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US agency proposes 10 point plan to cut smoking
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     A US government agency has drawn up a comprehensive plan to encourage five million Americans to stop smoking. The Interagency Committee on Smoking and Health, which developed the 10 point plan over 14 months, has proposed increasing the tax on a pack of cigarettes by $2 (¡ê1; €1.60).

    Details of the national plan for tobacco cessation are published in the American Journal of Public Health (2004;94:205-10), and the plan was endorsed by four former US surgeons general¡ªJesse Steinfeld, Julius Richmond, C Everett Koop, and David Satcher¡ªat a press conference last week in Washington, DC. The $2 tax is estimated to bring in $28bn, half of which would go toward funding parts of the plan. Studies have shown that increasing tax on tobacco discourages use.

    Besides the tax increase the recommendations include universal access to smoking cessation programmes, adequate training to ensure that effective cessation treatment is provided, media campaigns to discourage smoking, insurance coverage to encourage cessation among people covered by federal insurance programmes such as Medicare and Medicaid, programmes for treating tobacco dependency, and establishing a national counselling and support service for people trying to stop smoking.

    This last recommendation was immediately taken up by the health and human services secretary, Tommy Thompson, who announced that $25m would be dedicated to a toll free national "quitline" to be set up by the end of the year. It would be an access point for smokers who want to quit, he said.

    The plan would also encourage health insurers and employers, among others, to foster tobacco cessation efforts as part of their benefits and provide for the effective use of tobacco dependency treatment

    The plan was drafted by the interagency committee’s subcommittee on cessation, which is headed by Dr Michael Fiore of the University of Wisconsin Medical School in Madison.

    Referring to the need to address smoking Dr Fiore drew a parallel with the way the United States handled the polio outbreaks of the 1950s. "Only through a significant commitment, including federal funds, were we able to eradicate polio," he said.

    Unlike polio, there was no vaccine against tobacco dependence, he said. "But we do have many effective treatments that can help people break free of their addiction to tobacco. This plan, if implemented, will make these treatments readily available to anyone in the country who wants to quit smoking."(Washington, DC Charles Ma)