emergency contraception set for unrestricted over-the-counter sales

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Emergency contraception set forunrestricted over-the-counter sales

AFTER YEARS of courtbattles over the

accessibüity of emergencycontraception, the drug wülsoon be avaÜable over thecounter and without age orpoint-of-sale restrictions.Advocates are haiUng thelatest court-directed turn-around as a victory for sci-ence and women's health.

"We are relieved that theadministration has finallylistened to science andmedicine and that womenof aU ages wul have accessto emergency contracep-tion," said Nancy Stanwood,MD, MPH, Physicians forReproductive Health boardchair. "For over a decade,(our organization has)endorsed an end to theunfounded and harmful agerestrictions on this safe andeffective medication."

In April, a U.S. districtcourt judge ordered theU.S. Food and DrugAdministration to makeemergency contraceptionavaÜable over the counterwithout restriction, citingearlier actions by U.S.Health and Human Ser-vices Secretary KathleenSebelius as "politicaUymotivated, scientificaüyunjustified and contrary toagency precedent." In late2011, Sebelius blockedFDA's approval of emer-gency contraception PlanB One-Step's over-the-counter application.

Unfortunately, theObama administrationappealed the AprÜ ruling.Around the same time, FDAapproved an application tooffer Plan B over thecounter without a prescrip-tion to girls and womenages 15 years old and older,though many advocatesquestioned how 15-year-olds ^vould be able toprove their age withoutgovernment-issued identifi-cation. But in June, the fed-eral government droppedits appeal, and FDA said it

' WÜ1 allow the sale of one-piü versions of emergencycontraception without agerestrictions beginning withPlan B One-Step.

Before the April ruling,women younger than 17

had to get a doctor'sprescription to access aUforms of emergencycontraception.

"For pediatricians, thescience has always beenclear: Emergency contra-ception is a safe, effectivetool to prevent unintendedpregnancy in adolescentsof any reproductive age,"said American Academy ofPediatrics PresidentThomas Mclnemy, MD,FAAP, in a joint newsrelease with the AmericanCongress of Obstetriciansand Gynecologists and theSociety for AdolescentHealth and Medicine."Since nearly 80 percent ofpregnancies in adolescentsare unintended, allowingunrestricted access toemergency contraceptionproducts is a historic stepforward in protecting thehealth of our patients whoare sexually active."

After the governmentwithdrew its appeal of theAprÜ ruling, FDA invitedPlan B's manufacturer tosubmit a supplementalnew drug application withproposed labeling require-ments that would aüow thedrug to be sold over thecounter without agerestrictions. A June 10 let-ter from a U.S. attorney toU.S. District Court JudgeEdward Korman, whoissued the April ruling,stated that upon receivingthe new drug application,"FDA will approve it w ith-out delay." And on June 20,FDA approved Plan B One-Step as a nonprescriptionproduct for all women.

FDA first approved PlanB as an emergency contra-ceptive for prescription usein 1999, and Plan B's manu-facturers first appUed tooffer the drug over thecounter a decade ago.

Emergency contracep-tion can reduce the risk ofpregnancy up to 120 hoursafter unprotected sex orcontraception faüure.

For more information onthe recent court decisions,visit www.reproductiverights.org. •

— Kim Krisberg

CDC campaign stresses patient-doctorrelationship in kicking smoking habit

ACENTERS FOR DiseaseControl and Preven-

tion campaign to get smok-ers to quit the habitunveÜed a new approachthis spring: the importanceof talking with a doctor.

The Talk With Your Doc-tor initiative is the newestpart of CDC's Tips FromFormer Smokers Campaign,which has used hard-hittingads since 2012 to show thephysical effects of smoking.Ads for the new initiativeaired from May 27 throughJune 2 with the tagline"You can quit. Talk to yourdoctor for help."

During a May 22 newsconference in Washington,D.C., then-Surgeon GeneralRegina Benjamin, MD,MBA, said patients whosephysicians advise them toquit have a 66 percent suc-cess rate for quitting, buttoday one in five adults inthe U.S. still smokes.

"As physicians, we needto discuss various forms ofassistance, such as nicotinereplacement therapy andprescriptions," Benjaminsaid.

The American Academyof Pediatrics, AmericanMedical Association andother physician groupshave partnered with CDC toteach doctors to addresstobacco use with patients.

The American Academyof Famüy Physicians hasproduced a toolkit thatincludes resources such astip sheets in English andSpanish about adoptinghealthy habits to staysmoke-free.

Jeff Cain, MD, FAAP,president of the AmericanAcademy of FamÜy Physi-cians, said during the newsconference that patientsmight think physicians are

too busy treating heart dis-ease, lung disease or cancerto have time to talk aboutsmoking, yet do not realizethat the No. 1 cause ofthose diseases is smoking.He said even if patientshave tried before but faÜedor are embarrassed, physi-cians are wiüing to talk tothem about how^ to quit.

The new initiative alsoencourages health careproviders to initiate discus-sions on quitting with theirpatients.

"Today I'm teUing youthat America's physicianshave been trained to talkwith you," Cain said. "Theyhave the time to talk withyou. They're able to talkwith you and they w ant totalk with you. The door isopen."

More pediatricians needto talk with patients andtheir parents about theeffects of secondhandsmoke, said Thomas Mcln-emy, MD, MAAP, presidentof the American Academyof Pediatrics.

Only three out of 10parents say their chüdren'sphysician asked themabout exposure to second-hand smoke in the homeand only two out of 10parents who smoked wereadvised to keep theirhomes smoke free, accord-ing to data from theNational Social ClimateSurvey of Tobacco Control.

The website for the cam-paign features fact sheetswith tips for starting theconversation with patients,downloadable posters,informational videos andmore.

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 Smokerscampaign, speaks at a May news conference in Washington, D.C.

Benjamincompletes termas US, surgeongeneral

SURGEONS GENERAL ofthe U.S. have the

opportunity to make amajor impact on the coun-try during the years thatthey serve, and SurgeonGeneral Regina Benjamin,MD, MBA, WÜ1 be remem-bered for teaching Americahow to walk again.

In response to Ben-jamin's June 12 announce-ment that she would bestepping down in July,APHA praised her serviceas the 18th surgeon gen-eral of the U.S. APHAExecutive Director GeorgesBenjamin, MD, notedRegina Benjamin's focuson walking as exercise.

"She elevated walkingas a simple yet importantform of physical activityavailable to most Ameri-cans," he said in a state-ment. "Through her walks,she brought communitiestogether and worked tomake being healthy funagain."

Georges Benjamin alsonoted that as surgeon gen-eral, Regina Benjamin con-tinued the tradition of herpredecessors by advocat-ing for reduced tobaccouse in the U.S. Twotobacco reports releasedduring her tenure focusedon how tobacco smokecauses disease and pre-venting tobacco useamong youth.

During her four years ofservice, Benjamin also ledthe release of the NationalPrevention Strategy, aroadmap to guide healthpartners at the local,national and internationallevels to reduce health dis-parities and improve thehealth of all Americans.

She noted in herfarewell statement thatthere have been positivetrends in leading healthindicators, includingdecreases in youth expo-sure to secondhand smokeand overall cancer deaths.

"(Benjamin) has been aremarkable advocate inpromoting the value ofprevention as a nationalhealth priority," GeorgesBenjamin said. "We areextraordinarüy grateful forher strong public healthleadership." •

— Charlotte Tucker

T H E N A T I O N ' S H E A L T H • A U G U S T 2 0 1 3

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