Two new reports released today by the Centers for Disease Control and Prevention show that while the United States has made dramatic progress in the fight against tobacco, too many Americans still smoke and too many non-smokers – including more than half of all young children – are still exposed to secondhand smoke.
Along with recent surveys showing that youth smoking declines have slowed, these reports sound loud and clear warnings that the battle against tobacco use – the nation's number one cause of preventable death – is far from over. Rather than declaring premature victory, elected officials at all levels must resist complacency and step up efforts to implement proven measures to reduce tobacco use and exposure to secondhand smoke. These measures include higher tobacco taxes, smoke-free air laws, well-funded tobacco prevention and cessation programs, greater health coverage for smoking cessation therapies, and effective regulation of tobacco products and marketing.
Report on Adult Smoking Rate
The first CDC report finds that the U.S. adult smoking rate in 2009 was 20.6 percent – the same rate as 2008 and essentially unchanged since 2004, when 20.9 percent smoked. This is further evidence that declines in the adult smoking rate have stalled after falling steadily from 42.4 percent in 1965.
However, it is important to note that while the percentage of adults who smoke has been essentially unchanged, cigarette sales have declined significantly, especially in 2009 when the federal cigarette tax increased by 61 cents per pack. According to data from the Alcohol and Tobacco Tax and Trade Bureau (http://ttb.gov/tobacco/tobacco-stats.shtml), cigarette sales in the U.S. declined by 20.1 percent between 2004 and 2009 and by 8.3 percent in 2009 alone. The 2009 decline is one of the largest in recent years. These data indicate that those who continue to smoke are smoking less. This decline in cigarette consumption could be a precursor to declines in the smoking rate, especially if proven tobacco control measures are implemented more aggressively.
Report on Exposure to Secondhand Smoke
The second CDC report finds that the percentage of U.S. non-smokers exposed to secondhand smoke declined by 23.6 percent between 1999 and 2008. However, four in ten non-smokers were still exposed to secondhand smoke in 2007-2008, including nearly 54 percent of children aged 3-11. Exposure to secondhand smoke was determined based on blood levels of cotinine, a nicotine byproduct.
These results underscore the need for every state and community to enact comprehensive smoke-free laws that apply to all workplaces and public places, including restaurants and bars. To date, 28 states, Washington, DC, Puerto Rico and more than 550 cities have passed laws requiring smoke-free restaurants and bars, covering 63 percent of the U.S. population. The high level of child exposure to secondhand smoke also underscores the need for parents to take additional steps to protect children, such as ensuring that homes, cars and other places frequented by children are smoke-free. For parents who smoke, the best step to protect children is to quit smoking.
According to the U.S. Surgeon General, secondhand smoke is a proven cause of heart disease and lung cancer in non-smoking adults and of sudden infant death syndrome (SIDS), low birth weight, respiratory problems, ear infections and more severe asthma in infants and children. The Surgeon General found that that secondhand smoke kills tens of thousands of Americans every year, and there is no safe level of exposure.
Additional Information
There is no question that we know how to significantly reduce tobacco use, as evidenced by the fact that the U.S. has reduced adult smoking by more than half since the 1960s and high school smoking by 46 percent since 1997 (from 36.4 percent in 1997 to 19.5 percent in 2009).
There is also no question that the U.S. can achieve even greater reductions in smoking, as shown by states and cities that have implemented comprehensive, well-funded and sustained strategies. New York City has reduced adult smoking to 15.8 percent and high school smoking to just 8.4 percent with a comprehensive strategy that includes the nation's highest cigarette tax, a pioneering smoke-free law, hard-hitting media campaigns and programs to help smokers quit. Washington State, employing similar strategies, just reported that it has reduced adult smoking to 14.8 percent. California, with the nation's longest-running tobacco control program, has reduced adult smoking to 12.9 percent.
The new national survey demonstrates that what's missing are the political will and resources to effectively implement proven strategies nationwide and in every state and community. Obstacles to greater progress have included deep cuts to state tobacco prevention and cessation programs, uneven application of state tobacco tax increases and smoke-free air laws across the country, and the tobacco industry's huge marketing expenditures.
State funding for tobacco prevention peaked at $750 million in 2002 and has been cut repeatedly since, including a 21 percent cut between 2008 and 2010 (from $717.7 million to $567.5 million). In 2010, states provided just 17 percent of the funding recommended by the CDC. In contrast, the tobacco companies spent $12.8 billion on marketing in 2006 (the last year for which data are available), and the bulk of it was spent on price discounting that have kept cigarette prices flat despite tax increases.
All levels of government must do more if we are to continue making progress against tobacco:
At the federal level, the FDA must effectively exercise its new authority to regulate the manufacturing, marketing and sale of tobacco products. In addition, the Obama Administration and Congress must implement a national tobacco prevention and cessation campaign. The Prevention and Public Health Fund created as part of the health care reform law provides one opportunity to do so.
The states must use more of the billions of dollars they collect from the 1998 tobacco settlement and tobacco taxes to fund tobacco prevention and cessation programs. In addition, they must continue to increase tobacco taxes and enact comprehensive smoke-free laws that apply to all workplaces and public places.
Despite the progress we have made, tobacco use still kills more than 400,000 Americans and costs $96 billion in health care bills each year. We cannot declare victory until we have eliminated the death and disease caused by tobacco.
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