Originally published as JCO Early Release 10.1200/JCO.2003.04.154 on May 31 2003

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American Society of Clinical Oncology Policy Statement Update: Tobacco Control—Reducing Cancer Incidence and Saving Lives

Adopted on May 23, 2003, by The American Society Of Clinical Oncology

From the American Society of Clinical Oncology, Alexandria, VA.

Address reprint requests to Suanna S. Bruinooge, American Society of Clinical Oncology, Cancer Policy and Clinical Affairs, 1900 Duke St, Suite 200, Alexandria, VA 22314; email: bruinoos{at}asco.org.

Executive Summary: As an international medical society dedicated to cancer prevention, the American Society of Clinical Oncology (ASCO) advocates a fundamental reform of United States and international policy toward addictive tobacco products. ASCO’s goal is the immediate reduction of tobacco use and ultimate achievement of a tobacco-free world.

The centerpiece of ASCO’s policy is the recommendation for an independent commission to study the tobacco problem in all of its dimensions: social, medical, legal, and economic (both domestically and globally). The commission membership should include broad-based representation and expertise on tobacco issues. In ASCO’s view, tobacco control efforts to date have been less than successful because they are too fragmented and incremental, leaving many important issues unaddressed. A more comprehensive solution could flow from this study, including input from a variety of government agencies involved with public health, agriculture, First Amendment and other legal considerations, and international trade. The study, within defined time limits, should culminate in a report that outlines a strategy for achieving immediate reduction of tobacco use and ultimate achievement of a tobacco-free world, including explicit plans and a timetable for implementation.

Although this comprehensive approach to tobacco control will take many years to implement even under the best of circumstances, there are certain measures that could be undertaken immediately with meaningful impact on tobacco usage. These include:

• Increasing efforts to discourage tobacco use, particularly among the young
  
• Raising federal excise taxes by at least $2 per pack and encouraging states to consider tobacco taxes as a first resort in revenue enhancement
  
• Ensuring that tobacco settlement funds be devoted only to health-related projects, including medical treatment, biomedical research, and tobacco prevention efforts
  
• Requiring disclosure of all ingredients in tobacco products
  
• Comprehensively reforming third-party payment for tobacco cessation efforts
  
• Additional restriction of secondhand smoke in any places where the public may congregate
  
• Supporting necessary research into tobacco addiction, toxicities, and prevention strategies
  
• Enhancing global tobacco control, including a halt of United States government promotion of tobacco products
  

ASCO sincerely appreciates the contributions of the Public Issues Committee (PIC), which devoted significant time and effort to this project. The efforts were led by Paul Bunn, MD, ASCO President (University of Colorado Cancer Center, Denver, CO) and David G. Pfister, MD, Chair of the PIC Working Group (Memorial Sloan-Kettering Cancer Center, New York, NY). A list of Committee members and other project participants appears in the Appendix.

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