In 2020, the number of middle and high school students who use e-cigarettes decreased by 1.8 million compared to 2019, the Centers for Disease Control and Prevention and U.S. Food and Drug Administration reported in the results of the 2020 National Youth Tobacco Survey. However, the results also showed that youth tobacco use is still an epidemic in the United States.

Like cancer, viruses know no political parties, no country boundaries, and no personal attributes. As the COVID-19 coronavirus spread in an infectious wave across the earth in record time, it decimated economies and devastated populations. To defend their countries against an invisible enemy, governments around the world stepped in with unprecedented command.

The global COVID-19 coronavirus pandemic has forced elected officials and political leaders to reevaluate the provision of health care in the United States. To address inequal access to care and representation among health professionals, on April 24, 2020, U.S. Representative Jan Schakowsky (D-IL) and Democratic Whip and U.S. Senator Dick Durbin (D-IL) introduced the Health Heroes 2020 Act, a bicameral piece of legislation.

When standing up for patients, championing treatments, or stopping an unfair process, nurses speak truth to power. Being on the front lines is part of every nurse’s routine, but many shy away from engaging in the policy world under similar circumstances that affect the profession, patients, and peers. It doesn’t have to be that way. Nurses can educate themselves on the candidates and policy issues and lend their voice to the political conversation.

On April 1, 2020, the U.S. House of Representatives Subcommittee on Economic and Consumer Policy asked the U.S. Food and Drug Administration (FDA) to clear the market of e-cigarettes because of the COVID-19 coronavirus pandemic. It was responding to FDA’s request to give e-cigarette manufacturers four additional months to submit applications to stay on the market before enforcing a ban.  

The public push for a transformation in tobacco policy began with a persistent legislator seeking real change. Opening his historic congressional hearing in 1994, U.S. House of Representatives Energy and Commerce Committee Chair Henry Waxman (D-CA) said, “The truth is that cigarettes are the single most dangerous consumer product ever sold. Nearly a half million Americans die every year as a result of tobacco. This is an astounding, almost incomprehensible statistic. Imagine our nation’s outrage if two fully loaded jumbo jets crashed each day, killing all aboard. Yet that is the same number of Americans that cigarettes kill every 24 hours. Sadly, this deadly habit begins with our kids. Each day 3,000 children will begin smoking. In many cases they become hooked quickly and develop a life-long addiction that is nearly impossible to break.” 

A day after President Donald Trump was considering lifting some of the quarantine mandates, healthcare leaders from the American Hospital Association, American Medical Association and American Nurses Association (ANA) released an open letter urging Americans to stay home.

Change at the federal level takes time and perseverance. Thanks to great effort from the smoking cessation community—including ONS—the federal government is updating package and advertising warning for tobacco products for the first time since 1984. Advocates have been calling on agencies to exercise authority over tobacco products along with their marketing and distribution, and on March 17, 2020, the U.S. Food and Drug Administration (FDA) issued a final rule requiring new health warning labels for cigarette packages and advertisements.

The alarmingly quick spread of the COVID-19 coronavirus has put a strain on the U.S. healthcare system, including the availability of personal protective equipment and other safety resources. The speed at which the virus spreads requires an even swifter response from federal agencies, government officials, and public health experts to combat the disease. To cut the red tape and accelerate data collection, the Department of Health and Human Services (HHS) has used statutory authority under the Paperwork Reduction Act to survey Health Resources and Services Administration healthcare institutions to understand the current COVID-19 response, challenges institutions are facing, and ways to help.

Drug pricing is a top legislative issue for Congress, and amid rising COVID-19 concerns, health policy topics are more pressing than ever. On March 5, Senator Martha McSally (R-AZ) introduced the Lowering Prescription Drug Prices for America’s Seniors and Families Act of 2020, which would allow Medicare to negotiate prices after a drug’s patent expires as well as cap out-of-pocket prescription spending for seniors at $3,100 per year.

Medical cannabis has been approved for use in more than 33 states, many of which have decriminalized its use as well, and a health policy wave has spread across the country through state referendums to ease the burden for legalizing cannabis for health purposes. It’s a different world than it was 30 years ago, and the National Institute on Drug Abuse (NIDA) is frequently called to testify before Congress to address concerns and questions from lawmakers.

Further understanding of the human genome and the proliferation of genetic data has spurred significant advancement in the understanding of the way cancer impacts individuals. To share the crucial work in genetics, the National Institutes of Health (NIH), led by the National Institute for Cancer (NCI), has compiled survivor stories from patients who have benefited from cutting-edge genomic technology. Their stories illustrate and contribute to the ongoing successes brought on by NIH’s genomic efforts.

