Notice2023-13928
Request for Information: Draft HHS 2023 Framework To Support and Accelerate Smoking Cessation
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
June 30, 2023
Issuing agencies
Health and Human Services Department
Abstract
The Department of Health and Human Services (HHS or Department) is issuing this request for information (RFI) to receive input from the public on the Draft HHS 2023 Framework to Support and Accelerate Smoking Cessation to guide the Department's efforts to sustain and strengthen existing programs and drive further progress toward smoking cessation, with an emphasis on serving populations and communities disproportionately impacted by smoking-related morbidity and mortality.
Full Text
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<title>Federal Register, Volume 88 Issue 125 (Friday, June 30, 2023)</title>
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[Federal Register Volume 88, Number 125 (Friday, June 30, 2023)]
[Notices]
[Pages 42377-42379]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-13928]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Request for Information: Draft HHS 2023 Framework To Support and
Accelerate Smoking Cessation
AGENCY: Office of the Assistant Secretary for Health (OASH), Office of
the Secretary, Department of Health and Human Services (HHS).
ACTION: Notice of request for information.
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SUMMARY: The Department of Health and Human Services (HHS or
Department) is issuing this request for information (RFI) to receive
input from the public on the Draft HHS 2023 Framework to Support and
Accelerate Smoking Cessation to guide the Department's efforts to
sustain and strengthen existing programs and drive further progress
toward smoking cessation, with an emphasis on serving populations and
communities disproportionately impacted by smoking-related morbidity
and mortality.
DATES: To be assured consideration, comments must be received at the
email address provided below, no later than midnight Eastern Time (ET)
on July 30, 2023. HHS will not reply individually to responders but
will consider all comments submitted by the deadline. Please do not
provide confidential information as comments may be published or
otherwise used for agency purposes.
ADDRESSES: Please submit all comments via email to
<a href="/cdn-cgi/l/email-protection#c58d8d9696a8aaaeacaba286a0b6b6a4b1acaaab83b7a4a8a0b2aab7aef7f5f7f685adadb6eba2aab3"><span class="__cf_email__" data-cfemail="60282833330d0f0b090e07230513130114090f0e2612010d05170f120b52505253200808134e070f16">[email protected]</span></a> as a Word document, Portable
Document Format (PDF), or in the body of an email. Please include
``Request for Information: Draft HHS 2023 Framework to Support and
Accelerate Smoking Cessation'' in the subject line of the email
message.
FOR FURTHER INFORMATION CONTACT: Please submit questions for further
information to Sarah Boateng, Principal Deputy Assistant Secretary for
Health. Email: <a href="/cdn-cgi/l/email-protection#80f3e1f2e1e8aee2efe1f4e5eee7c0e8e8f3aee7eff6"><span class="__cf_email__" data-cfemail="b2c1d3c0d3da9cd0ddd3c6d7dcd5f2dadac19cd5ddc4">[email protected]</span></a> at (202) 205-0725.
SUPPLEMENTARY INFORMATION: The mission of HHS is to enhance the health
and well-being of all Americans, by providing for effective health and
human services and by fostering sound, sustained advances in the
sciences underlying medicine, public health, and social services.
On February 22, 2022, President Joe Biden and First Lady Jill Biden
reignited the Cancer Moonshot, setting an ambitious, achievable goal:
to reduce the death rate from cancer by at least 50 percent over the
next 25 years and improve the experience of people and families living
with and surviving cancer, ultimately ending cancer as we know it.
Additionally, on January 20, 2021, President Biden signed Executive
Order 13985, Advancing Racial Equity and Support for Underserved
Communities Through the Federal Government, which directed the
Department to make achieving health equity part of its mission by
developing programs, policies, and activities to address the
disproportionately high and adverse health disparities in underserved
communities. Then on February 16, 2023, President Biden signed
Executive Order 14091, Further Advancing Racial Equity and Support for
Underserved Communities Through the Federal Government. This second
Executive Order reaffirmed the Administration's commitment to health
equity by extending and strengthening equity-advancing requirements for
agencies.
To support the executive order initiatives, and to pursue the
Administration's priorities for advancing health equity and driving
down cancer deaths, the Office of the Assistant Secretary for Health
(OASH) is leading the development of a framework to support and
accelerate smoking cessation. The Draft HHS 2023 Framework to Support
and Accelerate Smoking Cessation (the Framework) will provide direction
to enhance collaboration and coordination across HHS, and with Federal
and non-Federal stakeholders, drive further progress toward smoking
cessation and delivering equitable outcomes for all persons in America.
The draft Framework was developed with valued input from subject matter
experts across HHS Operating Divisions. The Framework aims to
accelerate smoking cessation and reduce smoking-related health
disparities by building on current activities and collaborations across
the Department, including work guided by the HHS Tobacco Control
Strategic Action Plan developed in 2010.
