82 FR 50428 - Request for Information on Effective, Large-Scale, Sustainable Approaches To Help People Quit Using Tobacco by Employing Evidence-Based Treatment Options

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention

Federal Register Volume 82, Issue 209 (October 31, 2017)

The Centers for Disease Control and Prevention (CDC) within the Department of Health and Human Services (HHS) is requesting information from the public to inform future activities regarding how to efficiently and cost effectively help people quit using tobacco using evidence-based treatment options.

[Federal Register Volume 82, Number 209 (Tuesday, October 31, 2017)]
[Notices]
[Pages 50428-50429]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-23669]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Docket No. CDC-2017-0103]


Request for Information on Effective, Large-Scale, Sustainable 
Approaches To Help People Quit Using Tobacco by Employing Evidence-
Based Treatment Options

AGENCY: Centers for Disease Control and Prevention, Department of 
Health and Human Services (HHS).

ACTION: Request for information.

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SUMMARY: The Centers for Disease Control and Prevention (CDC) within 
the Department of Health and Human Services (HHS) is requesting 
information from the public to inform future activities regarding how 
to efficiently and cost effectively help people quit using tobacco 
using evidence-based treatment options.

DATES: Written comments must be received on or by January 2, 2018.

ADDRESSES: Submit comments by any one of the following methods:
     Internet: Electronic comments may be sent via http://www.regulations.gov, docket control number CDC-2017-0103. Please follow 
the directions on the site to submit comments; or
     Mail: Comments may also be sent by mail to the attention 
of Pamela Lemos, Office on Smoking and Health, Centers for Disease 
Control and Prevention, 4770 Buford Highway, Mail Stop F-79, Atlanta, 
GA 30341.
    All relevant comments will be posted without change to http://www.regulations.gov including any personal information provided.

FOR FURTHER INFORMATION CONTACT: Pamela Lemos, Office on Smoking and 
Health, Centers for Disease Control and Prevention, 4770 Buford 
Highway, Atlanta, GA 30341; Telephone (770) 488-5709; Email: 
[email protected].

SUPPLEMENTARY INFORMATION:

Scope of Problem

    Cigarette smoking is the leading cause of premature death and 
disease in the United States, causing about 480,000 deaths each year 
and costing the country over $300 billion annually in health care 
spending and lost productivity.1 2 Helping tobacco users 
quit completely is the quickest approach to reducing tobacco-related 
disease, death, and costs.\7\ Quitting smoking has immediate and long-
term health benefits.\1\ While quitting smoking at any age is 
beneficial, smokers who quit by the age of 35 to 44 years can prevent 
most of the risk of dying from a smoking-related disease.1 8
    Most cigarette smokers say that they want to quit, more than half 
try to quit each year, and almost three in five American adults who 
ever smoked have quit.\3\ Several treatments are proven effective in 
helping tobacco users quit, including individual, group, and telephone 
counseling and seven FDA-approved cessation medications.3 4 
Receiving advice to quit and quitting assistance from health care 
providers also increases quit rates.4 5 The use of both 
counseling and medication when trying to quit is more effective than 
using either method alone.4 5 However, only one-third of 
smokers use counseling and/or medication when trying to quit, and only 
one in twenty smokers use both.\3\ While adult cigarette smoking rates 
have been declining overall for several decades, certain groups 
continue to smoke at high rates and face special challenges in 
quitting, including adults who live below the poverty level and adults 
with behavioral health conditions.\6\ Those with behavioral health 
conditions include adults with mental illness or substance abuse 
disorders. The Substance Abuse and Mental Health Services 
Administration's National Survey on Drug Use and Health (NSDUH) defines 
mental illness as any diagnosable mental, behavioral, or emotional 
disorder and defines substance use disorder as dependence or abuse of 
alcohol or illicit drugs.
    Many resources are available to help smokers connect with evidence-
based treatments. Telephone quitlines exist in all states and other 
innovative and emerging resources are available such as web based 
platforms, texting, chat, and mobile apps. Many smokers, however, are 
unaware of these resources or have misconceptions about them.

