83_FR_63882 83 FR 63645 - Advancing Tobacco Control Practices To Prevent Initiation of Tobacco Use Among Youth and Young Adults, Eliminate Exposure to Secondhand Smoke, and Identify and Eliminate Tobacco-Related Disparities; Request for Information

83 FR 63645 - Advancing Tobacco Control Practices To Prevent Initiation of Tobacco Use Among Youth and Young Adults, Eliminate Exposure to Secondhand Smoke, and Identify and Eliminate Tobacco-Related Disparities; Request for Information

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

Federal Register Volume 83, Issue 237 (December 11, 2018)

Page Range63645-63646
FR Document2018-26708

The Centers for Disease Control and Prevention (CDC) within the Department of Health and Human Services (HHS) leads comprehensive efforts to prevent the initiation of tobacco use among youth and young adults; eliminate exposure to secondhand smoke; help current smokers quit; and identify and eliminate tobacco-related disparities. In late 2017, CDC solicited input from the public in the Federal Register Notice 82 FR 50428 regarding nationwide priorities for cessation. CDC is currently reviewing and compiling public comments to inform future activities that could efficiently and cost effectively help people quit using tobacco by employing evidence-based treatment options. CDC will share the outcome of this request for information with the public on a date to be determined. Now, CDC is seeking information to inform future activities to advance tobacco control practices that prevent initiation of tobacco use among youth and young adults; eliminate exposure to secondhand smoke; and identify and eliminate tobacco-related disparities.

Federal Register, Volume 83 Issue 237 (Tuesday, December 11, 2018)
[Federal Register Volume 83, Number 237 (Tuesday, December 11, 2018)]
[Notices]
[Pages 63645-63646]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-26708]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Docket No. CDC-2018-0115]


Advancing Tobacco Control Practices To Prevent Initiation of 
Tobacco Use Among Youth and Young Adults, Eliminate Exposure to 
Secondhand Smoke, and Identify and Eliminate Tobacco-Related 
Disparities; Request for Information

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

ACTION: Request for information.

-----------------------------------------------------------------------

SUMMARY: The Centers for Disease Control and Prevention (CDC) within 
the Department of Health and Human Services (HHS) leads comprehensive 
efforts to prevent the initiation of tobacco use among youth and young 
adults; eliminate exposure to secondhand smoke; help current smokers 
quit; and identify and eliminate tobacco-related disparities. In late 
2017, CDC solicited input from the public in the Federal Register 
Notice 82 FR 50428 regarding nationwide priorities for cessation. CDC 
is currently reviewing and compiling public comments to inform future 
activities that could efficiently and cost effectively help people quit 
using tobacco by employing evidence-based treatment options. CDC will 
share the outcome of this request for information with the public on a 
date to be determined. Now, CDC is seeking information to inform future 
activities to advance tobacco control practices that prevent initiation 
of tobacco use among youth and young adults; eliminate exposure to 
secondhand smoke; and identify and eliminate tobacco-related 
disparities.

DATES: Written comments must be received on or before February 11, 
2019.

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-2018-0115. Please follow 
the directions on the site to submit comments; or
    Mail: Comments may also be sent by mail to the attention of Randi 
Frank, Office on Smoking and Health, Centers for Disease Control and 
Prevention, 4770 Buford Hwy, Mail Stop S107-7, Atlanta, GA 30341.
    Instructions: All submissions received must include the agency name 
and Docket Number. All relevant comments received will be posted 
without change to, including any personal information provided. For 
access to the docket to read background documents or comments received, 
go to http://www.regulations.gov.

FOR FURTHER INFORMATION CONTACT: Randi Frank, Office on Smoking and 
Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, 
Mail Stop S107-7, Atlanta, GA 30341; Telephone (770) 488-5114; Email: 
[email protected].

