1. Preventing 3 Million Premature Deaths Helping 5 Million Smokers Quit A National Action Plan for Tobacco Cessation Michael C. Fiore, M.D., M.P.H., Chair Subcommittee on Cessation Interagency Committee on Smoking and Health December 11, 2003

2. University of Wisconsin - Center for Tobacco Research and Intervention Subcommittee on Cessation Interagency Committee on Smoking and Health

3. University of Wisconsin - Center for Tobacco Research and Intervention Charge Make recommendations on how best to promote tobacco use cessation Identify specific action steps for DHHS to take and opportunities for public-private partnerships to promote cessation

4. University of Wisconsin - Center for Tobacco Research and Intervention Goals Reduce prevalence of tobacco use by at least 10% Prevent 3 million premature deaths Help at least 5 million smokers quit within the first year Address disparities

5. University of Wisconsin - Center for Tobacco Research and Intervention Timeline August 2002: Subcommittee established February 11, 2003: Interagency Committee on Smoking and Health, chaired by Surgeon General Carmona, unanimously endorsed sending final report to DHHS Secretary Thompson for his consideration

6. University of Wisconsin - Center for Tobacco Research and Intervention Members Robert Croyle, PhD (NCI) Susan Curry, PhD (University of Illinois at Chicago) Charles Cutler, MD, MS (American Association of Health Plans) Ronald Davis, MD (Henry Ford Health System and American Medical Association) Michael Fiore, MD, MPH (University of Wisconsin Medical School (chair)) Catherine Gordon, RN, MBA (CMS) Cheryl Healton, DrPH (American Legacy Foundation)

7. University of Wisconsin - Center for Tobacco Research and Intervention Members (continued) Rosemarie Henson, MSSW, MPH (CDC) Howard Koh, MD, FACP (Commonwealth of Massachusetts) James Marks, MD, MPH (CDC) C. Tracy Orleans, PhD (The Robert Wood Johnson Foundation) Dennis Richling, MD (Union Pacific Railroad) David Satcher, MD (Morehouse School of Medicine) John Seffrin, PhD (American Cancer Society) Christine Williams, MEd (AHRQ) Larry Wiliams, DDS, MAGD (Dental Corps, US Navy)

8. University of Wisconsin - Center for Tobacco Research and Intervention The National Action Plan for Tobacco Cessation

9. University of Wisconsin - Center for Tobacco Research and Intervention Targeted Features Meaningful reductions in both tobacco use and the resultant burden of illness, premature death, and economic costs Science-based Address disparities National in scope, regional in application

10. University of Wisconsin - Center for Tobacco Research and Intervention Targeted Features (continued) Public-private partnerships Impact should be both immediate and sustained Comprehensive and integrated Evaluated Securely funded

11. University of Wisconsin - Center for Tobacco Research and Intervention Recommendations Six Federal Initiatives Four Public-Private Partnerships

12. University of Wisconsin - Center for Tobacco Research and Intervention Federal Initiatives 1.A national tobacco quitline network Evidence-based Counseling and medications Barrier-free Managed by the states

13. University of Wisconsin - Center for Tobacco Research and Intervention Federal Initiatives 2.A national paid media campaign Promote National Tobacco Quitline network Motivate tobacco users to quit Inform parents about risks of second-hand smoke

14. University of Wisconsin - Center for Tobacco Research and Intervention Federal Initiatives 3.Coverage for evidence-based tobacco cessation counseling and medications for all Federal beneficiaries and in all federally- funded healthcare programs Access to treatment for 100 million Americans Reduce disparities Model for private sector

15. University of Wisconsin - Center for Tobacco Research and Intervention Federal Initiatives 4.Invest in a new, broad, and balanced research agenda Improve long-term successful cessation rates to at least 50% Identify treatments for underserved tobacco users (adolescents, low SES, racial and ethnic minorities, pregnant smokers)

16. University of Wisconsin - Center for Tobacco Research and Intervention Federal Initiatives 5.Educate clinicians-in-training and practicing clinicians Curricula Licensure and certification examinations Advanced training

17. University of Wisconsin - Center for Tobacco Research and Intervention Federal Initiatives 6.Establish a Smokers’ Health Fund Increase the Federal Excise Tax on cigarettes by $2.00 per pack (from the current rate of $0.39 to $2.39) Similar increase in the excise tax on other tobacco products Earmark at least 50% of the new revenue ($14 billion of estimated $28 billion) generated to help smokers quit through the steps outlined in the action plan

18. University of Wisconsin - Center for Tobacco Research and Intervention Public-Private Partnerships 1.Partner with insurers, employers, and purchasers to include coverage for evidence-based tobacco cessation counseling and medications as part of the basic benefits package Improve employee health Save money (absenteeism, healthcare costs)

19. University of Wisconsin - Center for Tobacco Research and Intervention Public-Private Partnerships 2.Utilize systems-level changes and quality improvement strategies to expand the delivery of evidence-based tobacco dependence treatments Systems supports Enhance access to services Improve patient care

20. University of Wisconsin - Center for Tobacco Research and Intervention 3.Establish the provision of evidence-based tobacco dependence treatment as a standard of care National quality assurance and health care organizations Establish a uniform measurement Improve patient care Public-Private Partnerships

21. University of Wisconsin - Center for Tobacco Research and Intervention 4.Partner with community organizations to support programs and policies at the local level Motivate tobacco users to quit Support use of evidence-based treatments to increase success Address disparities in treatment participation and success Public-Private Partnerships

22. University of Wisconsin - Center for Tobacco Research and Intervention Next Steps