Cancer Panel Attacks Tobacco Industry and Government

WASHINGTON, Aug. 17 -- The President's Cancer Panel blasted industry policies and government inaction for failing to help the public make lifestyle changes needed to protect against cancer.

Calling the tobacco industry a "vector of disease and death," the panel's 2006-2007 report cited government failure to tax and regulate tobacco use and exposure to environmental smoke, the lack of available and affordable healthy foods, and limited physical education in school as having spawned a "culture that struggles to make healthy choices-a culture in dire need of change."

Appointed by the President, the panel members included Margaret L. Kripke, Ph.D., of M.D. Anderson Cancer Center, LaSalle D. Lefall, Jr., M.D., of Howard University, who served as chairman, and cycling champion and cancer survivor Lance Armstrong.

The year 2007 brought the steepest decline in cancer deaths ever recorded in the U.S., the panel members reported. Yet this year alone, they said, "more than half a million Americans will lose their battle with cancer. Tragically, nearly two-thirds of these deaths could have been prevented through changes in lifestyle."

Examining primary care and individual responsibility, the panel wrote that although efforts have been made to halt alarming obesity trends, the number of organizations and institutions committed to healthy living is still too small.

Physicians and health care providers have a crucial role in helping patients understand the increased risk for many cancers related to obesity, yet their efforts have been stymied by inefficient or absent policies, the panelists said.

For example, they noted, the services of a nutritionist or dietitian are seldom reimbursed outside of specialized cardiac or diabetes management programs.

The panel called for increasing disease prevention services, including providing physicians with more time to counsel patients, and ensuring that nutrition and physical activity interventions become an integral and reimbursable component of primary care.

The recommendations did not let patients off the hook, though. "Individuals -- to the best of their ability -- must assume personal responsibility for learning cancer risks associated with obesity and tobacco use in order to make healthy lifestyle choices for themselves and their families," the panel said.

The Panel's recommendations for diet and exercise were:

• Structure U.S. agricultural subsidies to encourage increased production of fruits and vegetables and limit subsidies that promote production of high fructose corn syrup for use in food.
• Regulate and monitor food advertising in media targeting children.
• Improve access to affordable healthy foods in urban communities by implementing "fair food" policies similar to fair housing policies.
• Replace unhealthy food choices in school food service facilities and vending machines.
• Make nutrition information about restaurant foods readily available.
• Private and public health insurance should provide coverage for nutrition counseling and fitness programs as part of all health-benefit packages.
• Reinstate school physical education at meaningful levels in grades K-12.
• Plan new communities that encourage physical activity and redesign existing communities by installing sidewalks, improved community centers, parks, and playgrounds.

An extended list of recommendations to reduce smoking and environmental smoke exposure included:

• Authorize the FDA to regulate tobacco products and marketing and provide adequate funding to carry out this role.
• Increase the federal excise tax on tobacco products.
• Require all federal facilities to be smoke free. Reallocate existing NCI and CDC, and other federal resources to better mirror the tobacco-related disease burden.
• Reduce the influence of the tobacco industry: Candidates for office should refuse campaign contributions from the industry, and recipients of NCI grants and contracts should not accept money from tobacco companies.
• Strengthen anti-tobacco efforts at the state and local levels including smoking bans, particularly in public facilities, and increased taxes.
• Cease including images of smoking in movies, TV, music videos, and games children, adolescents, and young adults.
• Prohibit smoking in and around the workplace, and support worker efforts to quit.

"Individuals can only adopt healthy lifestyles if they have the resources and opportunities to do so," the panel wrote in a letter to the President. "We can and must empower individuals to make healthy choices through appropriate policy and legislation, and the Panel urges you to use the power of your office toward this life-saving goal."