Approach

    CDC is seeking information from the public to inform future 
activities that could efficiently and cost effectively connect tobacco 
users with evidence-based treatment options to help them quit. We plan 
to use the information gathered to inform activities including, but not 
limited to, state tobacco control programming, national governmental 
and nongovernmental organization work, and other entities that work to 
make broadly available and sustainable connections between people who 
want to quit using tobacco and evidence-based cessation assistance.
    The goal of this effort is to ensure that all tobacco users who 
want help quitting are aware of and have ready access to evidence-based 
treatment options through channels that they are comfortable using, 
including but not limited to telephone quitlines. We will carefully 
review and consider all comments received to this request for 
information.
    CDC is specifically interested in receiving information on the 
following topics:
    (1) How can CDC leverage emerging technologies to deliver evidence-
based cessation interventions through new and innovative platforms that 
have broad reach, especially among younger adults, those with low 
income, and adults with chronic and/or behavioral health conditions?
    (2) What are some innovative approaches to reduce the cost--in 
time, staffing, and funding--of providing effective cessation services 
to people who want to quit using tobacco?
    (3) How might standardization of quitline services achieve greater 
efficiency while also preserving state quitlines' ``brands,'' 
flexibility, and capacity for innovation?
    (4) What communication channels and communication strategies should 
CDC consider employing to ensure that both tobacco users, including 
those belonging to high-risk and disadvantaged populations, and health 
care providers are aware of and have access to evidence-based cessation 
resources?
    (5) What role should CDC, state and local health departments, not 
for profit institutions, traditional healthcare providers, and/or 
professional healthcare partner organizations, play in ensuring that 
high-risk populations (such as smokers living below the poverty level 
or those with behavioral health conditions) have access to tailored 
cessation services of appropriate intensity to help them successfully 
quit?

[[Page 50429]]

    (6) How can CDC support state and local health departments, 
traditional healthcare providers, not for profit health institutions, 
and professional healthcare partner organizations to ensure that 
evidence-based tobacco cessation interventions are integrated into 
primary and behavioral health care settings on a consistent and 
sustainable basis?
    (7) How can the public health sector most effectively maximize the 
impact of public and private insurance coverage of cessation treatments 
as part of efforts to ensure that all tobacco users have barrier-free 
access to these treatments?

References

1. U.S. Department of Health and Human Services. The Health 
Consequences of Smoking--50 Years of Progress: A Report of the 
Surgeon General. Atlanta: U.S. Department of Health and Human 
Services, Centers for Disease Control and Prevention, National 
Center for Chronic Disease Prevention and Health Promotion, Office 
on Smoking and Health, 2014.
2. Xu X, Bishop EE, Kennedy SM, Simpson SA, Pechacek TF. Annual 
Healthcare Spending Attributable to Cigarette Smoking: An Update. 
American Journal of Preventive Medicine 2014;48(3):326-33.
3. Babb S, Malarcher A, Schauer G, Asman K, Jamal A. Quitting 
Smoking Among Adults--United States, 2000-2015. MMWR Morb Mortal 
Wkly Rep 2017;65:1457-1464.
4. Siu AL; US Preventive Services Task Force. Behavioral and 
pharmacotherapy interventions for tobacco smoking cessation in 
adults, including pregnant women: U.S. Preventive Services Task 
Force recommendation statement. Ann Intern Med 2015;163:622-34.
5. Fiore MC, Ja[eacute]n CR, Baker TB, et al. Treating Tobacco Use 
and Dependence: 2008 Update--Clinical Practice Guidelines. Rockville 
(MD): U.S. Department of Health and Human Services, Public Health 
Service, Agency for Healthcare Research and Quality, 2008.
6. Jamal A, King BA, Neff LJ, Whitmill J, Babb SD, Graffunder CM. 
Current Cigarette Smoking Among Adults--United States, 2005-2015. 
MMWR Morb Mortal Wkly Rep 2016;65:1205-1211.
7. Institute of Medicine. Ending the Tobacco Problem: A Blueprint 
for the Nation. Washington: The National Academies Press, 2007.
8. Jha P, Ramasundarahettige C, Landsman V, Rostron B, Thun M, 
Anderson RN, McAfee T, Peto R. 21st-century hazards of smoking and 
benefits of cessation in the United States. New England Journal of 
Medicine 2013;368(4):341-50.

    Dated: October 25, 2017.
Sandra Cashman,
Executive Secretary, Centers for Disease Control and Prevention.
[FR Doc. 2017-23669 Filed 10-30-17; 8:45 am]
BILLING CODE 4163-18-P