The scope is focused on cessation of the use of commercial
cigarettes, cigars, and cigarillos, for people of all ages across the
lifespan. The Department also recognizes the importance of tobacco use
prevention and cessation of other tobacco products. These issues as
well as those related to e-cigarettes are topics that are out of scope
for this phase but will be addressed in a later phase of this effort.
The purpose of this request for information (RFI) is to seek public
comment on the Draft 2023 Framework to Support and Accelerate Smoking
Cessation. Please see the Draft Framework below, followed by an RFI in
the form of questions to the public.
Draft U.S. Department of Health and Human Services 2023 Framework To
Support and Accelerate Smoking Cessation
Background
Cigarette smoking is the leading cause of preventable disease,
disability, and death in the United States, including about 30% of all
cancer deaths. Enormous progress has been made over the last 60 years
in driving down rates of cigarette smoking. In 2021, 11.5% of U.S.
adults smoked cigarettes, down from an all-time high of 42%, and two-
thirds (66.5%) of all adults who ever smoked cigarettes have quit.
Despite this progress, cigarette smoking still claims approximately
480,000 American lives every year.
Furthermore, the gains that have been made over the past several
decades have not occurred equally across the population, leaving behind
many of those who have the least resources and who face the greatest
barriers to quitting. Encouraging and assisting every person in America
to quit smoking is critical to ensuring a healthier future for all
people in America and to helping achieve the Cancer Moonshot goal of
reducing cancer death rates by at least half over
[[Page 42378]]
the next 25 years, a central part of President Biden's Unity Agenda,
issues areas where all of us can come together and make additional
progress for the American people. In fact, ahead of the President's
State of the Union, the Administration announced that helping Americans
avoid smoking in the first place and supporting Americans who want to
quit would be a major priority for the President's Cancer Moonshot this
year.
Vision
The Framework vision is to ensure that every person in America has
access to comprehensive, evidence-based cessation treatment and can
benefit from HHS cessation supports, programs, and policies.
Framework Goals
The Framework is organized around the six goals that serve as a
foundation for long-standing HHS efforts to support and promote
cessation. Moving forward, these goals will guide future HHS cessation
actions, building on the work that is already underway to achieve the
Framework vision.
The Framework identifies six goals.
1. Eliminate smoking- and cessation-related disparities
2. Increase awareness and knowledge related to smoking and cessation
3. Strengthen and sustain cessation services and supports
4. Increase access to and coverage of comprehensive, evidence-based
cessation treatment
5. Expand surveillance of smoking and cessation behaviors and
strengthen performance measurement and evaluation
6. Promote ongoing and innovative research to support and accelerate
smoking cessation
Cross-Cutting Principles
The Framework is underpinned by cross-cutting guiding principles
that apply across all six goals. These cross-cutting principles reflect
the Department's commitment to leveraging the best available smoking
cessation science, programs, and policies to reach diverse populations
and all communities across America.
<bullet> Advancing Equity: Employ culturallycompetent strategies that
support and accelerate cessation, focusing especially on groups with
high smoking prevalence and/or persistent cessation-related disparities
<bullet> Community Engagement: Ensure that the public, especially
communities that are disproportionately affected by smoking, are
engaged in the development and implementation of cessation programs,
policies, and infrastructure
<bullet> Coordination, Collaboration, and Integration: Promote
coordination, collaboration, and integration of programs and activities
across HHS to support the implementation and sustainability of
effective cessation practices, programs, and policies
<bullet> Evidence-Based Approaches: Leverage the strongest evidence
base to guide actions for cessation treatment and messaging, while
identifying research gaps and needs
Broad Strategies
Each of the six goals are supported by broad strategies to drive
progress toward smoking cessation at the population and individual
levels. HHS will advance the Framework goals through coordinated
strategies that leverage the full capacity and resources of the
Department, including continued support for ongoing activities that
serve these goals.
Goal 1: Eliminate Smoking- and Cessation-Related Disparities
Addressing disparities in smoking prevalence rates and cessation
outcomes is essential to achieving equitable progress in reducing
smoking-related morbidity and mortality. A commitment to health equity
involves understanding health disparities related to smoking and the
factors that cause these disparities. Through the Framework, HHS seeks
to execute broad strategies that will reach all communities and address
unique barriers to cessation experienced by disparately affected
groups.
Examples of broad strategies that advance this goal include:
<bullet> Promoting access to cessation resources that are culturally
competent and use consumers' preferred languages
<bullet> Engaging community partners in promotion and outreach to key
population groups, focusing especially on groups with high smoking
prevalence and/or persistent cessation-related disparities
<bullet> Building capacity for cessation services and supports in care
settings serving key populations
<bullet> Regulating the manufacturing, marketing, and distribution of
tobacco products to protect public health
Goal 2: Increase Awareness and Knowledge Related to Smoking and
Cessation
Raising knowledge and awareness about the harmful effects of
smoking and evidence-based cessation interventions drives attempts to
quit and promotes treatment utilization. Through the Framework, HHS
seeks to execute broad strategies that will increase awareness and
knowledge related to smoking and cessation.
