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State Tobacco Control a Mixed Bag
Date:6/12/2009

policies exist among the states.

For example, the prevalence of smoking among those aged 18 to 29 is 2.5 times higher in Kentucky than in California (36.2 percent vs. 14.4 percent). Moreover, by 2007, 66 percent of those 30 and older in New Hampshire had quit smoking, but only 45 percent of West Virginians in the same age group had quit.

The report also says that in states with the fewest smokers, those still smoking are less likely to be dependent on smoking and more likely to want to quit, compared with smokers in states with a high prevalence of smokers.

States need to do more to educate people not to smoke and help smokers quit, Giovino said.

"There is wide variation in cigarette-smoking prevalence across states and a clear relationship between smoking prevalence and the rate of mortality that can be attributed to smoking," Giovino said. "Strong tobacco-control programs save lives."

While outreach programs, legislation, cigarette price increases and coverage for and access to stop-smoking treatment work, most states are not fully implementing these approaches to reduce smoking rates and protect nonsmokers, the report said.

For example, about 27 percent of people receiving Medicaid smoke, which is significantly more than the 17 percent of people with private health insurance who smoke. Yet, 12 states do not provide Medicaid coverage to help people quit.

Making smoking more expensive through excise taxes on cigarettes is a proven way to get people not to start smoking or to quit, the report says. But taxes vary by state -- Rhode Island's tax of $3.46 a pack is the highest; South Carolina's 7-cent tax is lowest.

Combined state and federal cigarette taxes make up a smaller percent of the cost of a cigarette pack in 2009, at 40 percent, than they did in 1970, at 49 percent, the authors noted.

On the bright side, state programs have shown progress in reducing smoking and expos
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