Interview with Centers for Disease Control chief — Tobacco is still the No. 1 health issue in America

Thomas R. Frieden

Really good interview I saw on a site called Vox.com (was not familiar with it) with Tom Frieden, head of the Centers for Disease Control, about health in America. The headline talks about legalized pot, but honestly, I didn’t see pot mentioned in the article. Just trying to drive clicks, I guess. Hee, the interview room looks pretty spartan. Did they conduct this interview in an old parking garage somewhere?

Anyway, it’s a wide-ranging interview touching on  e-cigs, tobacco, vaccines, prescription drugs, etc. I’m going to focus on the tobacco and e-cig and pot part of the discussion. There’s a lot of other good stuff there if you want to read the whole thing.

Some excerpts:

Frieden’s comments on tobacco control, when asked if tobacco has become a passe public health issue. The message is, yeah, fewer people might be smoking today than in the past 100 years, but the health crisis caused by the smoking epidemic has not gone away, and we must remain continually vigilant to get the message out to kids that smoking isn’t cool:

What is the single biggest opportunity out there in health?

 I would start with tobacco control. You know what, people sometimes think, “Oh, tobacco. That’s yesterday’s issue.” It still kills more people than anything else in this country and around the world. And there’s a lot more that we can do about it. It doesn’t just kill people, it disables, disfigures, causes diseases. It increases our health care cost. Tobacco is really the number one enemy of health in this country and around the world.

When you say that a lot of people think that tobacco is yesterday’s news, what is the next step on policy? At this point you’re dealing with taxes in New York that are high enough that one out of three packs is basically smuggled into the state. When you say there’s a lot more to do, what is there more to do?

First off, there are a lot of places that haven’t yet implemented the things that we know will work, whether that’s protecting people from second-hand smoke at work or increasing tax or reducing smuggling, which there are ways to do. Or running hard hitting ads, which we know make a major impact – they save lives and save money. These are some of the things that work.

Health care system can do much better at helping people quit. Medications will double or triple the chances that you’ll succeed. But the things that are going to make the biggest impact are price, hard hitting ads and smoke-free laws.

Now, some interesting comments about e-cigs. Frieden actually mentions a couple of issues I hadn’t thought about much personally.

E-cigarettes may help in some ways but they are definitely harmful in many ways as well. If they get kids hooked on tobacco and nicotine, which they are doing. If they get smokers to continue smoking rather than quit. If they get smokers who quit to come back to smoking.

What’s your view of the evidence on whether they actually help people quit?

If they re-glamorize the act of smoking or confuse smokers at what works to quit. These are all real problems with only at this point potential benefits from e-cigarettes.

There’s one small well-done study that they helped a little bit. The patches helped a little bit in that study too. The two weren’t statistically different. We do know that people who are using e-cigarettes are not quitting at higher rates than people who aren’t using them now. As we learn more, I have no doubt that an individual here or there can be helped by them, that they might be helpful to some people. As a societal issue, they’re only going to be helpful if they’re well-regulated and if cigarettes are well-regulated.

 

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