United States Surgeon General Jerome Adams spoke at the 2018 SRNT Annual Conference in front of a packed audience at the Hilton Baltimore. Adams talked passionately about treating tobacco use as “the ethical thing to do. We’re doing a great job bringing the rates down, but it’s still affecting millions of Americans. And we know how to fix the problem.”
He emphatically pledged to work to eliminate menthols from cigarettes, noting they disproportionately affect African Americans, but called on researchers to help him by providing additional evidence to propel policy.
“It is in our power to end tobacco use in this country,” Adams said.
When FDA Commissioner Dr. Scott Gottlieb spoke later in the conference, he mentioned several times needing to take time for more research and public input, including listening to the tobacco industry, before proceeding with policy changes to end tobacco use.
When Dr. Phil Gardner of UCSF asked why the FDA wasn’t moving faster to remove menthols from the market because they disproportionately harm disparate populations, especially low-income African Americans, Gottlieb responded he appreciated the comments and was aware of the issue. “We share the concerns,” Gottlieb said. “We’re issuing an advanced notice of rule making and we’ll be evaluating those comments.”
When asked about the tobacco industry’s response to block his progressive plan to down-regulate nicotine in cigarettes below addictive levels, which the FDA has the power to do, Gottlieb called the issue “mostly a political question.” He added, “We’ll continue to build support. The tobacco industry has talked for many years about moving into products that present lower risk to consumers.” He said the FDA is interested in moving consumers down the continuum of risk and off combustible tobacco. “I think what we did with our announcement and the framework we’re committed to putting out, embraces that platform, maybe accelerates it a little bit beyond what some people might have had in mind.”
Adams noted his work as an anesthesiologist, and how he would use the peri-operative stage as an opportunity to address tobacco use with patients. He called on researchers and providers to treat every stage of the health care visit as a time to address tobacco use. Adams noted that electronic health records can bolster interventions and follow-up.
While some health care providers still worry that patients will react negatively to being asked about their tobacco use, Adams noted the evidence base shows that patients welcome and expect interventions.
He preached “better health through better partnerships,” encouraging researchers to reach out to organizations like Medicaid, the military, law enforcement, and faith-based organizations. He said he believes in anti-tobacco media campaigns and has spoken to the TRUTH campaign about continuing their effective work. He pointed to new Housing and Urban Development rules as a step forward.
A father of three kids aged 13, 12, and 8, Adams declared “No child should be vaping.” He said he would like to see more research about vaping to reduce the harm of smoking, but he worried about vaping leading to nicotine addiction.
When Dr. Jed Rose of Duke University asked Gottlieb about clearing the way to allow clinical trials of vaping devices to test their efficacy to help people quit smoking, Gottlieb said he had plans to address it.
Adams said he worked as a child in tobacco fields – resulting in an asthma flare-up, and his grandfather died from smoking, so the industry has affected him personally on several levels.
“I urge you all to renew your commitment to research,” Adams said to the SRNT audience, and to look for new partnerships. To watch a video of Adams’ talk, click here. To watch Gottlieb’s presentation, click here.