Recently, the Centers for Disease Control and Prevention (CDC) hosted the National Conference on Tobacco or Health (NCTOH) in Kansas City. This event had been three years in the making as the last NCTOH was held in Phoenix in June 2009. As public health officials, researchers and advocates gathered in Phoenix in 2009, Congress passed the Family Smoking Prevention and Tobacco Control Act giving the Food and Drug Administration power to regulate tobacco products. A wave of excitement and anticipation swept through Phoenix that day as attendees imagined a tobacco regulatory world in which the federal government would be a true partner. Three years later, we gathered in Kansas City, to take a pulse of where we are in tobacco regulation and where we need to be. The meeting reflected the achievements of the FDA’s Center for Tobacco Products (CTP) and the involvement of CTP staff in making improvements in public health. But the agenda and the hallway and happy hour chatter also made it clear that state and local health officials and advocates still have much to do to improve public health by reducing tobacco use.
It was refreshing to return to NCTOH. Those of my tenure were happy to reconnect with each other, to adore those who have worked in tobacco regulation for longer and, perhaps most importantly, to welcome those new to the field. I recommend sitting down with some newbies to your field if you are feeling jaded in your public health career; they’ll remind you of why we do what we do and reinvigorate the belief that we can improve the future of public health. The scars from years of funding declines and political attack can be muted by youthful enthusiasm, innovative thinking and a shared vision.
Substantively, the conference agenda revealed that we have benefitted from the Tobacco Control Act and the CTP’s work, but gaps in the law and limitations faced by the CTP must be addressed by action at the state and local level. While ten years ago our focus was on reducing cigarette smoking—a goal we have met over the last decade—other tobacco products (OTP) have charged into the marketplace and threatened progress. The conference featured interactive presentations and posters on these products—flavored cigars and smokeless tobacco; tobacco products that melt in the mouth; and electronic cigarettes. Courageous state and local public health officials and policymakers continue to show others how to use community education, law and policy to stop the invasion of these products. Public health attorneys, many falling under the umbrella of the Tobacco Control Legal Consortium, continue to support these efforts with legal analysis, legislative drafting and submitting amicus support.
The agenda also revealed the persistent problem of disparities in tobacco use. Tobacco companies have successfully targeted and addicted vulnerable populations. Policy must address these disparities directly. Our accomplishments are dimmed when we look at the faces of who we have left behind. Policies that make effective cessation readily available, that prevent exposure to secondhand smoke, and remove products that are designed to addict targeted populations should be on the itinerary of all public health officials, policymakers and advocates.
While we agreed that gaps in current regulation must be closed and that target populations must be the focus of public health efforts, the agenda and chatter also revealed that we have spirited and respectful debate within the community about how to eradicate the health harms from tobacco use. As a lawyer, maybe I appreciated this aspect of the conference too much. But I earnestly believe that we will improve tobacco regulation efforts by having these debates. And I believe we will move forward with ideas that are founded on good science and survive the scrutiny of experts.
I am grateful that the CDC was able to host the NCTOH again—it was a long three years from Phoenix to Kansas City. Let’s hope that the next gathering will be equally vigorous and effective and a lot sooner than three years hence.
This blog was prepared by Kathleen Dachille, J.D., director at the Network for Public Health Law – Eastern Region at the University of Maryland School Of Law.
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.