Transcript for CDC Telebriefing: New Vital Signs Report - Cancer and Tobacco Use

OPERATOR: Stand by for today's conference, we will begin shortly.  Please continue to hold.  Thank you. 

OPERATOR: Welcome and thank you all for standing by.  All participants will be on the listen-only mode until the question and answer session of today's call.  At that time, you can press star 1 to ask a question from the phone line.  I would also like to inform callers that the call is being recorded.  If you have any objections, you may disconnect at this time.  I’ll turn the meeting over to Michelle Bonds, thank you, ma'am, you may begin. 

MICHELLE BONDS: Thank you.  My name is Michelle Bonds, I’m the Division Director for Public Affairs at CDC.  I want to thank you for joining us today for the release of the latest CDC vital signs.  This edition is on the topic of tobacco and cancer.  We are joined today with Tom Frieden, the CDC Director.  I’m turning the call over to him right now.  Thank you. 

TOM FRIEDEN: Hello and thank you very much for joining us.  As you know, CDC's vital signs highlights an important public health issue each month, bringing the latest data about a critical health issue.  And most importantly, what we can do about it.  CDC works 24/7 to keep Americans healthy, safe, and secure.  Today we highlight a persistent and preventable health threat in this country.  Tobacco use and the many cancers it causes.  Most people know that smoking causes lung cancer, which is the leading cause of cancer deaths.  The bottom line of this briefing is that although smoking rates are at an all-time low, tobacco causes cancer of at least 12 parts of the body, accounts for three in ten cancer deaths, and will kill 6 million current smokers, unless we implement programs to help them quit.  Reducing tobacco use prevents cancer and prevents deaths and saves money.  This is important.  Tobacco use continues to cause an enormous amount of disability and death from cancer. Cancers linked to tobacco make up 40% of all cancers that are diagnosed in this country. These are actually conservative estimates as we learn more each year, we continue to see lengths between cancer and tobacco.  The cancers that were attributing to tobacco here are those that have very clear proof that there's a relationship.  In a separate article, in the same issue of this week's MMWR, we're releasing data that shows that cigarette smoking has hit an all-time low.  15% of U.S. adults were smokers in 2015, down from nearly 21% in 2005.

 If you look just at the years between 2009 and 2015, the number of adult cigarette smokers declined by ten million.  That is a remarkable number.  That number represents literally  millions of people who will not develop cancer or die from it.  We’ve also seen a decrease in tobacco-related cancer deaths in the U.S.  Because of reductions and tobacco use and also the early detection and treatment of certain cancers, there have been approximately 1.3 million deaths avoided from cancers linked to tobacco use since 1990.  Despite this, tobacco continues to cause too many health problems and too many deaths.  The most recent data shows that 660,000 people are diagnosed with a tobacco-related cancer every year, and sadly, 343,000 of them will die from cancer each year.  Much of the good work that's been done to reduce tobacco use has happened at state and local levels.  Much more needs to be done to address the gaps and better health communities that are disproportionately impacted by tobacco-related cancers.  Progress across the U.S. has been inconsistent.  There are large disparities among groups of people who use tobacco and disparities in the groups affected by tobacco-related cancers.  Men have higher tobacco-related cancer deaths than women, and unfortunately we've seen that male smoking rates have not decreased as quickly as female smoking rates in recent years. That difference is likely to even grow in the future.  African-American men and women have higher tobacco-related cancer deaths compared to other racial groups.  This is related to both historically higher rates of smoking among African-Americans and the persistent observation that even at the same stage of diagnosis, the outcomes are worse and mortality is higher among African-Americans.  This is believed to be related to the quality of care provided and the consistency of follow-up.  The burden of tobacco-related cancers is worse in areas with low levels of education or higher levels of poverty.  These are areas where cancer rates are both higher and are going down slower.  There’s a lot that can be done.  We can support state and community-based efforts that have been proven to work.  We can fund comprehensive cancer and comprehensive tobacco control programs that do what works to reduce tobacco use.  Health care providers, systems and programs can make tobacco cessation treatment available to every smoker who wants to quit.  It’s important to remember that most Americans who've ever smoked have already quit.  Most Americans who continue to smoke want to quit.  The health care system should do everything possible to support them.  We can also protect non-smokers from secondhand smoke which also causes cancer by ensuring that all indoor public places, restaurants, bars, and casinos are smoke-free.  We know that funding for these programs will yield a return on investment.  States that invest in these initiatives and interventions will reduce tobacco users.  That will result in fewer people with cancer, fewer deaths, and reduced health care costs.  It has been estimate that the annual cost of caring for an ex-smoker is about $1,000 less than the annual cost of caring for a smoker.  The bottom line here - tobacco use causes at least 12 different types of cancer in addition to a wide range of other diseases, including heart attacks, strokes, the vast majority of cases of COPD, and much more.  There are currently more than 36 million smokers in the U.S., and sadly, about half of them will die from tobacco-related disease, if they don't quit.  This includes 6 million who will die from cancer unless we implement programs that will help them quit.  We’re focusing on cancer today and we know that helping people quit tobacco use for good and preventing others from starting to can save millions of lives. 

MICHELLE BONDS: Thank you, Dr. Frieden.  We’re now ready to take questions.  Operator?

