Benjamin Toll, Ph.D., is excited and hopeful about the new national focus on smoking cessation.
He's spent his career helping people to stop smoking, so to see smoking cessation become an integral part of the federal administration's Cancer Moonshot is heartening.
"I've been doing tobacco treatment research since the late '90s, and no president since I've been doing this has taken on this specific issue as part of their administration," Toll said. "And multiple people said yesterday that this is part of what President Biden wants to do, so I was really energized by that, and I think it gives smoking cessation a lot of emphasis that will help highlight it for health care professionals."
Toll spoke after spending the afternoon at the White House as part of a Cancer Moonshot smoking cessation forum. Toll, the MUSC Hollings Cancer Center chief of Tobacco Cessation and Health Behaviors and co-director of the Lung Cancer Screening Program, was invited to participate because of his role as the president-elect of the Society for Research on Nicotine & Tobacco.
The Cancer Moonshot is a national effort to reduce deaths from cancer by 50% within 25 years and to improve quality of life for people with cancer and cancer survivors. A big part of that effort will be to increase the number of people who quit smoking because smoking leads to about 30% of cancer deaths in the U.S.
The smoking cessation forum included public comments from advocates and officials, including Andrea Palm, deputy secretary of the U.S. Department of Health and Human Services; Shereef Elnahal, M.D., undersecretary for health in the U.S. Department of Veterans Affairs; and Robert Califf, M.D., U.S. Food and Drug Administration commissioner. Following the public session, there was a brainstorming session by participants, including researchers and public health advocates.
"About half of our patients who come in for lung cancer screening currently smoke. So if we can increase rates of lung cancer screening, that would be a good way to increase rates of smoking treatment, too." Benjamin Toll, Ph.D.
Toll said a number of the suggestions covered policy changes that would make tobacco cessation counseling more accessible, like his own suggestion to improve Medicare coverage of tobacco cessation counseling and over-the-counter medications.
New rules that were put in place during the pandemic to enable easier access to telehealth might now be rolled back, which Toll warned could hurt progress in smoking cessation.
"In a state like South Carolina, many of our patients at Hollings drive three to four hours to come for care," Toll explained. "We can't expect them to come in person for smoking treatment. So we have to really push telehealth. A lot of payers, including Medicare and Medicaid, are putting the clamps down on telephone treatment reimbursement, and that's really going to hurt tobacco treatment counseling. Because a person is not going to drive for four hours, and especially if they're a senior citizen and don't have a computer and can't do a video visit, it's important that we cover phone-based treatments with insurance."
Other suggestions covered vaping; ensuring that vulnerable populations with high rates of smoking, like the LGBTQ community, are considered in smoking cessation efforts; pushing forward regulations to limit the amount of nicotine in cigarettes; and linking lung cancer screening with tobacco cessation programs.
"Those two things are yoked because about half of our patients who come in for lung cancer screening currently smoke," Toll said. "So if we can increase rates of lung cancer screening, that would be a good way to increase rates of smoking treatment, too."
Toll said the forum's suggestions will be incorporated into a working document for a national plan for smoking cessation treatment. He'd like to see some of the Cancer Moonshot's funding for cancer prevention go toward smoking cessation efforts.
"I'm hoping and certainly going to encourage that it be spent toward new smoking treatments – possibly research and certainly clinical care."
