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4 NEWS JANUARY 2011 • CHEST PHYSICIANNew COPD, Tobacco Goals SetHealthy People • from page 1those aged 18-21 years, and 7 or morehours for those aged 22 years and older(from 69.6% to 70.9%).Respiratory DiseaseThe respiratory disease category focuseson asthma and chronic obstructive pulmonarydisease, and the main goal is to“promote respiratory health through betterprevention, detection, treatment, andeducation efforts,” according to the report,which states that asthma affects 23million people in the United States andCOPD affects 13.6 million U.S. adults.The cost to the health care system ishigh, and society pays through higherhealth insurance rates and lost productivityand tax dollars. Annual expendituresfor asthma alone are estimated atnearly $21 billion.Healthy People 2020 seeks to reduceasthma-related deaths, hospitalizations,emergency department visits, activitylimitations, and missed school or workdays, and to increase the proportion ofasthma sufferers who receive appropriatecare. Improved surveillance at thestate level is another goal.IN THIS ISSUENews From the College • 14Editorial Advisory BoardCHEST PHYSICIAN’s editorialboard gains new members and adeputy editor. • 14CHEST PHYSICIAN Is OnlineCHEST PHYSICIAN is available onthe Web at www.chestnet.org/accp/chest-physician.For example, goals for 2020 in regardto asthma-related deaths include reductionsfrom 11.0 to 6.0 deaths per 1 millionpeople aged 35-64 years,and from 43.3 to 22.9 per1 million people aged65 and older. Goals regardingannual asthmarelatedhospitalizationinclude a reduction from 41.4to 18.1 per 10,000 children under age 5,from 11.1 to 8.6 per 10,000 people aged5-64 years, and from 25.3 to 20.3 per10,000 adults aged 65 years and older.Goals regarding appropriate asthmacare include improvements in the numberof patients who receive written asthmamanagement plans, instructions for inhaleruse, education about appropriate responseto an asthma episode, andfollow-up visits each year.COPD-related objectives include reducingactivity limitations, deaths, hospitalizations,and emergency departmentvisits, and improving diagnosis amongadults with abnormal lung function.Specific goals include a reduction from23.2 to 18.7 in the percentage of adultswith COPD aged 45 years and olderwith activity limitations from COPD,and a reduction from 112.4 to 98.5 in thenumber of COPD-related deaths per10,000 people aged 45 years and older.Tobacco UseTobacco use is not a new topic in theHealthy People initiative, but ongoing effortsto reduce use are needed, accordingto the report, because tobacco use remainsthe single most preventable causeof death and disease in the United States.About 443,000 Americans die from tobacco-relatedillnesses each year, and forevery 1 who dies, 20 more suffer with atleast one serious tobacco-related illness.Healthy People 2020 seeks to “providea framework for action to reduce tobaccouse to the point that it is no longer apublic health problem for the nation.”More than 4 decades of evidence hasshown that the toll tobacco use takes onfamilies and communities can be significantlyreduced by fully funding tobaccocontrol programs, increasing the pricesof tobacco products, enactingsmoke-free policies, controllingaccess to products,reducing tobaccoadvertising and promotion,implementing antitobaccomedia campaigns, andencouraging and assisting users to quit.Healthy People 2020 addresses tobaccouse prevalence, health system changes,and social and environmental changes.Among the key goals for adults are: Reducing the percentage of adult cigarettesmokers (from 20.6% to 12.0%). Reducing the percentage of adultusers of smokeless tobacco (from 2.3%to 0.3%). Reducing the percentage of adult cigarsmokers (from 2.2% to 0.2%).In adolescents, goals include reducingthe percentage of those who used tobaccoin the past month from 26% to21%, and reducing the percentages whosaid they used cigarettes, smokeless tobacco,and cigars