Earlier this year, the American Society of Clinical Oncology (ASCO) released a series of updated recommendations regarding tobacco use and control. Their aim was to include new developments in tobacco cessation, which have come onto the market since the previous recommendations were issued in 2003. Since tobacco consumption rates in Kentucky are among the highest in the nation, the ASCO advice is particularly pertinent to regional physicians.
The full text of the ASCO statement may be found in the Journal of Clinical Oncology. However, a brief summary of some key recommendations is offered below.
Lost productivity and healthcare associated with tobacco-related illnesses and secondhand smoke cost the United States an estimated $200 billion each year. Although cigarette smoking rates have declined, there has been a marked increase in the use of other tobacco products, including hookahs and e-cigarettes, which have recently made headlines for their popularity among teenagers. The researchers responsible for the updated recommendations predict that a global epidemic of tobacco-related disease is only just beginning and that rates will soar in coming years. With this in mind, ASCO recommends:
- Health care professionals must continue to address the “devastating consequences of tobacco use” with their patients. Evidence of the effects of tobacco use on one’s health is indisputable, and therefore doctors should strongly encourage patients who use tobacco to quit. Contrary to popular belief, low-tar cigarettes do not reduce health risks, a fact which patients should be made aware of. The report also highlighted a need for better education of physicians and medical students, noting that fewer than 40% medical students felt they had received adequate training on the subject of smoking cessation techniques.
- Oncology specialists, in particular, should be given greater resources and tools to educate their patients of the risks associated with tobacco use. Giving patients the support to quit their tobacco usage should be an integral part of cancer treatment. Patients should also be made more aware of how continued tobacco use can affect their cancer recovery, for example, leading to increased risk of cancer recurrence, shorter survival rates, and a higher likelihood of secondary cancers.
- Tobacco cessation services and initiatives which are provided through the Affordable Care Act should be promoted more widely. These offerings may vary by state, so it is important that healthcare professionals become aware of what is available. All Medicare beneficiaries have been entitled to receive tobacco cessation support since 2011 but many remain unaware of services in their area. As of January 2014, all Medicaid recipients will be eligible for prescription tobacco cessation drugs.
- Further research is needed, especially for programs to target certain populations. For example, how can programs achieve better success among young smokers? How should programs be tailored to meet the needs of cancer survivors?
- The American Society of Clinical Oncology will continue to support increased taxation of tobacco products, enforcement of clean air initiatives, and an end to youth-targeted advertising. Furthermore, the society demands that all tobacco products should be subject to the same regulations.
The full text of this report is available online through the Journal of Clinical Oncology at http://jco.ascopubs.org/content/31/25/3147.
by Fiona Young-Brown, Editor, KY Doc Magazine