Where We Stand
Section: Public Health
Policy: Tobacco Use

Tobacco Use

1. Importance of issue: The primary public health goal of the OMA is to reduce illness, disability, and deaths related to tobacco use and second hand smoke exposure. Tobacco use is the single most preventable cause of disease and death in the US.


2. Basis of policy: Physicians, physician`s assistants and other health care providers can be effective in smoking cessation efforts.
   
   The US Preventive Services Task Force (USPSTF), part of the Agency for Research and Quality (ARHQ): found good evidence that brief smoking cessation interventions, including screening, brief behavioral counseling (less than 3 minutes), and pharmacotherapy delivered in primary care settings, are effective in increasing the proportion of smokers who successfully quit smoking and remain abstinent after one year.
   
   The USPSTF found good evidence that extended or augmented smoking cessation counseling (5-15 minutes) using messages and self-help materials tailored for pregnant smokers, compared with brief generic counseling interventions alone, substantially increases abstinence rates during pregnancy, and leads to increased birth weights. Although relapse rates are high in the post-partum period, the USPSTF concluded that reducing smoking during pregnancy is likely to have substantial health benefits for both the baby and the expectant mother.
   
   The USPSTF concluded, and reaffirmed in 2009, that the benefits of smoking cessation counseling outweigh any potential harms .


3. The OMA vigorously endorses the 20 objectives related to Tobacco Use contained in Healthy People 2020: www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=41.
   
   These objectives apply to all nicotine materials and delivery systems, excluding those regulated by the FDA as nicotine replacement, sensation or treatment products. 

TU-1 Reduce tobacco use by adults
TU-2 Reduce tobacco use by adolescents
TU-3 Reduce the initiation of tobacco use among children, adolescents, and young adults
TU-4 Increase smoking cessation attempts by adult smokers
TU-5 Increase recent smoking cessation success by adult smokers
TU-6 Increase smoking cessation during pregnancy
TU-7 Increase smoking cessation attempts by adolescent smokers
TU-8 Increase comprehensive Medicaid insurance coverage of evidence-based treatment for nicotine dependency in States and the District of Columbia
TU-9Increase tobacco screening in health care settings
TU-10Increase tobacco cessation counseling in health care settings
TU-11Reduce the proportion of nonsmokers exposed to secondhand smoke
TU-12Increase the proportion of persons covered by indoor worksite policies that prohibit smoking (Note: this is already law in Oregon)
TU-13 Establish laws in States, District of Columbia, Territories, and Tribes on smoke-free indoor air that prohibit smoking in public places and worksites (Oregon law already covers tobacco smoke)
TU-14 Increase the proportion of smoke-free homes
TU-15 Increase tobacco-free environments in schools, including all school facilities, property, vehicles, and school events
TU-16 Eliminate State laws that preempt stronger local tobacco control laws
TU-17 Increase the Federal and State tax on tobacco products
TU-18 Reduce the proportion of adolescents and young adults grades 6 through 12 who are exposed to tobacco advertising and promotion
TU-19 Reduce the illegal sales rate to minors through enforcement of laws prohibiting the sale of tobacco products to minors
TU-20 (Developmental) Increase the number of States and the District of Columbia, Territories, and Tribes with sustainable and comprehensive evidence-based tobacco control programs.


4. Nicotine products and nicotine delivery systems should be consistently regulated. This specifically prohibits sale to, possession by and access by minors.