Down But Not Out: Reflections from NCTOH 2025

The Hawai‘i contingent at NCTOH 2025

The National Conference on Tobacco or Health (NCTOH) remains one of the largest, long-standing gatherings for tobacco prevention and control professionals in the United States. It attracts a diverse set of public health professionals committed to advancing best practices and policies to reduce tobacco use, the nation’s leading cause of preventable disease and death. 

The last NCTOH, held in 2022 in New Orleans, now feels like a world away. At that time, the CDC’s Office on Smoking and Health (OSH) and the FDA’s Center for Tobacco Products (CTP) had a huge presence at NCTOH. They also had stable funding, racism had been declared a public health epidemic, and efforts to ensure fair access to health were front and center. The conference was a resounding success that year, leaving attendees energized and optimistic about what progress might be made by the next convening three years later. Naturally, our CTFH team at HIPHI was thrilled when NCTOH 2025 was announced in mid-2024.

By April of this year, however, many wondered if the conference would even happen.  Dr. Brian King, who had previously led FDA/CTP and worked at CDC/OSH, was forced out. Soon after, nearly everyone at CDC/OSH was terminated, effectively dismantling an office that had been vital since its creation following the 1964 Surgeon General’s report. While staffing cuts and reduced funding at FDA will hinder regulatory work, the gutting of CDC/OSH is almost unimaginable. As  Stat News reported, these actions represent “the greatest gift to the tobacco industry in the last half-century.” The full impact is still unfolding, but many health departments may not be able to sustain their programs, leaving entire states in limbo about whether their current funding will be their last. Against this backdrop, NCTOH moved forward.

This year’s conference, held in Chicago, IL, brought together a robust HIPHI team eager to learn how to navigate these new challenges, connect with colleagues across the country, and share Hawai‘i’s perspective. The opening plenary featured Dr. Brian King, now Executive Vice President for U.S. Programs at the Campaign for Tobacco-Free Kids, and Karla Sneegas, former Program Services Branch Chief at CDC/OSH. Together, they shared more than 60 years of federal experience. Dr. King struck an optimistic tone, reminding us that setbacks are not new to this movement—we’ve been knocked down before, but always get back up. 

Sneegas, still grappling with the abrupt dismantling of CDC/OSH, called it the “worst day in her 45-year career,” noting the cruel timing of a 5 a.m. April Fool’s Day email instructing staff to turn in their badges and computers. Notably, RAI Services Co., a subsidiary of Reynolds American, was the largest corporate donor to Trump’s campaign, contributing $10 million—a fact that left many in the field questioning whether there was a connection to these cuts. She also asked for a moment of silence for Officer David Rose, who was killed on August 12 during an attack on the CDC campus in Atlanta. Karla is now working to support the national network of advocates and urged us all to keep our heads high and continue the fight. This spirit set the tone for the conference. 

Over three days, NCTOH 2025 delivered a wealth of content: plenaries, panels, workshops, and poster sessions covering every aspect of tobacco prevention and cessation work. A highlight came from Illinois Senator Dick Durbin, who recounted his early battles against the tobacco industry, including his fight for smoke-free air travel.  He reflected on decades of challenges, underscoring the importance of persistence and the ability to negotiate with policymakers. His message echoed the conference’s theme: never give up.

There were just under 40 participants from Hawai‘i, representing a wide range of programs across the state, stemming from cessation to prevention. A few individuals had the opportunity to showcase their impactful work. The HIPHI team attended sessions reaching diverse youth and rural communities, managing e-cigarette waste, and tracking emerging products like nicotine pouches. Policy sessions explored many topics, including strategies to close legal loopholes, fight preemption, and defend local authority. Hundreds of posters were presented over two nights, including one by CTFH Program Manager Kevin Ramirez. His poster, 808NOVAPE: Utilizing Mural Arts in Prevention, highlighted HIPHI’s ‘Breathe Aloha’ murals in over a dozen schools across Hawai‘i. Many attendees praised the creative use of art to strengthen prevention campaigns. 

NCTOH 2025 was exactly the “shot in the arm” our movement needed with a chance to recharge, refuel, and recommit to eliminating the devastation caused by tobacco, which is still responsible for 490,000 preventable deaths annually in the U.S. 

The closing plenary, led by Dr. Pebbles Fagan, Director of the Center for the Study of Tobacco at the University of Arkansas for Medical Sciences, reminded the audience about the importance of continuing to advance health for all. She emphasized the importance of downloading and using the most recent Surgeon General’s Report—Eliminating Tobacco-Related Disease and Death: Addressing Disparities—before it is potentially removed from circulation. This report, she said, should serve as our roadmap for the future. 

The HIPHI team has taken this message to heart. We’ve heard the assignment, and we are ready to keep up the fight. For more information please visit https://www.hiphi.org/tobacco.