The NATION

Health news at the national and federal levels

Emergency contraception set for
unrestricted over-the-counter sales
A
FTER YEARS of court
battles over the
accessibity of emergency
contraception, the drug wl
soon be avaable over the
counter and without age or
point-of-sale restrictions.
Advocates are haiUng the
latest court-directed turn-
around as a victory for sci-
ence and women's health.
"We are relieved that the
administration has finally
listened to science and
medicine and that women
of aU ages wul have access
to emergency contracep-
tion," said Nancy Stanwood,
MD, MPH, Physicians for
Reproductive Health board
chair. "For over a decade,
(our organization has)
endorsed an end to the
unfounded and harmful age
restrictions on this safe and
effective medication."
In April, a U.S. district
court judge ordered the
U.S. Food and Drug
Administration to make
emergency contraception
avaable over the counter
without restriction, citing
earlier actions by U.S.
Health and Human Ser-
vices Secretary Kathleen
Sebelius as "politicaUy
motivated, scientificay
unjustified and contrary to
agency precedent." In late
2011, Sebelius blocked
FDA's approval of emer-
gency contraception Plan
B One-Step's over-the-
counter application.
Unfortunately, the
Obama administration
appealed the Apr ruling.
Around the same time, FDA
approved an application to
offer Plan B over the
counter without a prescrip-
tion to girls and women
ages 15 years old and older,
though many advocates
questioned how 15-year-
olds ^vould be able to
prove their age without
government-issued identifi-
cation. But in June, the fed-
eral government dropped
its appeal, and FDA said it
' W1 allow the sale of one-
pi versions of emergency
contraception without age
restrictions beginning with
Plan B One-Step.
Before the April ruling,
women younger than 17
had to get a doctor's
prescription to access aU
forms of emergency
contraception.
"For pediatricians, the
science has always been
clear: Emergency contra-
ception is a safe, effective
tool to prevent unintended
pregnancy in adolescents
of any reproductive age,"
said American Academy of
Pediatrics President
Thomas Mclnemy, MD,
FAAP, in a joint news
release with the American
Congress of Obstetricians
and Gynecologists and the
Society for Adolescent
Health and Medicine.
"Since nearly 80 percent of
pregnancies in adolescents
are unintended, allowing
unrestricted access to
emergency contraception
products is a historic step
forward in protecting the
health of our patients who
are sexually active."
After the government
withdrew its appeal of the
Apr ruling, FDA invited
Plan B's manufacturer to
submit a supplemental
new drug application with
proposed labeling require-
ments that would aow the
drug to be sold over the
counter without age
restrictions. A June 10 let-
ter from a U.S. attorney to
U.S. District Court Judge
Edward Korman, who
issued the April ruling,
stated that upon receiving
the new drug application,
"FDA will approve it w^ith-
out delay." And on June 20,
FDA approved Plan B One-
Step as a nonprescription
product for all women.
FDA first approved Plan
B as an emergency contra-
ceptive for prescription use
in 1999, and Plan B's manu-
facturers first appUed to
offer the drug over the
counter a decade ago.
Emergency contracep-
tion can reduce the risk of
pregnancy up to 120 hours
after unprotected sex or
contraception faure.
For more information on
the recent court decisions,
visit www.reproductive
rights.org.
Kim Krisberg
CDC campaign stresses patient-doctor
relationship in kicking smoking habit
A
CENTERS FOR Disease
Control and Preven-
tion campaign to get smok-
ers to quit the habit
unveed a new approach
this spring: the importance
of talking with a doctor.
The Talk With Your Doc-
tor initiative is the newest
part of CDC's Tips From
Former Smokers Campaign,
which has used hard-hitting
ads since 2012 to show the
physical effects of smoking.
Ads for the new initiative
aired from May 27 through
June 2 with the tagline
"You can quit. Talk to your
doctor for help."