SUPPLEMENTARY INFORMATION:

Scope of Problem

    Tobacco use is the leading cause of preventable disease, 
disability, and death in the United States.\1\ The burden of death and 
disease from tobacco use in the United States is overwhelmingly caused 
by cigarettes and other combusted tobacco products; therefore, rapid 
elimination of their use will dramatically reduce this burden.\1\
    Cigarette smoking alone causes more than 480,000 deaths each year, 
including more than 41,000 secondhand smoke related deaths, and costs 
the country over $300 billion annually in health care spending and lost 
productivity.\1 2\ Cigarette smoking is causally linked to numerous 
types of cancer, respiratory and cardiovascular diseases, diabetes, eye 
disease, complications to pregnancy and reproduction, and compromises 
the immune system.

Prevent Initiation of Tobacco Use Among Youth and Young Adults

    Any form of tobacco product use is unsafe for youth, irrespective 
of whether it is smoked, smokeless, or electronic. Since brain 
development continues through the early to mid-20s, the use of products 
containing nicotine, including e-cigarettes, can be harmful to youth 
and young adults. Specifically, the use of these products can disrupt 
the growth of brain circuits that control attention, learning, and 
susceptibility to addiction.\3\ In 2018, nearly 4.9 million United 
States middle and high school students currently used (>=1 day in past 
30 days) at least one type of tobacco product, with e-cigarettes being 
the most commonly used tobacco product.\4\ Flavors are a major factor 
contributing to the use of these products among young people; 85% of 
youth e-cigarette users report using flavors.\5\ The use of e-
cigarettes may also lead to future cigarette smoking among some 
youth.\6\ In addition to e-cigarettes, youth also use several other 
types of tobacco products, and disparities in use of these products 
exist across population groups.\14\

[[Page 63646]]

Eliminate Exposure to Secondhand Smoke

    The U.S. Surgeon General has concluded that there is no risk-free 
level of secondhand smoke exposure; even brief exposure can be harmful 
to health.7 8 During 2011-2012, about 58 million nonsmokers 
in the United States were exposed to secondhand smoke, and exposure 
remains higher among children, non-Hispanic blacks, those living in 
poverty, and those who rent their housing.\9\ Secondhand smoke exposure 
can cause heart disease, lung cancer, and stroke among adults, as well 
as the following in children: 1 7 8

 Ear infections
 More frequent and severe asthma
 Respiratory symptoms (for example, coughing, sneezing, and 
shortness of breath)
 Respiratory infections (bronchitis and pneumonia)
 Sudden unexplained infant death syndrome (SUIDS)

Identify and Eliminate Tobacco-Related Disparities

    Although progress has been made in reducing tobacco use in the 
general population, disparities persist across population groups.\1\ 
These disparities can affect populations on the basis of certain 
factors, including but not limited to: 10 11
 Age
 Disability
 Educational attainment
 Geographic location (e.g., rural/urban)
 Income
 Mental health and substance abuse conditions
 Employment status
 Race/ethnicity
 Sex
 Sexual orientation and gender identity
 Veteran and military status

    Addressing the social and environmental factors that influence 
tobacco use can advance equity in tobacco prevention and control, and 
reduce tobacco-related disparities among populations disproportionately 
impacted by tobacco use.\12\ These efforts can help reduce the overall 
prevalence of tobacco use.\13\
    Approach: CDC is seeking input to inform future activities to 
advance tobacco control practices to prevent initiation of tobacco use 
among youth and young adults; eliminate exposure to secondhand smoke; 
and identify and eliminate tobacco-related disparities. The information 
gathered will be used to inform activities that encompass technical 
assistance and guidance to state tobacco control programs and 
collaborative work with national governmental and nongovernmental 
partners, who share CDC's goals to prevent initiation of tobacco use 
among youth and young adults; eliminate exposure to secondhand smoke; 
and identify and eliminate tobacco-related disparities.
    CDC is specifically interested in receiving information on the 
following issues:
    (1) What innovative strategies are working in communities to 
prevent tobacco use among youth, especially in terms of flavored 
tobacco products and e-cigarettes?
    (2) How can CDC best educate all community members about the 
harmful effects of secondhand smoke exposure?
    (3) How can CDC support state and local health departments and 
their partners to improve community engagement with populations most at 
risk for tobacco use?
    (4) What innovative strategies are effective in communities to 
decrease tobacco use in population groups that have the greatest burden 
of tobacco use and secondhand smoke exposure?
    (5) What science, tools, or resources does the public health sector 
need CDC to develop in order to enhance and sustain tobacco prevention 
and control efforts?

