The American Lung Association today released its State of Tobacco Control 2009 report, which grades the strength of federal and state laws to protect citizens from tobacco-caused illnesses. These illnesses are now at the heart of America's chronic disease crisis.
The report finds the federal government made major strides but still has significant room for progress. Most state governments, however, failed to enact critical measures to protect people from deadly tobacco products. Ten states made alarming cuts to their tobacco control programs.
Tobacco's toll continues to be devastating. Smoking-caused illness remains the number-one preventable cause of death in the U.S., killing more than 393,000 Americans each year and costing the economy more than $193 billion. Another 50,000 Americans die from exposure to secondhand smoke. The U.S. Surgeon General has declared there is no safe level of exposure to secondhand smoke.
"Our leaders in Washington have made a strong start in confronting the tobacco epidemic and taking steps that ultimately will save millions of lives and hundreds of billions of dollars for the American economy. Ending the epidemic, however, will require more hard work," said Charles D. Connor, American Lung Association President and CEO. "Forty-six million adults smoke, and political leaders in the states need to stand up to the tobacco industry and enact policies proven to reduce the devastating death and disease caused by tobacco use."
To arrive at the grades published in State of Tobacco Control 2009, the American Lung Association compared policies against targets based on the most current, recognized scientific criteria for effective tobacco control, or policies considered the best in the nation.
FEDERAL RESULTS
The federal government took major and meaningful steps to curb the enormous burden caused by tobacco use in 2009. For two decades the American Lung Association has advocated giving authority to the U.S. Food and Drug Administration (FDA) to regulate tobacco products. Congress finally passed this legislation early in 2009. President Obama signed it on June 22.
Congress also more than doubled the federal cigarette tax, from 39 cents to $1.01 per pack. In addition, both chambers of Congress passed healthcare reform legislation that could expand coverage under Medicaid and private insurance for helping smokers quit (called cessation). As the House and Senate passed bills are reconciled, the Lung Association urges Congressional leaders to require state Medicaid programs to offer comprehensive cessation benefits.
The American Lung Association gives federal tobacco control grades for these criteria:
Federal Grades:
"A" for FDA Regulation of Tobacco Products—The Family Smoking Prevention and Tobacco Control Act was signed into law in 2009 and already the FDA has begun to implement the law. It has tremendous potential to reduce death and disease caused by tobacco in the U.S.
"D" for Federal Cigarette Tax—Congress agreed in February 2009 to raise the federal government's cigarette tax by 62 cents per pack of 20 to $1.01 in order to fund the Children's Health Insurance Program (CHIP). This increase has led many smokers to attempt to quit. The tax still falls short, however, of the "A" standard of $2.68 per pack.
"F" for Cessation—The federal government continues to fail to help smokers quit—an effort that would save lives and money. However, the U.S. House of Representatives and Senate have approved different versions of healthcare reform legislation that include an expansion of cessation coverage under Medicaid, Medicare and private insurance plans. At press time, it was uncertain whether a final bill would include these policies, and whether it would be passed into law; the House version provided broader coverage.
"D" for Ratification of the Framework Convention on Tobacco Control—The Obama administration has not submitted the international tobacco control treaty to the Senate for ratification, leaving the U.S. unable to participate in negotiations to implement and enforce it. The treaty has been ratified by 168 nations representing 86 percent of the world's population.
STATE RESULTS
As states faced record budget deficits, many turned to cigarette taxes to increase revenues. Fourteen states and the District of Columbia raised cigarette taxes, a proven means to reduce smoking. These states are Arkansas, Connecticut, Delaware, Florida, Hawaii, Kentucky, Mississippi, New Hampshire, New Jersey, North Carolina, Pennsylvania, Rhode Island, Vermont and Wisconsin.
Disturbing trends emerged, however. Ten states and the District of Columbia took a step backward by sharply reducing funding for tobacco control and prevention programs. This trend undermines other advances because robust tobacco control programs help sustain and even expand the impact of higher cigarette taxes and smokefree workplace laws. Wisconsin, for example, increased its cigarette tax by 75 cents but also slashed funding for tobacco prevention and cessation programs by more than half. New Hampshire raised its cigarette tax by 45 cents, yet it spends not a single state dollar on tobacco prevention and cessation programs. In addition, the pace for states passing comprehensive smokefree air laws slowed dramatically.
"Increasing tobacco taxes and requiring smokefree workplaces are two important steps in reducing the leading cause of preventable death in the United States," said Mary H. Partridge, American Lung Association National Board Chair. "But that is still not enough. Comprehensive cessation programs must also be made available to support them in quitting."
No Straight A's
No state received straight "A's" on its report card. Six received all "F's." They are Alabama, Kentucky, Missouri, South Carolina, Virginia and West Virginia.
States and the District of Columbia are graded on the following: