The FDA has issued broad new regulations restricting the sale and marketing of tobacco products to children and adolescents.
HHS secretary Kathleen Sebelius said during a March 18 news conference(www.youtube.com) that the rules -- which were published March 19 in the Federal Register(edocket.access.gpo.gov) and take effect June 22 -- will make it more difficult for manufacturers to advertise tobacco products and more difficult for children and adolescents to buy them.
The rules prohibit
- sales of cigarettes or smokeless tobacco to individuals younger than age 18;
- sales of cigarette packages with fewer than 20 cigarettes;
- sales of cigarettes and smokeless tobacco in vending machines, self-service displays or other impersonal modes of sale, except in very limited situations;
- free samples of cigarettes;
- tobacco brand name sponsorship of any athletic, musical, or other social or cultural event, or any team or entry in those events;
- gifts or other items in exchange for buying cigarettes or smokeless tobacco products; and
- sale or distribution of items, such as hats and tee shirts, with tobacco brands or logos.
The AAFP has weighed in with suggestions and comments as part of the development of Healthy People 2020 objectives.
The Academy focused its comments primarily on immunizations(healthypeople.gov), tobacco use(healthypeople.gov), and nutrition and weight status(healthypeople.gov).
In addition to voicing support for many objectives in those topic areas that were retained or modified from Healthy People 2010 and several that are new to Healthy People 2020, the AAFP suggested two objectives not present in the HHS draft related to tobacco use:
- an objective should be developed to increase the number of smokers referred to a quitline, and
- an objective should be developed to increase the level of tobacco dependence treatment provided to those who have mental health and substance abuse issues.
HHS is expected to release the final Healthy People 2020 objectives in the fall.
The new regulations also limit distribution of smokeless tobacco products and require that audio advertisements use only words with no music or sound effects.
"We are very pleased with these new FDA rules regarding tobacco marketing to youth," said Pamela Rodriguez, AAFP tobacco control manager. "They are consistent with the AAFP tobacco use policy and position paper."
Howard Koh, assistant secretary for health at the Department of Health and Human Services, said 90 percent of smokers start before age 18. An estimated 4,000 children under age 18 try their first cigarette every day, and one-fourth of those become daily smokers.
According to the Campaign for Tobacco-Free Kids(www.tobaccofreekids.org), 20 percent of U.S. high-school students are smokers, and the tobacco industry spends nearly $13 billion a year on marketing.
According to Sebelius, it is no coincidence that the three brands that spend the most on advertising -- Marlboro, Newport and Camel -- are preferred at higher rates by children and adolescents than by adults. "Despite a ban on direct marketing to young Americans, tobacco companies have still found ways to reach out to them," she said.
Sebelius said 450,000 Americans die prematurely each year because of smoking or second-hand smoke, and smoking is the leading cause of premature death in the country. She said tobacco use adds about $100 billion a year in costs to the U.S. health care system.