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. U.S. Department of Health and Human Services. E-cigarette use 
among youth and young adults: a report of the Surgeon General. 
Atlanta, GA: US Department of Health and Human Services, CDC; 2016 
[accessed 2018 Oct 18].
    4. Cullen KA, Ambrose BK, Gentzke AS, Apelberg BJ, Jamal A, King 
BA. Notes from the Field: Increase in e-cigarette use and any 
tobacco product use among middle and high school students--United 
States, 2011-2018. Morbidity and Mortality Weekly Report. 
2018;67(45);1276-1277.
    5. Ambrose BK, Day HR, Rostron B, et al. Flavored Tobacco 
Product Use Among US Youth Aged 12-17 Years, 2013-2014. JAMA. 
2015;314(17):1871-1873.doi:10.1001/jama.2015.13802U.S.
    6. National Academies of Sciences, Engineering, and Medicine. 
2018. Public health consequences of e-cigarettes. Washington, DC: 
The National Academies Press. doi: https://doi.org/10.17226/24952.
    7. Department of Health and Human Services. A Report of the 
Surgeon General: How Tobacco Smoke Causes Disease: What It Means to 
You. 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, 2010 [accessed 2018 Oct 10].
    8. U.S. Department of Health and Human Services. The Health 
Consequences of Involuntary Exposure to Tobacco Smoke: 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, 2006 [accessed 2018 Oct 10].
    9. Centers for Disease Control and Prevention. Vital signs: 
Disparities in nonsmokers' exposure to secondhand smoke--United 
States, 1999-2012. Morbidity and Mortality Weekly Report. 
2015;64:103-108.[accessed 2018 Oct 22].
    10. Centers for Disease Control and Prevention. Cigarette 
smoking--United States, 1965-2008. Morbidity and Mortality Weekly 
Report. 2011;60(01):109-3. [accessed 2018 Oct 22].
    11. King BA, Dube SR, Tynan MA. Current tobacco use among adults 
in the United States: findings from the National Adult Tobacco 
Survey. American Journal of Public Health 2012;102(11):e93-e100. 
[accessed 2018 Oct 23].
    12. Centers for Disease Control and Prevention. Best Practices 
User Guide: Health Equity in Tobacco Prevention and Control. 
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, 2015.
    13. Centers for Disease Control and Prevention. Best Practices 
for Comprehensive Tobacco Control Programs--2014. 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 [accessed 2018 
Oct 18].
    14. Centers for Disease Control and Prevention. Flavored Tobacco 
Product Use Among Middle and High School Students--United States, 
2014. Morbidity and Mortality Weekly Report. 2015;64(38);1066-1070. 
[accessed 2018 Nov 16].

    Dated: December 4, 2018.
Sandra Cashman,
Executive Secretary, Centers for Disease Control and Prevention.
[FR Doc. 2018-26708 Filed 12-10-18; 8:45 am]
BILLING CODE 4163-18-P



                                                                         Federal Register / Vol. 83, No. 237 / Tuesday, December 11, 2018 / Notices                                           63645