Patient-centered research is vital in the effort to move the needle in cancer care, and nurse researchers rely on funding from organizations like the Patient-Centered Outcomes Research Institute (PCORI) to support new and ongoing studies. In December 2019, the U.S. House of Representatives approved the Further Consolidation Appropriations Act, 2020 (H.R. 1865), extending funding for PCORI through fiscal year 2029.

Since 1981, more than 700,000 Americans have died from HIV/AIDS. Nearly 32 million people have died worldwide, and experts suggest that almost 38 million are currently infected with the virus. In the decades since the disease was first discovered, HIV/AIDS treatments have advanced, providing patients with a chance to manage a once-deadly diagnosis. With an active and outspoken community of advocates, patients with HIV/AIDS have seen a swell of support.

Uninsured women or women on Medicaid are at a greater risk to develop advanced stage III breast cancer compared to women with health insurance, according to the results of a National Institutes of Health (NIH)-funded study reported in JAMA Oncology. Naomi Ko, MD, and Gregory Calip, PhD, noted that up to 47% of racial and ethnic disparities in advanced stage breast cancer could be mitigated by health insurance coverage.

As part of its focus to dismantle the 2010 healthcare law, the GOP repealed the Affordable Care Act individual mandate in 2017. Republican state attorneys general then challenged the law’s constitutionality in a series of lower court cases, and the most recent has been lingering in federal courts for more than a year. On March 2, the Supreme Court agreed to take up the issue, marking the third time the law will be heard at the highest court in the country.  

When oncology nurses speak, people listen. An op-ed column published February 24, 2020, written by ONS member Janice Phillips, PhD, RN, FAAN, outlined the potential harm to the future of health care and the nursing profession if the Trump administration’s budget cuts are approved. As an oncology nurse, Phillips’ insights have made a difference in Washington before, and she explained that the budget cuts could target key funding for items like nursing development and workforce programs.

The growing rates of teen vaping and e-cigarette use have been a focal point at the national legislative level for the past several years. From the U.S. surgeon general’s youth vaping epidemic announcement to the investigation of vaping industry leader Juul, congressional representatives have been busy addressing the issue.

During the Year of the Nurse, many organizations are finding ways to promote and champion the expertise and experiences that make up the most trusted profession in the United States. The American Association of Colleges of Nursing (AACN) is focusing on ways nurses will affect the upcoming presidential election, ensuring nursing professionals are registered, educated, and ready to vote in 2020.

Although most cancers contain four to five driver mutations, those drivers remain unknown for about 5% of cancers, according to results of a series of studies examining genomes from 38 different cancer types. The international Pan-Cancer Analysis of Whole Genomes Consortium reported the findings in a collection of 23 articles published in Nature and other affiliated journals.

Only 65% of all U.S. teens have received the first dose of the human papillomavirus (HPV) vaccine—and only 48.6% of those teens are up to date with the series of HPV vaccinations. Studies have shown the HPV vaccination is effective at reducing the rates of cervix, vaginal, anal, and penile cancers. HPV vaccination rates have become a national health prevention priority, and oncology nurses can help lead the discussion about ways to prevent more than 90% of all HPV-related cancers.

Despite restrictive legislation raising the age of purchase for tobacco products to 21, vaping remains a top legislative concern, and some believe that vaping restrictions are already out of date. For nearly two decades, youth smoking rates were on the decline. After e-cigarette companies like Juul brought their products to market, those rates have seen a sharp uptick and led the U.S. surgeon general to declare a youth smoking epidemic. Although some progress has been made, the issue remains a top priority for organizations like ONS and its members.

By all accounts, the 2020 political environment is one of the most contentious in American history. The two parties that dominate the political system, liberal and conservative, are even more entrenched in their separate ideals and doubling down during the presidential election cycle. The federal budget, immigration, and health care are the top issues discussed around the watercooler, kitchen table, and coffee shops—and of course the president’s impeachment is looming large.

The Iowa Democratic Caucus did not go as smoothly as the political prognosticators expected. Most news outlets are only reporting the level of dysfunction with a voting app that delayed the final numbers significantly, but beneath that is one truth that still rings true: Americans want solutions to their healthcare problems. Health care remained the number one policy issue for 41% of caucus attendees, an astoundingly high rate that beat every other issue handedly.

The Centers for Medicare and Medicaid Services (CMS) has been trying to find new avenues to implement a conservative approach to Medicaid spending at the state level. At the end of January 2020, the agency introduced a program that enables states to convert funding into block grants and determine how best to allocate health funding in their own jurisdictions.

