Realignment of the nation's tobacco agenda: The need to treat tobacco dependence

Background. Tobacco use remains the leading cause of preventable death in t he United States, Although comprehensive tobacco control has a number of es sential components, support for cessation services can yield the largest sh ort-term public health benefit. While effective treatments for tobacco depe ndence do exist, they are not currently available to many of the tobacco us ers who want and need them. Finding cost-effective, science-based strategie s for reducing tobacco dependence in the United States should be a national priority. Methods. Late in 1997 a group of experts in the science of tobacco control was convened by the Center for the Advancement of Health to develop recomme ndations regarding the use of federal funds for treating tobacco dependence , These recommendations were prepared based on the priority of the actions and the estimated cost and effort required to implement them. Following the Master Settlement Agreement in 1998, the recommendations were adapted to a ddress the needs of state policy makers. Results, Effective treatments for tobacco dependence do exist; however, our nation currently lacks the capacity to deliver these services to the many millions who require them. There is a compelling need for funding from a va riety of sources to create this capacity, Conclusions. The priority must be to develop the systems, competencies, and resources needed to deliver, and to monitor the delivery of, evidence-base d treatments to tobacco users. Treatment must be delivered in an integrated manner, consistent with the needs of tobacco users. Additionally, financia l barriers to treatment must be reduced, and consistent, high-quality treat ment services must be ensured for oil tobacco users who seek them, (C) 2001 American Health Foundation and Academic Press.