                                              POLICIES AND PRACTICES FOR STORAGE OF                   DEPARTMENT OF HEALTH AND                              to, including any personal information
                                              RECORDS:                                                HUMAN SERVICES                                        provided. For access to the docket to
                                                Records are maintained in paper and                                                                         read background documents or
                                                                                                      Centers for Disease Control and                       comments received, go to http://
                                              electronic form, including on computer
                                                                                                      Prevention                                            www.regulations.gov.
                                              databases and cloud-based services, all
                                              of which are securely stored.                           [Docket No. CDC–2018–0115]                            FOR FURTHER INFORMATION CONTACT:
                                                                                                                                                            Randi Frank, Office on Smoking and
                                              POLICIES AND PRACTICES FOR RETRIEVAL OF                 Advancing Tobacco Control Practices                   Health, Centers for Disease Control and
                                              RECORDS:                                                To Prevent Initiation of Tobacco Use                  Prevention, 4770 Buford Hwy, Mail
                                                                                                      Among Youth and Young Adults,                         Stop S107–7, Atlanta, GA 30341;
                                                Records are retrieved by name,                        Eliminate Exposure to Secondhand                      Telephone (770) 488–5114; Email:
                                              account number, email address, phone                    Smoke, and Identify and Eliminate                     OSHFRN@cdc.gov.
                                              number, social media handle,                            Tobacco-Related Disparities; Request                  SUPPLEMENTARY INFORMATION:
                                              demographics, or other unique identifier                for Information
                                              of the individual about whom they are                                                                         Scope of Problem
                                              maintained.                                             AGENCY:  Centers for Disease Control and
                                                                                                                                                              Tobacco use is the leading cause of
                                                                                                      Prevention (CDC), Department of Health
                                                                                                                                                            preventable disease, disability, and
                                              POLICIES AND PRACTICES FOR RETENTION AND                and Human Services (HHS).
                                                                                                                                                            death in the United States.1 The burden
                                              DISPOSAL OF RECORDS:                                    ACTION: Request for information.                      of death and disease from tobacco use
                                                These records are maintained in                       SUMMARY:    The Centers for Disease                   in the United States is overwhelmingly
                                              accordance with General Records                         Control and Prevention (CDC) within                   caused by cigarettes and other
                                              Schedules 6.4 (Public Affairs Records)                  the Department of Health and Human                    combusted tobacco products; therefore,
                                              and 6.5 (Public Customer Service                        Services (HHS) leads comprehensive                    rapid elimination of their use will
                                              Records) issued by the National                         efforts to prevent the initiation of                  dramatically reduce this burden.1
                                              Archives and Records Administration                                                                             Cigarette smoking alone causes more
                                                                                                      tobacco use among youth and young
                                                                                                                                                            than 480,000 deaths each year,
                                              (NARA).                                                 adults; eliminate exposure to
                                                                                                                                                            including more than 41,000 secondhand
                                                                                                      secondhand smoke; help current
                                                                                                                                                            smoke related deaths, and costs the
                                              ADMINISTRATIVE, TECHNICAL, AND PHYSICAL                 smokers quit; and identify and eliminate
                                              SAFEGUARDS:
                                                                                                                                                            country over $300 billion annually in
                                                                                                      tobacco-related disparities. In late 2017,
                                                                                                                                                            health care spending and lost
                                                FRTIB has adopted appropriate                         CDC solicited input from the public in