During a May 22 news
conference in Washington,
D.C., then-Surgeon General
Regina Benjamin, MD,
MBA, said patients whose
physicians advise them to
quit have a 66 percent suc-
cess rate for quitting, but
today one in five adults in
the U.S. still smokes.
"As physicians, we need
to discuss various forms of
assistance, such as nicotine
replacement therapy and
prescriptions," Benjamin
said.
The American Academy
of Pediatrics, American
Medical Association and
other physician groups
have partnered with CDC to
teach doctors to address
tobacco use with patients.
The American Academy
of Famy Physicians has
produced a toolkit that
includes resources such as
tip sheets in English and
Spanish about adopting
healthy habits to stay
smoke-free.
Jeff Cain, MD, FAAP,
president of the American
Academy of Famy Physi-
cians, said during the news
conference that patients
might think physicians are
too busy treating heart dis-
ease, lung disease or cancer
to have time to talk about
smoking, yet do not realize
that the No. 1 cause of
those diseases is smoking.
He said even if patients
have tried before but faed
or are embarrassed, physi-
cians are wiing to talk to
them about how^ to quit.
The new initiative also
encourages health care
providers to initiate discus-
sions on quitting with their
patients.
"Today I'm teUing you
that America's physicians
have been trained to talk
with you," Cain said. "They
have the time to talk with
you. They're able to talk
with you and they w^ant to
talk with you. The door is
open."
More pediatricians need
to talk with patients and
their parents about the
effects of secondhand
smoke, said Thomas Mcln-
emy, MD, MAAP, president
of the American Academy
of Pediatrics.
Only three out of 10
parents say their chdren's
physician asked them
about exposure to second-
hand smoke in the home
and only two out of 10
parents who smoked were
advised to keep their
homes smoke free, accord-
ing to data from the
National Social Climate
Survey of Tobacco Control.
The website for the cam-
paign features fact sheets
with tips for starting the
conversation with patients,
downloadable posters,
informational videos and
more.
For more information,
visit www.cdc.gov/tips/
hep. S
Natalie McCill
Photo by Natalie McGill
Terrie Hall, who is featured in CDC's Tips from Former Smokers
campaign, speaks at a May news conference in Washington, D.C.
Benjamin
completes term
as US, surgeon
general
S
URGEONS GENERAL of
the U.S. have the
opportunity to make a
major impact on the coun-
try during the years that
they serve, and Surgeon
General Regina Benjamin,
MD, MBA, W1 be remem-
bered for teaching America
how to walk again.
In response to Ben-
jamin's June 12 announce-
ment that she would be
stepping down in July,
APHApraised her service
as the 18th surgeon gen-
eral of the U.S. APHA
Executive Director Georges
Benjamin, MD, noted
Regina Benjamin's focus
on walking as exercise.
"She elevated walking
as a simple yet important
form of physical activity
available to most Ameri-
cans," he said in a state-
ment. "Through her walks,
she brought communities
together and worked to
make being healthy fun
again."
Georges Benjamin also
noted that as surgeon gen-
eral, Regina Benjamin con-
tinued the tradition of her
predecessors by advocat-
ing for reduced tobacco
use in the U.S. Two
tobacco reports released
during her tenure focused
on how tobacco smoke
causes disease and pre-
venting tobacco use
among youth.
During her four years of
service, Benjamin also led
the release of the National
Prevention Strategy, a
roadmap to guide health
partners at the local,
national and international
levels to reduce health dis-
parities and improve the
health of all Americans.
She noted in her
farewell statement that
there have been positive
trends in leading health
indicators, including
decreases in youth expo-
sure to secondhand smoke
and overall cancer deaths.
"(Benjamin) has been a
remarkable advocate in
promoting the value of
prevention as a national
health priority," Georges
Benjamin said. "We are
extraordinary grateful for
her strong public health
leadership."
Charlotte Tucker
THE NAT I ON' S HEALTH AUGUST 2 0 1 3