Progress in cancer fight, but Congress, States must step up efforts to reduce smoking, lung cancer

Nov 26 2008

Delivering good news for our nation's health, a new report released by the nation's leading cancer organizations finds that, for the first time, both the incidence and death rates for all cancers combined are decreasing for both men and women, driven in part by declines in smoking and lung cancer.

The report attributes much of the overall progress to declines in the three most common cancers among men (lung, colon/rectum and prostate) and the two most common cancers among women (breast and colon/rectum), combined with a leveling off of lung cancer death rates among women.

This report provides powerful and concrete evidence that efforts to reduce smoking, particularly at the state and local level, are paying off by saving lives and improving health. However, the report also provides troubling evidence that the federal government and the states are not doing nearly enough to implement scientifically proven solutions to reduce smoking. Lung cancer - the vast majority of which is caused by smoking - remains by far the leading cancer killer among both men and women. In addition, there are large state and regional disparities in lung cancer trends, especially among women, and these disparities not surprisingly coincide with higher smoking rates and fewer tobacco control activities. There is no question that, to win the war against cancer, we must also step up the fight against smoking, which causes 30 percent of all cancers, according to the U.S. Surgeon General.

In many ways, we have become a nation of haves and have-nots when it comes to reducing smoking and lung cancer. The most successful states have implemented a comprehensive, scientifically proven strategy that includes higher tobacco taxes, smoke-free workplace laws and well-funded tobacco prevention and cessation programs. In California, the first state to implement such a comprehensive strategy, lung cancer death rates declined an average of 2.8 percent per year among men from 1996 to 2005, more than twice the decline seen in many states in the Midwest and the South, the new report shows. In contrast, lung cancer death rates among women increased from 1996 through 2005 in 13 states and decreased only in three. As the report notes, these 13 states have higher percentages of female smokers, low tobacco excise tax rates, fewer tobacco control activities and local economies that are traditionally dependent on tobacco farming and production.

Every single case of tobacco-caused cancer is ultimately preventable. There is no question that we know how to dramatically reduce smoking and the many cancers and other devastating diseases it causes. What's needed is the political leadership to more aggressively implement these solutions nationally and in every state. Recent landmark reports by the Institute of Medicine and the President's Cancer Panel have agreed on the steps that Congress and the states must take to accelerate declines in tobacco use - and eventually eliminate the death and disease it causes:

• Congress should enact long-overdue legislation granting the U.S. Food and Drug Administration authority to regulate the manufacturing, marketing and sale of tobacco products. The U.S. House of Representatives on July 30 voted 326 to 102 to approve this legislation, and it has 60 sponsors in the Senate, including President-elect Barack Obama and Senate Majority Leader Harry Reid. Among other things, this legislation would crack down on tobacco marketing and sales to kids; require larger, more effective health warnings on tobacco products; require tobacco companies to disclose the contents of tobacco products; grant the FDA authority to regulate the contents of tobacco products; and stop tobacco companies from making misleading or unproven health claims.
• Congress should also significantly increase the federal tobacco tax and utilize some of the revenue to fund a national public education and smoking cessation campaign.
• Every state should fund a tobacco prevention and cessation program at the level recommended by the U.S. Centers for Disease Control and Prevention. Unfortunately, as a report released last week by the Campaign for Tobacco-Free Kids and our partners showed, no state is currently meeting the CDC's recommendation, and only nine states are funding prevention programs at even half the CDC's recommendation. In the last 10 years, the states have received $203.5 billion in tobacco-generated revenue from the tobacco settlement and tobacco taxes, but have spent only 3.2 percent of it ($6.5 billion) on tobacco prevention and cessation programs.
• The states should also enact comprehensive smoke-free workplace laws and further increase tobacco taxes. To date, 24 states and the District of Columbia have enacted smoke-free laws that include restaurants and bars. Every state should do so. While 44 states and the District of Columbia have increased tobacco taxes in recent years, there are vast disparities in state tobacco tax rates, from 7 cents per pack in South Carolina and 17 cents in Missouri to $2.75 in New York and $2.58 in New Jersey.    

Tobacco use remains the leading cause of preventable death in the United States, killing more than 400,000 people and costing the nation nearly $100 billion in health care bills each year. While our nation has made remarkable progress in reducing smoking, political complacency and the tobacco companies' aggressive marketing threatens continued progress. Our challenge today is to combat the tobacco epidemic with a level of political leadership and resources that match the scope of the problem. If our nation's leaders do so, we can win the fight against tobacco use and contribute significantly to winning the war against cancer as well.