                                                                                                                                                            productivity.1 thnsp;2 Cigarette
                                                                                                      the Federal Register Notice 82 FR 50428
                                              administrative, technical, and physical                                                                       smoking is causally linked to numerous
                                                                                                      regarding nationwide priorities for
                                              controls in accordance with FRTIB’s                                                                           types of cancer, respiratory and
                                                                                                      cessation. CDC is currently reviewing
                                              security program to protect the security,                                                                     cardiovascular diseases, diabetes, eye
                                                                                                      and compiling public comments to
                                              confidentiality, availability, and                                                                            disease, complications to pregnancy and
                                                                                                      inform future activities that could
                                              integrity of the information, and to                                                                          reproduction, and compromises the
                                                                                                      efficiently and cost effectively help
                                              ensure that records are not disclosed to                                                                      immune system.
                                                                                                      people quit using tobacco by employing
                                              or accessed by unauthorized                             evidence-based treatment options. CDC                 Prevent Initiation of Tobacco Use
                                              individuals.                                            will share the outcome of this request                Among Youth and Young Adults
                                                                                                      for information with the public on a                     Any form of tobacco product use is
                                              RECORD ACCESS PROCEDURES:
                                                                                                      date to be determined. Now, CDC is                    unsafe for youth, irrespective of whether
                                                Individuals seeking to access records                 seeking information to inform future                  it is smoked, smokeless, or electronic.
                                              within this system must submit a                        activities to advance tobacco control                 Since brain development continues
                                              request pursuant to 5 CFR part 1630.                    practices that prevent initiation of                  through the early to mid-20s, the use of
                                              Attorneys or other persons acting on                    tobacco use among youth and young                     products containing nicotine, including
                                              behalf of an individual must provide                    adults; eliminate exposure to                         e-cigarettes, can be harmful to youth
                                              written authorization from that                         secondhand smoke; and identify and                    and young adults. Specifically, the use
                                              individual, such as a Power of Attorney,                eliminate tobacco-related disparities.                of these products can disrupt the growth
                                              in order for the representative to act on               DATES: Written comments must be                       of brain circuits that control attention,
                                              their behalf.                                           received on or before February 11, 2019.              learning, and susceptibility to
                                                                                                      ADDRESSES: Submit comments by any                     addiction.3 In 2018, nearly 4.9 million
                                              CONTESTING RECORD PROCEDURES:                           one of the following methods:                         United States middle and high school
                                                                                                         • Internet: Electronic comments may                students currently used (≥1 day in past
                                                 See Record Access Procedures above.
                                                                                                      be sent via http://www.regulations.gov,               30 days) at least one type of tobacco
                                                                                                      docket control number CDC–2018–0115.                  product, with e-cigarettes being the
                                              NOTIFICATION PROCEDURES:
                                                                                                      Please follow the directions on the site              most commonly used tobacco product.4
                                                 See Record Access Procedures above.                  to submit comments; or                                Flavors are a major factor contributing
                                                                                                         Mail: Comments may also be sent by                 to the use of these products among
                                              EXEMPTIONS PROMULGATED FOR THE SYSTEM:                  mail to the attention of Randi Frank,                 young people; 85% of youth e-cigarette
                                                                                                      Office on Smoking and Health, Centers                 users report using flavors.5 The use of e-
amozie on DSK3GDR082PROD with NOTICES1




