Tobacco control: reducing cancer incidence and saving lives. American Society of Clinical Oncology.

INTRODUCTION

The American Society of Clinical Oncology (ASCO) supports the elimination of tobacco products. Toward that goal, ASCO urges the adoption of national policy that strengthens regulation of the sale, promotion, and distribution of such products. To reduce cancer mortality, our regulatory policies must recognize that the nicotine within tobacco is an addictive substance, the use of which leads to 30% of all cancer deaths and a total of 419,000 deaths each year.

RESTRICTING ADVERTISING AND PROMOTION

Tobacco-related advertising and promotion should be banned. At a minimum, national policies should: ban billboards; limit advertising to black and white text only; prohibit the sale or giveaway of products that contain tobacco brand names or logos; prohibit brand name sponsorship of sporting or entertainment events; and require stronger and more prominent warning labels on all tobacco products.

RESTRICTING ACCESS BY CHILDREN AND TEENAGERS

Despite existing state laws prohibiting sale of tobacco products to minors, children are able to buy such products easily. National regulation of the sale and distribution of tobacco products is necessary to eliminate children's access to tobacco. Where sales are permitted, they should be limited to face-to-face purchases by individuals 18 and older. Vending machines and other means of distributing tobacco without a face-to-face purchase should be outlawed.

ENHANCING PUBLIC EDUCATION

To the extent tobacco sales are allowed to continue, the federal government should mandate that the tobacco industry contribute substantial funds for a national public education campaign to prevent young people from smoking and other tobacco use.

RAISING TOBACCO EXCISE TAXES

ASCO has long advocated a substantial increase (in the range of $2) in the federal excise tax on cigarettes and other tobacco products- a measure known to decrease consumption, particularly among children. Revenue from a tax on tobacco products should be used to support retraining for tobacco farmers, biomedical research, health care delivery, and antitobacco education.

CONTROLLING TOBACCO EXPORTS

United State trade policies should discourage the export of tobacco products and manufacturing to foreign markets. At a minimum, United States tobacco companies selling or manufacturing tobacco products in foreign markets that have not developed comparable health warning labels should be required to retain United States warning labels.

TAKING RESPONSIBILITY AS HEALTHCARE PROFESSIONALS

Physicians, nurses, and other health care professionals-especially those in primary care disciplines-have the opportunity and responsibility to assist patients' efforts to quit tobacco use and to ensure that nonsmokers continue to avoid the addiction. Oncology specialists should discuss the causal relationship between tobacco use and cancer as well as a variety of other chronic diseases and assist, as required, the patient and family members to end tobacco dependency. In addition, health care professionals must advocate that public and private insurers be required to provide health care coverage for medically necessary interventions, such as counseling and nicotine transdermal systems.