in the past month from19.5% to 16%, from 8.9% to 6.9%, andfrom 14% to 8%, respectively.Initiation of tobacco use among children,adolescents, and young adults isalso addressed, with a goal of reducingit among those aged 12-17 years from7.7% to 5.7%, and among those aged 18-25 years from 10.8% to 8.8%.Numerous goals are also set in regardto health system changes, and social andenvironmental changes.For example, the report calls for increasesin comprehensive Medicaid coveragefor nicotine dependency treatment,increased tobacco screening and counselingin health care settings, reductions inthe proportion of nonsmokers exposed tosecondhand smoke, increases in the proportionof persons covered by worksitepolicies that prohibit smoking, and increasesin tobacco-free environments inschool facilities and at school events.Efforts should be made to eliminatestate laws that preempt stronger local tobaccocontrol laws, to reduce illegal salesto minors, and to reduce exposure to tobaccoadvertising and promotion among6th-12th graders. Also, federal and statetaxes on tobacco products should be increased,the report states.Healthy People 2020 has been in developmentsince 2007. A panel of healthexperts drew on input from public andprivate health officials, preventive medicineexperts, representatives from 2,000health organizations, and thousands ofpublic comments.The initiative expands upon topics fromHealthy People 2010, and will incorporatethe Internet and other media in spreadingthe message. The ultimate goals,according to HHS officials, are to avoidpreventable diseases and to promote improvedquantity and quality of life. ■COMMENTARYDr. Paul A. Selecky, FCCP,comments: Each of these topicsis very importanttog o o dhealth,and oftengo hand inhand, e.g.,C O P Dand tobaccouse. It’salso good news that sleep finallygot on the HHS radar. It is thethird important pillar of goodhealth, along with regular exerciseand a balanced diet. We area sleep-deprived nation with a“National Sleep Debt,” a termcoined by William Dement, atrue pioneer in sleep medicine.Sleeping longer on the weekendwill not repay that debt.AMERICAN COLLEGE OF CHEST PHYSICIANSEditor in Chief Paul A. Selecky, M.D., FCCPDeputy Editor W. Michael Alberts, MD, FCCPPresident David D. Gutterman, MD, FCCPExecutive Vice President and CEO Paul A. Markowski, CAESenior Vice President, Communications Stephen J. WelchManager, Editorial Resources Pamela L. GoorskyMedical Copy Editor II Peggy E. Perona, R.D.Section EditorsMarilyn G. Foreman, M.D., FCCP - Pulmonary Perspectives EditorLoren J. Harris, M.D., FCCP - Pulmonary Perspectives Deputy EditorNeil Halpern, M.D., FCCP - Critical Care CommentaryJames Parish, M.D., FCCP - Sleep StrategiesEDITORIAL ADVISORY BOARDJoseph Barney, M.D., FCCP, AlabamaJun Chiong, M.D., FCCP, CaliforniaStephen Field, M.D., FCCP, CalgaryRichard Fischel, M.D., FCCP, CaliforniaStuart M. Garay, M.D., FCCP, New YorkCarl Kaplan, M.D., FCCP, MissouriBurt Lesnick, M.D., FCCP, GeorgiaDarcy D. Marciniuk, M.D., FCCP, SaskatchewanJeana O’Brien, M.D., FCCP, TexasMarcos I. Restrepo, M.D., MSc, FCCP, TexasNirupam Singh, M.D., FCCP, CaliforniaE-mail: chestphysiciannews@chestnet.orgCHEST PHYSICIANCHEST PHYSICIAN, the newspaper of the American College of ChestPhysicians, provides cutting-edge reports from clinical meetings, FDAcoverage, clinical trial results, expert commentary, and reporting onthe business and politics of chest medicine. Each issue also providesmaterial exclusive to the members of the American College of ChestPhysicians. Content for CHEST PHYSICIAN is provided by InternationalMedical News Group and Elsevier Global Medical News. Content forNEWS FROM THE COLLEGE is provided by the American College ofChest Physicians.The statements and opinions expressed in CHEST PHYSICIAN do notnecessarily reflect those of the American College of Chest Physicians,or of its officers, regents, members, and employees, or those of thePublisher. 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