                                                 None.
                                                                                                      for Disease Control and Prevention,                   cigarettes may also lead to future
                                              HISTORY:
                                                                                                      4770 Buford Hwy, Mail Stop S107–7,                    cigarette smoking among some youth.6
                                                                                                      Atlanta, GA 30341.                                    In addition to e-cigarettes, youth also
                                                 None.                                                   Instructions: All submissions received             use several other types of tobacco
                                              [FR Doc. 2018–26697 Filed 12–10–18; 8:45 am]            must include the agency name and                      products, and disparities in use of these
                                              BILLING CODE P                                          Docket Number. All relevant comments                  products exist across population
                                                                                                      received will be posted without change                groups.14


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                                              63646                      Federal Register / Vol. 83, No. 237 / Tuesday, December 11, 2018 / Notices

                                              Eliminate Exposure to Secondhand                        collaborative work with national                        7. Department of Health and Human
                                              Smoke                                                   governmental and nongovernmental                      Services. A Report of the Surgeon General:
                                                                                                      partners, who share CDC’s goals to                    How Tobacco Smoke Causes Disease: What It
                                                 The U.S. Surgeon General has
                                                                                                      prevent initiation of tobacco use among               Means to You. Atlanta: U.S. Department of
                                              concluded that there is no risk-free level
                                                                                                      youth and young adults; eliminate                     Health and Human Services, Centers for
                                              of secondhand smoke exposure; even                                                                            Disease Control and Prevention, National
                                              brief exposure can be harmful to                        exposure to secondhand smoke; and
                                                                                                      identify and eliminate tobacco-related                Center for Chronic Disease Prevention and
                                              health.7 8 During 2011–2012, about 58                                                                         Health Promotion, Office on Smoking and
                                              million nonsmokers in the United States                 disparities.
                                                                                                         CDC is specifically interested in                  Health, 2010 [accessed 2018 Oct 10].
                                              were exposed to secondhand smoke,                                                                               8. U.S. Department of Health and Human
                                                                                                      receiving information on the following
                                              and exposure remains higher among                                                                             Services. The Health Consequences of
                                                                                                      issues:
                                              children, non-Hispanic blacks, those                       (1) What innovative strategies are                 Involuntary Exposure to Tobacco Smoke: A
                                              living in poverty, and those who rent                   working in communities to prevent                     Report of the Surgeon General. Atlanta: U.S.
                                              their housing.9 Secondhand smoke                        tobacco use among youth, especially in                Department of Health and Human Services,
                                              exposure can cause heart disease, lung                  terms of flavored tobacco products and                Centers for Disease Control and Prevention,
                                              cancer, and stroke among adults, as well                e-cigarettes?                                         National Center for Chronic Disease
                                              as the following in children: 1 7 8                        (2) How can CDC best educate all                   Prevention and Health Promotion, Office on
                                              • Ear infections                                        community members about the harmful                   Smoking and Health, 2006 [accessed 2018
                                              • More frequent and severe asthma                       effects of secondhand smoke exposure?                 Oct 10].
                                              • Respiratory symptoms (for example,                       (3) How can CDC support state and                    9. Centers for Disease Control and
                                                 coughing, sneezing, and shortness of                 local health departments and their                    Prevention. Vital signs: Disparities in
                                                 breath)                                              partners to improve community                         nonsmokers’ exposure to secondhand
                                              • Respiratory infections (bronchitis and                engagement with populations most at                   smoke—United States, 1999–2012. Morbidity
                                                 pneumonia)                                           risk for tobacco use?                                 and Mortality Weekly Report. 2015;64:103–
                                              • Sudden unexplained infant death                          (4) What innovative strategies are                 108.[accessed 2018 Oct 22].
                                                 syndrome (SUIDS)                                     effective in communities to decrease                    10. Centers for Disease Control and
                                                                                                      tobacco use in population groups that                 Prevention. Cigarette smoking—United
                                              Identify and Eliminate Tobacco-Related
                                                                                                      have the greatest burden of tobacco use               States, 1965–2008. Morbidity and Mortality
                                              Disparities                                             and secondhand smoke exposure?                        Weekly Report. 2011;60(01):109–3. [accessed
                                                 Although progress has been made in                      (5) What science, tools, or resources              2018 Oct 22].
                                              reducing tobacco use in the general                     does the public health sector need CDC                  11. King BA, Dube SR, Tynan MA. Current
                                              population, disparities persist across                  to develop in order to enhance and                    tobacco use among adults in the United
                                              population groups.1 These disparities                   sustain tobacco prevention and control                States: findings from the National Adult