The pre-existing condition coverage component of the Affordable Care Act is a bipartisan plank that connects every policy conversation about health care. Public opinion overwhelmingly supports maintaining clauses to protect coverage for those with pre-existing conditions—like cancer—through treatment and survivorship, particularly as people change jobs and insurance companies.

Smoking cessation efforts had been gaining ground for decades. Tobacco use and smoking rates were dropping, year after year, as prevention and awareness campaigns worked to codify the dangers of tobacco. People weren’t just quitting smoking; people were avoiding the habit altogether—until the advent of vaping. Reversing a decade-long decline in smoking rates, e-cigarettes and vaping products have engendered an entirely new generation of would-be smokers to pick up the habit. Targeting underage users, the vaping industry experienced a boom. The issue grew with such ferocity that the U.S. Surgeon General declared a youth vaping epidemic in 2019.

To better understand the demands and demographics of the larger RN community, the Health Resources Services Agency (HRSA) compiled data from the National Sample Survey of RNs (NSSRN). Released in January 2020, the report is a compendium of information and questions RNs have answered about different aspects of the life and work. The data collected since 1977 provides insight into the latest trends and future workforce projections, and HRSA uses it to help allocate workforce resources.

In 2020, approximately 13,800 new cases of invasive cervical cancer will be diagnosed in the United States. Prevention and screening are critical to reducing its incidence, and the U.S. Department of Health and Human Services (HHS) launched an awareness campaign in January in recognition of Cervical Health Awareness Month. The movement educates women about cervical cancer risks, how and when to get the human papillomavirus (HPV) vaccine, the vaccine’s impact on cancer rates, and how to promote awareness.

The push and pull of budget negotiations makes for great headlines, but more important is the outcome when lawmakers finally arrive at a consensus. Earlier in December, the National Institutes of Health announced a $2.6 billion overall increase in funding, including a $297 million increase to the National Cancer Institutes (NCI), for fiscal year 2020.

In celebration and recognition of Florence Nightingale’s 200^th birthday, the World Health Organization (WHO) designated 2020 as the “Year of the Nurse and Midwife.” As part of this initiative, WHO is holding seminars, publishing papers, and is developing the first-ever State of the World’s Nursing report which will release at the 73rd World Health Assembly.

Congress returned from the winter holiday season to an administrative announcement partially curtailing flavored e-cigarettes and vaping mechanisms. Additionally, the U.S. Food and Drug Administration (FDA) began the year with the announcement of a new policy prioritizing enforcement against certain unauthorized flavored e-cigarette products to help curb the youth smoking epidemic. However, to the chagrin of the smoking cessation community, FDA is still allowing menthol and traditional tobacco flavors to be sold as usual, and reports have indicated that teens and other underage users will still opt for traditional products if they’re available.

Amid the epidemic levels of youth use of e-cigarettes and the popularity of certain products among children, the U.S. Food and Drug Administration today issued a policy prioritizing enforcement against certain unauthorized flavored e-cigarette products that appeal to kids, including fruit and mint flavors. Under this policy, companies that do not cease manufacture, distribution and sale of unauthorized flavored cartridge-based e-cigarettes (other than tobacco or menthol) within 30 days risk FDA enforcement actions.

Constitutional provisions, whose primary purposes are to create obstacles, govern the process that a bill goes through before it becomes law. The founders believed that efficiency was the hallmark of oppressive government, and they wanted to be sure that laws that actually passed all the hurdles were the well-considered result of inspection by many eyes.

Participants in ONS’s Fourth Annual Capitol Hill Days quickly saw the fruits of their efforts when two ONS priority bills were passed in the U.S. House of Representatives in October 2019. The yearly advocacy, education, and training event, held September 22–24, brought 110 ONS activists to Washington, DC, for two days of sessions, briefings, updates, and meetings. The advocates engaged in 55 hours of intensive political and policy analysis, enabling them to take the Society’s health policy priority agenda to the U.S. Congress and help transform the future of health care in the United States.

The Elijah E. Cummings Lower Drug Costs Now Act of 2019, otherwise known as H.R. 3, is a top priority for House Speaker Nancy Pelosi (D-CA). But she’s facing challenges from progressive Democrats on her left more so than the conservative Senate on her right. Watering down provisions in H.R. 3 too much will lose her the votes she needs to pass the bill in the House, but passing a bill that’s too overarching or progressive will allow Senate Majority Leader Mitch McConnell (R-KY) to refuse to take up the legislation at all.

Addressing the rising costs of prescription medications is a key priority for the Trump administration. As patients struggle with the financial burden of high drug prices, the U.S. Food and Drug Administration is reviewing options to import medications from Canada at a lower cost to consumers. However, the plan has major hurdles that FDA must address before it can become a reality.