OPERATOR: Thank you.  At this time if you would like to ask a question, please press star 1 you will be prompted to unmute your phone and record your name.  To withdraw your request, press star 2.  Once again, star 1 to ask a question.  One moment for those to come through. 

OPERATOR: Our first question comes from Pam Harrison with Medscape, your line is open. 

PAM HARRISON: Thank you.  I’m under the impression that only -- I mean anybody who is quit smoking who's going to quit has quit already.  You’re left with the really hard core, die hard addicted smokers.  Do you foresee the race coming down much further if that's really the core of smokers who are left? 

TOM FRIEDEN: That's actually a misconception.  That’s not what the data shows. It’s quite interesting. You might think that but when we look at the data, it, shifts from heavier smokers to lighter smokers. So, not only are fewer people smoking, but a larger portion of current smokers are lighter smokers.  They smoke less than a pack or half a pack a day -proportionately than the prior group of smokers and they’re more likely to be some day rather than every day smokers.  So, we’re seeing really good progress.  There are of course some people who are heavy smokers.  The pack a day smoker has actually become more and more rare.  I think there are many misconceptions when it comes to tobacco and smoking.  One of them that I think is very common is that smokers know how bad risks of tobacco use.  What we've learn over and over again is that first off, smokers underestimate the risks.  It’s not just cancer.  It’s not just lung cancer.  It’s not just heart disease, strokes, emphysema, COPD, it's a wide range of health conditions.  That’s why we're emphasizing 12 cancers here.  There’s also a clearer evidence that helping smokers quit can double or triple the likelihood that they will succeed.  Making cessation treatment widely available saves lives and saves money. 

PAM HARRISON: Thank you.  Could I ask a follow-up question? 

TOM FRIEDEN: Go ahead. 

PAM HARRISON:  Among the cessation that approaches that might help people quit smoking, would you include electronic cigarettes? 

TOM FRIEDEN: There are seven different FDA approved smoking cessation treatments.  All of those have been proven by rigorous trials to double or even triple the likelihood that a smoker who wants to quit, quit and tries will succeed.  We certainly recommend that virtually every smoker who wants to quit get one of those forms of treatment. Pregnant women and adolescents, special cases where that may not be indicated, but everyone else who wants to quit should get one of those seven medications.  Now we've heard stories of people who tried those medications, weren't able to quit and tell us they were able to quit using electronic cigarettes.  That’s a good thing.  Whatever has people stop smoking regular cigarettes can be very helpful, but no company has brought any electronic cigarette to the Food and Drug Administration in claiming that it can increase cessation rates.  In fact what we're seeing is the majority of Americans who use e-cigarettes are continuing to smoke.  So if you use e-cigarettes and you're able to completely stop regular cigarettes, that's a good thing.  If you use these cigarettes to enable you to keep smoking when you would have otherwise quit, that's a bad thing.  For anyone under 18, e-cigarettes are a really bad idea because they contain nicotine, it's addictive, and it's likely that a proportion of the kids who start using e-cigarettes will progress to using conventional cigarettes and could be addicted to nicotine and tobacco for life. 

OPERATOR: Thank you.  Our next question comes from Margarita Birnbaum with American Heart Association News.  Your line is now open. 

MARGARITA BIRNBAUM: Good afternoon, Dr. Frieden.  My question goes to cessation campaigns, targeted to suppress Hispanic groups. Specifically Puerto Ricans, Cubans and Mexicans in the U.S. have a higher rate of, smoking. I would like to know what can the CDC and health advocacy organizations do better in terms of targeting those Hispanic ethnic groups to reduce tobacco use, cigarette smoking, specifically in those populations? 

TOM FRIEDEN: Well there are very important differences both between and among different race and ethnic groups.  What we showed in this release was there are higher rates of cancer in men in low income areas, in areas with lower levels of education and among African- Americans. Among Hispanics, what we've seen generally is that the rate of smoking is lower than among white Americans, but there's a lot of variability between different groups with Mexican-Americans for example having lower rates of smoking, Puerto Ricans higher and Cubans much higher.  What’s important really is to have appropriate outreach the different groups.  Our tips from former smoker campaigns has been run in English and Spanish.  We’ve also reached out to African-Americans, Native Americans, Alaska native populations and we've had different real Americans telling their real stories to people from within their real communities.  That’s one of the reasons prosecute campaign has been so effective.  We also fund comprehensive tobacco controlled programs in states, territories, and jurisdictions throughout the U.S. and many have campaigns that are quite specific for the populations they work with.  Next question. 

OPERATOR: Once again, if you would like to ask a question, please press star 1.  One moment, please. 

TOM FRIEDEN: Okay.  Well I want to thank everyone for joining us.  Just a reminder to sum up that eliminating tobacco use may be the single best way to reduce cancer.  For those who smoke, quit.  For states and localities, funding comprehensive cancer and tobacco control programs will yield the return on investment from fewer tobacco users, fewer cancer diagnoses, fewer death and a health care system that can focus on keeping people healthy rather than caring for them when they have a serious or potentially fatal illness.  Thank you. 

MICHELLE BONDS: So thank you for joining us today.  For follow-up questions, please call the press office at 404-639-3286 or e-mail to media@cdc.gov.  Thank you for joining us and this concludes our call. 

OPERATOR: Thank you.  That does conclude today's conference.  Thank you all for participating.  You may disconnect your lines at this time.  

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES