Physicians, take note: Majority of US adults support tobacco ban

By Jules Murtha | Fact-checked by Barbara Bekiesz
Published May 10, 2023

Key Takeaways

  • A study found that 57.3% of American adults support legislation that would ban the sale of all tobacco products.

  • The American Lung Association reports that 28 states and the District of Columbia have enacted comprehensive smoke-free laws. At present, 16 states and DC include restrictions pertaining to e-cigarettes.

  • Physicians can treat patients who smoke tobacco with a variety of methods ranging from pharmacotherapeutic interventions and behavioral support to nicotine replacement therapy (NRT), experts say.

In 2021, the FDA proposed a rule that would prohibit the sale of menthol-flavored cigarettes and ban all characterizing flavors (such as grape, strawberry, and cola) in cigars. Since then, Americans’ distaste for tobacco products has steadily increased—so much so that more than half of adults in the US would support policies that prohibit the sale of all tobacco products, according to a research brief from the CDC.[]

But it may take time for widespread legislation to be enacted, if ever. In the meantime, physicians can take matters into their own hands by recommending evidence-based treatments for their patients who smoke tobacco, such as pharmacotherapy, behavioral support, and NRT.

Americans favor banning tobacco products

Americans are increasingly supportive of policies that would keep tobacco products out of stores.

The research brief from the CDC reports on a study investigating tobacco ban support. The 6,455 participants were asked two questions: “To what extent would you support a policy to prohibit the sale of menthol cigarettes?” and “To what extent would you support a policy to prohibit the sale of all tobacco products?”

The results showed that 62.3% of adults would embrace a policy to ban the sale of menthol cigarettes, and 57.3% supported a prohibition of the sale of tobacco products entirely.

These findings may be surprising, especially given legislators have more recently focused on banning flavored tobacco products, not tobacco itself, according to an article published by StatNews.[]

Still, some experts believe that these results reflect the progressiveness of the public.

“The public is ahead of policymakers and even public health on this issue,” said Ruth Malone, in speaking to StatNews. Malone is a researcher on the tobacco industry at the University of California, San Francisco, and editor-in-chief of the journal Tobacco Controls.

Why not just ban smoking?

Gallup surveys have been tracking Americans’ views on tobacco and smoking for many years. 

Back in 2018, Gallup found that one in four US adults would like to prohibit smoking altogether.[]

While that’s an optimistic thought, some leaders in medicine believe banning the act of smoking would be ineffective at best.

“Prohibitions don’t work. They never do, they never will, they never have,” Jasjit Ahluwalia, MD, MPH, MS, a professor of medicine at Brown University, told StatNews.

"Instead of banning it … why don’t we help people quit smoking [and] why don’t we prevent people from starting?"

Jasjit Ahluwalia, MD, to StatNews

In the meantime, there are a handful of tried-and-true treatments that physicians can employ to help patients kick tobacco.

Treatments that do—and do not—help patients quit tobacco

Although policies on the sale of tobacco products vary across the nation, you can help patients to achieve smoking cessation regardless of where you live.

A meta-analysis published by JAMA, covering 19,488 individuals who smoked cigarettes, evaluated the efficacy of various treatments.[] 

Researchers found that the combination of medication and behavioral counseling resulted in a quit rate of 15.2% over 6 months, compared with “brief advice or usual care” (8.6%).

A separate study showed the 6-month quit rate was higher for patients prescribed varenicline (21.8%), bupropion (16.2%), or the nicotine patch (15.7%) than for those using placebo (9.4%).

Physicians may therefore have greater success in treating patients who smoke by using a combination of behavioral support with pharmacotherapy and NRT. 

As far as e-cigarettes, vapes, and other electronic nicotine delivery systems (ENDS), the FDA states there is insufficient evidence to support the claim that these products help smokers quit.[]

“To date, no e-cigarette has been approved as a cessation device or authorized to make a modified risk claim, and more research is needed to understand the potential risks and benefits these products may offer adults who use tobacco products,” the agency wrote.

On the contrary, ENDS may enable nicotine addiction among patients—especially youth.

The health risks associated with e-cigarettes prompted these devices to be included in the smokefree air laws among 16 states and Washington, DC, according to the American Lung Association.[]

It’s hard to say what legislation governing the sale of tobacco products will look like in the future. What’s for certain, however, is physicians’ ability to help patients quit smoking—and live a healthier and longer life by doing so.

What this means for you

More Americans than ever are advocating for legislation that prohibits tobacco sales to varying degrees. Although a total ban on tobacco products is unlikely, physicians can help patients improve their overall health by encouraging them to eliminate their use of tobacco. Effective methods include the combination of NRT or varenicline, along with pharmacotherapy and behavioral support.

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