This content is sponsored by PMI U.S.
Cigarette smoking in the United States has declined considerably in recent decades, but it hasn’t flamed out entirely — millions of Americans still light up.
Smoking rates have fallen from more than 40% in the 1960s to below 10% today.
A wide range of public health campaigns over the years have contributed to the drop in smoking.
“That’s incredible progress,” said Dr. Brian Erkkila, director of external affairs and head of scientific engagement with PMI U.S. “One of the unfortunate things about that progress is it’s fallen off people’s radar.”
It’s estimated that more than 25 million adults still smoke, contributing to nearly half a million deaths each year.
Erkkila noted that his own father, a lifetime smoker, died a few years ago. He was a military veteran and died of chronic obstructive pulmonary disease (COPD) and lung cancer. Given that Erkkila himself was also a smoker at one time, he said studying its impact has become “a bit of a passion for me.”
“It remains the leading preventable cause of death in the United States, but for some reason it’s no longer at the top of our list,” Erkkila said, adding that healthcare and other issues related to smoking are costing the country billions of dollars a year.
The ‘Forgotten Smoker’
Those who continue to smoke are often collectively referred to as the “forgotten smoker” since cigarette smoking doesn’t receive the attention it once did as a major health issue. They are often military veterans, older people as well as those with lower incomes.
Erkkila said that everyone deserves help and attention.
Dr. Tom Price, who served as secretary of Health and Human Services during President Donald Trump’s first term, agreed.
He said close to 16 million Americans have a disease related to smoking and about $250 billion a year is spent to on care for them.
“We know that about two-thirds of the individuals who currently smoke have tried to quit but just haven’t been able to do so,” Price said. “We need a new approach.”
He noted that while some people are able to quit smoking “cold turkey,” many are simply unable to do so.
One of the issues is nicotine.
Erkkila and Price said there are widespread misconceptions about it — including in the medical community.
“Yes, it’s very addictive, but it doesn’t cause cancer, unlike the byproducts of smoking,” Price said, adding that many nurses and doctors still believe it causes cancer.
He and Erkkila pointed out that it is the chemicals from combustion within a cigarette that actually lead to serious health problems.
“We need to make certain that we’re providing individuals with a greater opportunity to do more healthful activities, instead of their current burning of tobacco,” Price said.
Alternatives to smoking cigarettes
“The good news is that there are wonderful solutions out there if we’ll address it as a society,” he said.
“I believe that if you don’t smoke, you shouldn’t start,” Price added. “If you do smoke, you ought to quit. But if you can’t quit, then you ought to switch to something that’s more healthful for you and doesn’t expose you to all of those carcinogens.”
Like Erkkila, Price said his father died from health issues linked to smoking.
Both believe the federal government can help those who currently smoke to find alternatives. “There are things that you can do to satisfy that craving that you have,” Price said.
Erkkila noted that the Food and Drug Administration could play a more active role in emphasizing how smoking alternatives can lead to better health outcomes.
“The FDA has said people who switch from cigarettes completely to nicotine pouches reduce their risks of cancer, cardiovascular disease and respiratory disease,” Erkkila said. “That’s an important message but is a message that is not reaching the public.”
Price also believes the FDA could be more active in identifying the “continuum of risk from tobacco consumption.”
He added, “Harm reduction is something I believe passionately in, for tobacco.”
There are all kinds of forms of “harm reduction,” whether it’s seat belts or putting a helmet on when riding a bike, Price shared. That’s why the FDA should encourage its own form of harm reduction, by encouraging a different approach to smoking, he said.
For example, he said products that are alternatives to cigarettes — like noncombustible tobacco products — could be taxed at a lower rate to help bring them to the market.
So what does he think about where these issues will go in the future?
“I’m optimistic about how we can move forward and provide that education for folks and recognize that there are new products that are out there that are available for individuals that will move them down that continuum of risk and make it so that they are not having to smoke cigarettes,” Price said.
Erkkila agreed.
“We want to see cigarettes in a museum, right?” he said. “Technology has delivering products with much less harm.”
“It’s just going to take more attention to a public health problem and a population that’s been forgotten for way too long,” he said.
Learn more about smoke-free alternatives.
