Increasing Tobacco Cessation in America: A Consumer Demand Perspective

Abstract

This supplement to the American Journal of Preventive Medicine is coming out at a critical juncture in U.S. tobacco control history. We’ve seen enormous progress in the past decades in several public health policy domains: Tobacco tax increases, clean indoor air laws, and effective counter-marketing campaigns have led to impressive declines in youth tobacco use. Great progress has been made as well in discovering and disseminating effective quit-smoking treatments and to a lesser extent in the policies that support their use. But these gains have not translated into expected reductions in adult tobacco use. Reductions in adult tobacco use have lagged behind declines in youth uptake. Moreover, the most vulnerable populations (racial/ethnic minorities and lower-income populations) have not kept pace with gains among more-advantaged groups, exacerbating existing health disparities. The aim of this supplement is to call attention to the utility of bringing a consumer-oriented perspective to population-level tobacco-cessation efforts—in order to increase the demand for, and use and reach of, evidencebased treatments, and to spur the wider adoption of policy changes that will make these treatments affordable, accessible, and easier to use. The articles and commentaries in this supplement 1–20 reflect the view that if we could increase consumer demand for evidence-based tobacco-cessation products and services, many more people would attempt to quit, and would succeed in doing so. They were stimulated by a series of roundtable meetings and a conference exploring this potential (i.e., consumer-demand.org/) and charting its possible population impact. The 2006 NIH State-of-the-Science Conference on Tobacco Use 21 and related reviews 22 have singled out the need to build consumer demand for and use of proven cessation services as having untapped potential for increasing their reach, use, and impact. The 2008 IOM report “Ending the Tobacco Problem: a Blueprint for the Nation” 23 emphasizes the need to expand treatment use by aligning cessation treatments and the policies that support their use and delivery across all levels of healthcare and public health systems, and it calls for a coordinated, comprehensive strategy to dramatically increase the number of smokers who quit each year. The IOM report and others concluded that “systems integration is arguably the single most critical missing ingredient needed to maximize the as yet un