1. Tobacco Control & Prevention
National Update
Presented to Tobacco Program Grant
Review Committee
Dec. 16, 2011

2. Major Initiatives
• Centers for Disease Control and
Prevention
–Office on Smoking & Health
• U.S. Food & Drug Administration
(FDA)
• National Tobacco Control Strategy
• Health Care Reform

3. CDC – Office on Smoking & Health
• “Accelerating the Decline” initiative
– Perception problem is solved, lack of advocacy
partners, 18-24 yrs. & low SES still high, better use
FDA authority.
• Upcoming Surgeon General’s Report on Youth
Tobacco Use – (Spring 2012)
• First ever national media campaign
– Spring of 2012, hard hitting, 1-800 Quitline number
• Less than .02 per dollar of revenue going towards
programs – big reductions in states
• Federal funding cuts, OSH competitive grant?

4. U.S. Food and Drug Administration
• Granted Regulatory Authority over tobacco
products (6/09)
• Restricts Marketing and Sales to Youth
• Requires Disclosure of Ingredients
• Regulates “reduces harm” claims (no more light,
mild, or low-tar)
• Bigger, bolder health warnings on packages
• Requires industry to pay user fee to FDA to
support efforts ($800M/yr)

5. U.S. Food and Drug Administration
• Authority to further restrict marketing
• Allows FDA to require changes in the product
(cannot ban nicotine completely)
• Created the Tobacco Products Scientific
Advisory Committee (TPSAC)
– Recommended removal of menthol cigarettes
from the market)
– Working on dissolvable tobacco products (3/12)

6. U.S. Food and Drug Administration
• Industry preventing progress by:
–Suing over warning labels
–Suing over Menthol report
– Increasing marketing and sales of
dissolvable tobacco products
–Suing some more about anything

7. National Tobacco Prevention and
Control Strategy
• First of its kind comprehensive national plan
• “Ending the Tobacco Epidemic” –Released by
HHS – Nov. 2010
• Focused on Evidenced- based strategies
• Includes national media campaign
• Requires all HHS campuses are tobacco free
• Required Medicare and Medicaid to include
tobacco cessation services
• Includes more funding for research

8. Health Care Reform
• New Coverage Under Medicaid
– Oct. 1, 2010 – state Medicaid programs must provide
a comprehensive cessation benefit with no-cost
sharing/co-pay & requires expanded private insurance
coverage of cessation/treatment without cost sharing
– Jan. 1, 2013 – increased federal reimbursements for
cessation
– Jan 1, 2014 – state Medicaid programs cannot exclude
smoking cessation drugs form their prescription drug
coverage

9. Health Care Reform
• Creation of Public Health Prevention Fund to
support proven prevention, wellness and
public health programs in communities
– Community Transformation Grants that include
additional funding for tobacco programs &
QuitLines
– Possible 68% cut to offset impact of continued
payroll tax deductions (changes by the day)

10. Key Opportunities
• National media campaign with quit smoking call
to action & QuitLine # (spring 2012)
• Warning labels with QuitLine # (fall 2013)
• Banning of Menthol ??
• Release of Surgeon Generals report on Youth
Tobacco Use (Spring 2012)
• Insurance Reimbursement for cessation services
and counseling
• FDA – needs for input, testimony from states

11. Key Threats
• Modified Risk Products
• Dissolvable Tobacco Products
• Stall in decreases of adult prevalence
• Increases in use among 18-24 year olds
• Competitive applications for CDC funds
• Tobacco issues is solved – obesity is the
problem
• Low SES smokers – how to get them to quit

12. Always the Question
• DOES SPENDING MORE ON
TOBACCO CONTROL PROGRAMS
MAKE ECONOMIC SENSE?

13. AN INCREMENTAL BENEFIT-COST ANALYSIS USING PANEL DATA
Journal of Contemporary Economic Policy, Nov. 27. 2011
• This paper presents a benefit-cost analysis of the ongoing,
state-level tobacco prevention and control programs in the
United States. Using state-level panel data for the years
1991–2007, the study applies several variants of
econometric modeling approaches to estimate the state-
level tobacco demand. The paper finds a statistically
significant evidence of a sustained and steadily increasing
long-run impact of the tobacco control program spending
on cigarette demand in states. The study also shows that, if
individual states follow the Best Practices funding
guidelines, potential future annual benefits of the tobacco
control program can be as high as 14–20 times the cost of
program implementation. (JEL C2, H5, I1)

14. Questions
& Discussion