Examples of broad strategies that advance this goal include:
<bullet> Expanding public education campaigns to increase knowledge
about the harms of smoking and the availability of cessation services
<bullet> Coordinating with Federal and non-Federal entities to share
cessation communication and education resources in order to amplify
their reach
<bullet> Promoting covered cessation treatments to insurance
beneficiaries and their health care providers
Goal 3: Strengthen and Sustain Cessation Services and Supports
To help people quit smoking, it is important to have strong
cessation supports in place with sustainable capacity and
infrastructure. Through the Framework, HHS seeks to execute broad
strategies that will support implementation of services that are
evidence-based, optimally effective, engaging, and sustainable.
Examples of broad strategies that advance this goal include:
<bullet> Strengthening and sustaining State and local cessation
programs and activities
<bullet> Working to ensure a baseline level of service for State
tobacco Quitlines
<bullet> Promoting connectivity and interoperability among HHS programs
and partnerships with other Federal and non-Federal entities
Goal 4: Increase Access to and Coverage of Comprehensive High-Quality
Cessation Treatment
Ensuring that high-quality, comprehensive cessation support is
accessible and affordable for all people in America is essential for
advancing smoking cessation. The Framework seeks to execute broad
strategies that will increase access to cessation treatment, especially
in settings serving population groups that experience barriers to
cessation and cessation-related disparities.
Examples of broad strategies that advance this goal include:
<bullet> Working with health insurers, payers, States, health care
facilities, community providers, and other stakeholders to remove
coverage barriers to treatment
<bullet> Ensuring that smoking assessment and treatment delivery and
referral are integrated into healthcare systems and connected to care
for other health conditions
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<bullet> Supporting, reimbursing, and evaluating innovative healthcare
delivery methods that support cessation and provide long-term support
to prevent and address relapse
<bullet> Promoting patient-centered approaches and ensuring that
cessation protocols are evidence-based
Goal 5: Expand Surveillance of Smoking and Cessation Behaviors and
Strengthen Performance Measurement and Evaluation
Expanding capacity for surveillance and evaluation is critical for
measuring progress, understanding barriers to quitting success, and
rewarding effective service delivery. Through the Framework, HHS seeks
to execute strategies that will support the measurement, monitoring,
and tracking of patterns, trends, and progress.
Examples of broad strategies that advance this goal include:
<bullet> Ensuring that surveillance systems can capture cessation-
related disparities and diverse tobacco use patterns
<bullet> Promoting development and use of common data elements
<bullet> Supporting program evaluation to ensure that high quality
smoking cessation and related services are provided
Goal 6: Promote Ongoing and Innovative Research To Support and
Accelerate Smoking Cessation
A robust evidence base exists to inform smoking cessation programs,
policies, and treatments. At the same time, it is essential to identify
what gaps exist in our current understanding of what works to
effectively address smoking cessation. Through the Framework, HHS seeks
to execute broad strategies that will support research efforts to
continually build the evidence base in this area.
Examples of broad strategies that advance this goal include:
<bullet> Increasing understanding of how to optimize current smoking
cessation interventions to maximize reach and treatment engagement and
effectiveness, particularly among populations disparately impacted by
smoking
<bullet> Supporting research on new cessation interventions
<bullet> Promoting sharing of data and resources generated by
federally-funded research
<bullet> Identifying research gaps
HHS is requesting information from the public regarding five
questions.
1. Are the proposed goals appropriate and relevant for addressing
the needs of populations disparately affected by smoking?
2. Do the broad strategies capture the key components and aspects
needed to drive progress toward increasing cessation?
3. Are there additional goals or broad strategies that should be
included in the Framework?
4. What targeted actions should HHS (Department-wide or within a
specific HHS agency) take to advance these goals and strategies?
5. What metrics and benchmarks should be included to ensure that
the Framework drives progress?
HHS invites all potentially interested parties--individuals,
associations, governmental and non-governmental organizations, academic
institutions, and private sector entities--to respond. HHS is
interested in the questions listed above, but respondents are welcome
to address as many or as few as they choose and may provide additional
relevant information that is within the scope of the Framework. To
facilitate review of the responses, please reference the question
number in your response.
This RFI is for planning purposes only and should not be construed
as a policy, solicitation for applications, or as an obligation on the
part of HHS to provide support for any ideas in response to it. HHS
will use the information submitted in response to this RFI at its
discretion and will not provide comments to any respondent's
submission. However, responses to this RFI may be reflected in future
initiatives, solicitations, or policies. Respondents are advised that
HHS is under no obligation to acknowledge receipt of the information
received or provide feedback to respondents with respect to any
information submitted.
Sarah N. Boateng,
Principal Deputy Assistant Secretary for Health, Office of the
Assistant Secretary for Health.
[FR Doc. 2023-13928 Filed 6-29-23; 8:45 am]
BILLING CODE 4150-28-P
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