The American Lung Association released its State of Tobacco Control 2010 report today, which tracks progress on key tobacco control policies at the federal and state level, assigning grades based on whether laws are adequately protecting citizens from the enormous burden caused by tobacco use.
This year, the Lung Association applauds the federal government for major advances in protecting citizens from tobacco-caused illnesses but faults most states for lagging behind and failing to enact much-needed laws and policies.
Tobacco continues to take a devastating toll. Each year, 443,000 people die from tobacco-related illnesses and secondhand smoke exposure, making tobacco the leading cause of preventable death. In addition, it costs the economy more than $193 billion annually in healthcare costs and lost productivity.
"President Obama and our leaders in the 111th Congress enacted what will be regarded as the strongest tobacco control policies thus far in American history," said Charles D. Connor, American Lung Association President and CEO. "While we still have a long way to go, for the first time, the Administration and the Congress joined forces to squarely confront the tobacco epidemic."
"Sadly, most of our states are failing miserably when it comes to combating tobacco-caused disease," Connor added. "Despite collecting millions of dollars – and in some cases billions – in tobacco settlement dollars and excise taxes, most states are investing only pennies on the dollar to help smokers quit."
It takes combined state and federal resources to reduce tobacco-related disease and death, as the tobacco industry will continue to adapt and engage in deadly deception. In 2010, the tobacco industry used new ways to push its products and target kids in a drive to replace dying customers. These tactics ranged from color-coding packages in order to falsely imply less harmful cigarettes, to pitching smokeless tobacco in order to get more young people hooked and keep current smokers addicted.
FEDERAL ACTION
The American Lung Association recognizes progress made at the federal level to protect people from the dangers of tobacco.
The U.S. Food and Drug Administration (FDA) began implementing landmark legislation passed in 2009 to restrict tobacco marketing and sales to kids, to end misleading health descriptors and to require larger health warnings on cigarettes and smokeless tobacco products.
On a separate front, Congress passed healthcare overhaul legislation in 2010 that greatly expanded benefits for tobacco cessation treatments to help people quit. Most private insurers will now be required to offer quit smoking treatments, and all pregnant women enrolled in Medicaid also have access to these services.
In another enormous stride, the U.S. Department of Health and Human Services for the first time incorporated both cessation and prevention of tobacco use as a cornerstone of a national strategy to reduce chronic disease and healthcare costs.
In this year's State of Tobacco Control report, the federal government earned a "B" for FDA regulation of tobacco products, with the American Lung Association urging FDA to take aggressive action in regulating the marketing, sales and manufacturing of tobacco products; a "C" for coverage of cessation treatments among major federal health care programs; a "D" for the federal cigarette tax; and a "D" for failure to ratify the Framework Convention on Tobacco Control, an international treaty.
STATE ACTION
Many states continued to bank on cigarette taxes for new revenues to help balance budgets in hard times, but most failed to invest in programs to help smokers quit and prevent kids from starting.
Six states raised cigarette excise taxes in 2010. Higher prices will encourage smokers to try to quit, but most smokers who ended up paying more for a cigarette pack got no additional help from the state to end their addiction to tobacco.
Low-income smokers suffer the greatest impact from this disturbing trend because they cannot afford higher cigarette prices and have the most difficulty accessing effective quit smoking treatments.
"Most states are ducking the responsibility to help smokers quit," Connor continued.
Forty states and the District of Columbia earned an "F" for funding tobacco prevention and control programs at needed levels, and 37 states earned an "F" for failing to offer comprehensive quit-smoking treatments to Medicaid recipients and state employees as well as make proper investments in state quitlines. Progress in states' passage of comprehensive laws protecting the public and workers from the dangers of secondhand smoke slowed to almost a standstill. Only one state, Kansas, passed a comprehensive smokefree law.
"To finally break tobacco's grip on America's health, it takes a harnessing of resources by every state as well as by the federal government," Connor said. "The annual report card spells out what they're doing right and where they must work harder to achieve that vision."
Overall Scores – No state earned straight "A's." Only Arkansas, Montana, Maine, Oklahoma and Vermont achieved all passing grades, although, Oklahoma barely passed with straight "D's." Receiving all "F's" were Alabama, Kentucky, Mississippi, Missouri, North Carolina, South Carolina, Virginia and West Virginia.
Tobacco Prevention and Control Programs – Forty states and the District of Columbia earned "F's" for spending at less than 50 percent of the level recommended by the Centers for Disease Control and Prevention (CDC). Alaska and North Dakota alone earned "A" grades for funding tobacco prevention and control programs and achieving the CDC-recommended funding levels.
Cessation Treatments – Thirty-seven states earned "F's" for failing to offer comprehensive tobacco cessation treatments to Medicaid recipients and state workers, and making recommended investments in state quitlines. No state earned an "A" grade.
State Cigarette Taxes – Despite a continuing trend toward increased cigarette taxes, only five states qualified for an "A" grade by collecting excise taxes of $2.90 per pack or more.
Quitlines – For the first time, the State of Tobacco Control provides a more complete picture of state cessation efforts by including data about quitlines in the state cessation grade. These are free, phone-based programs that provide services to help callers quit tobacco use. All 50 states and the District of Columbia operate a quitline, although the services and treatment provided vary. Quitlines provide a vital aid for smokers who have no other way to get or pay for treatment and they are often dramatically underfunded.
Smokefree Air Laws – Kansas was the only state that passed a strong smokefree air law in 2010. Twenty-seven states and the District of Columbia have now passed comprehensive smokefree laws, making public spaces and workplaces smokefree. The pace for passage has declined dramatically since 2006-2007, when 16 states and the District of Columbia met the American Lung Association's Smokefree Air Challenge.
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