                                              can affect populations on the basis of                  efforts?                                              Tobacco Survey. American Journal of Public
                                              certain factors, including but not limited                                                                    Health 2012;102(11):e93–e100. [accessed
                                              to: 10 11                                               References                                            2018 Oct 23].
                                              • Age                                                     1. U.S. Department of Health and Human                12. Centers for Disease Control and
                                              • Disability                                            Services. The Health Consequences of                  Prevention. Best Practices User Guide: Health
                                              • Educational attainment                                Smoking—50 Years of Progress: A Report of             Equity in Tobacco Prevention and Control.
                                              • Geographic location (e.g., rural/urban)               the Surgeon General. Atlanta: U.S.                    Atlanta: U.S. Department of Health and
                                              • Income                                                Department of Health and Human Services,              Human Services, Centers for Disease Control
                                              • Mental health and substance abuse                     Centers for Disease Control and Prevention,           and Prevention, National Center for Chronic
                                                 conditions                                           National Center for Chronic Disease                   Disease Prevention and Health Promotion,
                                                                                                      Prevention and Health Promotion, Office on
                                              • Employment status                                     Smoking and Health, 2014.
                                                                                                                                                            Office on Smoking and Health, 2015.
                                              • Race/ethnicity                                          2. Xu X, Bishop EE, Kennedy SM, Simpson
                                                                                                                                                              13. Centers for Disease Control and
                                              • Sex                                                   SA, Pechacek TF. Annual Healthcare                    Prevention. Best Practices for Comprehensive
                                              • Sexual orientation and gender                         Spending Attributable to Cigarette Smoking:           Tobacco Control Programs—2014. Atlanta:
                                                 identity                                             An Update. American Journal of Preventive             U.S. Department of Health and Human
                                              • Veteran and military status                           Medicine 2014;48(3):326–33.                           Services, Centers for Disease Control and
                                                 Addressing the social and                              3. U.S. Department of Health and Human              Prevention, National Center for Chronic
                                                                                                      Services. E-cigarette use among youth and             Disease Prevention and Health Promotion,
                                              environmental factors that influence                    young adults: a report of the Surgeon
                                              tobacco use can advance equity in                                                                             Office on Smoking and Health, 2014
                                                                                                      General. Atlanta, GA: US Department of                [accessed 2018 Oct 18].
                                              tobacco prevention and control, and                     Health and Human Services, CDC; 2016
                                              reduce tobacco-related disparities                      [accessed 2018 Oct 18].                                 14. Centers for Disease Control and
                                                                                                        4. Cullen KA, Ambrose BK, Gentzke AS,               Prevention. Flavored Tobacco Product Use
                                              among populations disproportionately
                                                                                                      Apelberg BJ, Jamal A, King BA. Notes from             Among Middle and High School Students—
                                              impacted by tobacco use.12 These efforts
                                                                                                      the Field: Increase in e-cigarette use and any        United States, 2014. Morbidity and Mortality
                                              can help reduce the overall prevalence
                                                                                                      tobacco product use among middle and high             Weekly Report. 2015;64(38);1066–1070.
                                              of tobacco use.13                                       school students—United States, 2011–2018.             [accessed 2018 Nov 16].
                                                 Approach: CDC is seeking input to                    Morbidity and Mortality Weekly Report.
                                              inform future activities to advance                     2018;67(45);1276–1277.                                  Dated: December 4, 2018.
                                              tobacco control practices to prevent                      5. Ambrose BK, Day HR, Rostron B, et al.            Sandra Cashman,
                                              initiation of tobacco use among youth                   Flavored Tobacco Product Use Among US                 Executive Secretary, Centers for Disease
amozie on DSK3GDR082PROD with NOTICES1




                                              and young adults; eliminate exposure to                 Youth Aged 12–17 Years, 2013–2014. JAMA.              Control and Prevention.
                                              secondhand smoke; and identify and                      2015;314(17):1871–1873.doi:10.1001/
                                                                                                      jama.2015.13802U.S.                                   [FR Doc. 2018–26708 Filed 12–10–18; 8:45 am]
                                              eliminate tobacco-related disparities.
                                                                                                        6. National Academies of Sciences,                  BILLING CODE 4163–18–P
                                              The information gathered will be used                   Engineering, and Medicine. 2018. Public
                                              to inform activities that encompass                     health consequences of e-cigarettes.
                                              technical assistance and guidance to                    Washington, DC: The National Academies
                                              state tobacco control programs and                      Press. doi: https://doi.org/10.17226/24952.



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Document Created: 2018-12-11 01:06:29
Document Modified: 2018-12-11 01:06:29
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionRequest for information.
DatesWritten comments must be received on or before February 11, 2019.
ContactRandi Frank, Office on Smoking and Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mail Stop S107-7, Atlanta, GA 30341; Telephone (770) 488-5114; Email: [email protected]
FR Citation83 FR 63645 

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