In the earliest ads, Terrie Hall wears a scarf around her throat to cover the artificial voice box that helps her speak. She talks about smoking on the day of her surgery; how she wishes she’d recorded her voice so her grandchildren would know how she used to sound.
Two years later, just days before her death from cancer at age 53, Hall insisted on filming again from her hospital bed in North Carolina. In these ads, she’s not wearing scarves or her shining blond wig anymore. She urges people who smoke to keep trying to quit until they succeed. “I don’t want anybody to have to go through what I’m going through.”
Hall was one of dozens of people who have been featured in the Tips From Former Smokers campaign that launched in 2012, run by a division of the Centers for Disease Control and Prevention. The ads have been a remarkably effective tool in the push to help Americans stop smoking: When the television spots air, calls to the state-run 1-800-QUIT-NOW hotlines go up. When they stop, calls go back down. The CDC estimates that in the first five years of the campaign alone, an estimated 1 million Americans quit smoking, preventing 129,100 premature deaths.
But as of April 1, the Office on Smoking and Health — responsible for the Tips campaign along with other projects aimed at spotting trends in tobacco use and preventing it at the national and state levels — is effectively shuttered, the roughly 120 full-time employees who worked there dismissed along with the contractors who lost their jobs in February. That’s left the future of OSH initiatives unclear, including not just the Tips campaign, which continues to air for now, but also the annual National Youth Tobacco Survey, which helped spur federal action on the alarming uptake of Juul and other e-cigarettes among teenagers a few years back. States and U.S. territories, which received the bulk of OSH’s $240 million in funding, relied on the agency’s support to run quit hotlines — which provide callers with counseling as well as access to medications — and to introduce other anti-tobacco initiatives like cigarette taxes or restaurant smoking bans. OSH was also responsible for Surgeon General’s reports on tobacco use, which in recent years had focused on topics like health disparities in tobacco-related disease and death, smoking cessation, and e-cigarette use among young people.
Amid the 10,000 job cuts so far this month at the U.S. health department, what happened to OSH is “the greatest gift to the tobacco industry in the last half century,” said Tim McAfee, who headed the division from 2010 to 2017.
As nicotine pouches like Zyn gain popularity among young adults and Philip Morris International rolls out a pilot program in Austin, Texas, for its heated tobacco device Iqos, there is no longer an office responsible for spotting emerging trends in the use of tobacco products, McAfee and three recently fired agency employees told STAT.
“This isn’t even DOGE business as usual,” said McAfee. “There were drastic cuts throughout CDC. But there was nothing like what they did to OSH.”
A spokesperson for the Department of Health and Human Services wrote that it is “committed to investigating any potential roof [sic] causes of the chronic disease epidemic. Critical programs within the CDC will continue as part of Secretary Kennedy’s vision to streamline operations and create a more efficient HHS.”
National Jewish Health, a respiratory hospital that operates quitline services in many states, said that it had not been notified about any changes to funding since OSH was shut down. CDC funds cover 75% of smoking quitline costs in five states and two U.S. territories, and at least 25% of costs in an additional 18 states, according to the North American Quitline Consortium.
The end of OSH comes alongside dramatic changes at the Center for Tobacco Products at the Food and Drug Administration, including the elimination of the center’s management and regulation divisions and the ouster of top tobacco regulator Brian King and head scientist Matthew Farrelly. Sometimes perceived by outsiders as redundant offices, they performed different but complementary roles: the FDA’s tobacco office regulates products, while the CDC’s focused on people, monitoring and attempting to reduce tobacco use.
Since OSH’s program providing coordinated tobacco control support to states and territories began in 1999, the percentage of American adults who smoke has fallen from nearly a quarter to 10.8%, while smoking among high school students fell from 28% in 2000 to 1.4% last year. Former OSH employees now worry that progress will not only stall but be reversed.
Without continued investment from the federal government, “more people will start smoking and fewer people will quit smoking,” said Maggie Mahoney, a contractor who worked with OSH until February when her position was eliminated.
“There are some states where a large portion, if not a majority of their resources for tobacco prevention, were coming from CDC,” said an OSH employee affected by the cuts, who requested anonymity because of potential retaliation. “So I’m worried some states will either severely pare back their prevention activities or even close them down.” Twenty-two U.S. states still do not have comprehensive smoking bans for workplaces, restaurants, bars, and casinos.
The first months of the new Trump administration have been largely positive for the tobacco industry. In January, the administration withdrew a proposed ban on menthol cigarettes. Tobacco companies have also been urging government officials to crack down on illegal vapes from China, which was the subject of a congressional hearing last week. White House chief of staff Susie Wiles previously lobbied on behalf of tobacco company Swisher International. And Health Secretary Robert F. Kennedy Jr. reportedly popped a nicotine pouch from a tin of Tucker Carlson’s brand ALP during his confirmation hearings in January. “The right more generally has been embracing nicotine,” River Page wrote in January for The Free Press.
Tobacco companies are also faring well in the markets. Philip Morris International stock is up 72% from the same time a year ago, Altria Group is up 36%, and British American Tobacco is up 43%.
“It’s a perfect time to shut down the capacity of society to track what’s actually happening to our children,” McAfee said.
Kennedy was on a press tour out West last week touting plans to combat chronic disease in the U.S., often emphasizing concerns about the effects of food additives and dyes. But smoking remains the leading cause of preventable death and disease, making the elimination of the agency all the more confounding to ex-OSH employees.
“If you’re really worried about the ingredients in cereal,” said one former worker, “wait until you find out about the thousands of chemicals that are contained in cigarettes.”
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.