The vaping conversation has drawn the attention of everyone on Capitol Hill, and it’s been a contentious debate so far. Tensions were high at the White House during a meeting with smoking cessation advocates after the Trump administration decided to step back from promises to ban flavored vaping products.

In 2018, long-time National Institute of Nursing Research (NINR) Director Patricia Grady, PhD, RN, FAAN, retired. A national search yielded no new directors, and the National Institutes of Health appointed Principal Deputy Director Lawrence Tabak, DDS, PhD, to serve as acting NINR director. However, when the director of the National Institute of Dental and Craniofacial Research announced she would retire at the end of 2019, Tabak, who previously served as the dental agency’s director, was appointed as the obvious replacement.

Throughout the country, Americans have seen the effects of opioid abuse. Rising numbers of overdoses have sent shockwaves through communities from Miami to Seattle and everywhere in between. As such, addressing the national opioid epidemic is still a major priority for the Trump administration.

Tobacco products are under more scrutiny than ever before. With the rise in youth vaping, the advent of flavored e-cigarettes, and the production of other nicotine delivery systems, the U.S. Food and Drug Administration (FDA) has tightened its review process for new products. The agency is looking to the smoking cessation community, taking insight from the Trump administration, and weighing feedback from other elected officials in the Senate and House of Representatives for ways to protect public health. That said, companies are using technology to create new tobacco-based products, and FDA must find ways to assess harm while balancing free market interests.

Once considered a death sentence, a cancer diagnosis was distressing and difficult on many levels. However, for the past 50 years the United States has been committed to finding treatments and cures for cancer; we have turned a corner, reversing devastating trends and changing the prognosis to one of survivorship for many.

ONS is a critical voice in the advocacy arena, helping to steward bills that are important to the future of oncology nursing practice and successful patient-centered care. On October 28, 2019, two ONS priority bills—the Palliative Care and Hospice Education and Training Act (H.R. 647) and the Title VIII Nursing Workforce Reauthorization Act of 2019 (H.R. 728)—passed the U.S. House of Representatives with unanimous bipartisan support.

As the largest ONS chapter in the United States with more than 2,000 members, the Houston ONS Chapter is primed to make an impact with the state’s lawmakers. In August 2019, chapter members did just that, combining forces with other local chapters for a pilot event featuring ONS policy education and advocacy training deep in the heart of Texas. Almost 100 ONS members participated to get support and education to speak with decision makers about the needs of the profession as well as the patients oncology nurses serve.

The evidence is clear: Nicotine is an addictive substance. Even current smokers acknowledge its power, and addiction information is required in advertisements and product promotions. Despite tobacco’s known issues, people still smoke at alarming rates. With vaping, e-cigarettes, and flavored tobacco being introduced to younger and younger consumers, youth smoking is on the rise for the first time in decades.

The youth vaping epidemic has dominated headlines since the U.S. surgeon general elevated the issue to the nation’s spotlight. In a 2019 survey of junior high and high school students, the National Institute on Drug Addiction (NIDA)—an arm of National Institutes of Health—found that the rate of e-cigarette use had doubled since 2017.

With the 2020 presidential election cycle in full swing, some Democratic candidates are pushing an aggressive proposal to combat the rising costs of prescription drugs by potentially ending patents for high-cost medications. Breaking the patent of an existing drug to allow competitors to make a cheaper version is a bold step to combat the drug pricing issue, but the potential proposal doesn't seem to be getting much negative push back from either side of the aisle. Many see it as a way to keep the industry in check, and the provision makes for great political fodder on the campaign trail.

Reaching a broad audience, Department of Health and Human Services (HHS) Secretary Alex Azar spoke to the American Cancer Society’s Cancer Action Network in early September 2019 about the state of healthcare delivery in the United States and outlined the Trump administration’s priorities. Azar praised advocates for being leaders in promoting more investments for education, prevention, and research, and he noted the laudable achievements thus far.

Designated as a national epidemic, opioid addiction and abuse are front and center at the federal level as lawmakers work to support the discovery of new treatments and resources to curb the growing problem. The National Institutes of Health (NIH), with support from the White House, Congress, and the Department of Health and Human Services, awarded $945 million in funding for grants, contracts, and cooperative agreements across 41 states for the Helping to End Addiction Long-Term (HEAL) Initiative. Targeting novel chronic pain interventions, opioid abuse, and the addiction crisis, the HEAL Initiative will funnel funding and resources into efforts that can make an impact immediately and in the future for healthcare providers and their patients.