, to continue for an estimated 25 years, was based on The National Action Plan for Tobacco Cessation prepared for and approved by the Department of Health and Human Services’ Interagency Committee on Smoking and Health in February 2003.  The plan was generated by a 15-member committee which worked for six months gathering information and conducting hearings in Chicago, Denver and Washington D.C.   Dr. Fiore, who is Professor of Medicine and Director of the University of Wisconsin Center for Tobacco Research and Intervention, chaired the committee.

            Dr. C. Everett Koop, former U S surgeon general, said, “The Action Plan provides a blue print for getting proven cessation treatment to literally every smoker in America who wants to quit.  This can have enormous benefit for everyone—adding years of life for former smokers and reducing healthcare costs for all Americans.  Making the tobacco companies pay for this is only proper.”

            The cessation plan, based on scientific evidence, included:

  • A comprehensive national quit line that would provide counseling and medication treatment to the ten percent of smokers projected to use it each year.
  • A paid media campaign promoting the quit line and evidence-based treatments for quitting smoking.
  • Smoking cessation research to help more smokers successfully quit.
  • Training for healthcare providers so that they can intervene more effectively with patients who smoke.

“Some people can quit smoking on their own, but treatment increases the odds of lasting success, which increases the odds of lasting health," said Jack E. Henningfield, Ph.D, Professor of Behavioral Biology and Director of The Robert Wood Johnson Foundation’s Innovators Combating Substance Abuse Awards Program at the Johns Hopkins University School of Medicine.  “If the nation were to fully fund the program Dr. Fiore outlined, both the human and financial tolls of tobacco would be dramatically reduced.”  Like Dr. Fiore, Dr. Henningfield served as an expert witness for the government in the DOJ trial.  Both are recipients of the Innovators Award.

Innovators Combating Substance Abuse is a national program of The Robert Wood Johnson Foundation that recognizes and rewards those who have made substantial, innovative contributions of national significance in the field of substance abuse. Each award includes a grant of $300,000, which is used to conduct a project over a period of up to three years that advances the field.  The program addresses problems related to alcohol, tobacco and illicit drugs, through education, advocacy, treatment and policy research and reform at the national, state and local levels.  The Innovators program is run by a national program office at The Johns Hopkins University School of Medicine.  For more information on Innovators Combating Substance Abuse, please visit www.innovatorsawards.org.

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 30 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org.

The Center for Tobacco Research and Intervention, University of Wisconsin Medical School, has provided cessation and prevention services in Wisconsin since 1992 and is a nationally-recognized research center.

**Press kit materials, the NEJM paper and background information about the National Action Plan can be found at www.ctri.wisc.edu

 

The model is based on data from the U.S. Census and the Centers for Disease Control and Prevention and assumes that there are currently about 47 million adult smokers, 33 million (70 percent) of whom report that they want to quit and are the targets of the proposed national cessation program. 

Copyright 2004 The Johns Hopkins University. Baltimore, Maryland.
All rights reserved. Last Updated January 15, 2010
 

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