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U.S. Flunks on Tobacco Control Report Card
Date:1/13/2009

Lung Association report says feds and most states neglect preventing tobacco-caused illness

TUESDAY, Jan. 13 (HealthDay News) -- A new report card gives the U.S. government consistently failing grades for not protecting Americans from illnesses caused by tobacco.

According to the American Lung Association's State of Tobacco Control 2008, the federal government as well as most states failed to enact critical policy measures, such as higher taxes on cigarettes and to adequately regulate tobacco products.

"Effective tobacco control saves both lives and money," Charles D. Connor, president and chief executive officer of the lung association, said during a Monday afternoon teleconference. "Tobacco use is the number one preventable cause of death in America."

Tobacco-related diseases such as lung cancer and COPD (chronic obstructive pulmonary disease) kill more than 392,000 Americans each year, and another 50,000 die from exposure to secondhand smoke, Connor said.

"All the while, tobacco companies continue to find new ways to keep smokers hooked," he said. "Each day, the tobacco industry lures 1,100 kids into becoming regular daily smokers. Also each day, 1,000 people die from tobacco-related diseases. It's easy to see from this arithmetic that the tobacco industry is motivated to attract new young replacement smokers."

This year's report card for the federal government was "abysmal," Paul Billings, the association's vice president for national policy and advocacy, said during the teleconference.

Specifically, the federal government got:

  • An "F" for FDA regulation of tobacco products -- the bill authorizing FDA regulation of tobacco products passed overwhelmingly in the U.S. House of Representatives but was not considered by the U.S. Senate before it adjourned for 2008.
  • An "F" for a cigarette tax -- the federal government's cigarette tax is 39 cents per pack, well below the "F" standard of anything just less than 60 cents a pack.
  • A "D" for failing to ratify the World Health Organization's Framework Convention on Tobacco Control, a treaty designed to limit smoking's health risks worldwide. The Bush Administration again "neglected to submit the treaty to the Senate for ratification," the report card said.

The report card also faulted the federal government for not doing more to increase access to smoking-cessation programs, Billings said. "While the Medicare drug program covers smoking-cessation drugs, the federal government does not require state Medicaid programs to cover cessation treatments and services for Medicaid recipients," he said. This, despite the fact that people receiving Medicaid smoke at almost a 60 percent higher rate than the national average, he added.

On the state level, no state earned a straight A. "Hawaii, Maine, Massachusetts and Rhode Island received the best grades," Billings said.

But even these states fell short in at least one grading categories, including smoke-free air laws, amount of state cigarette tax, funding for tobacco-cessation programs, and covering tobacco-cessation treatments for Medicaid recipients and state employees, Billings said.

The states with the worst grades -- all Fs -- were Alabama, Kentucky, Missouri, North Carolina, South Carolina, Virginia and West Virginia, according to the report.

Twenty-three states plus the District of Columbia and Puerto Rico have enacted comprehensive smoke-free air laws that protect almost all workers from exposure to secondhand smoke, Billings said. Fourteen states got an "F" in this category, he said.

In 2008, only Massachusetts, New Hampshire, New York and the District of Columbia raised cigarette taxes. The average state tax is $1.19 per pack, Billings said. New York state has the highest tax at $2.75 a pack; South Carolina has the lowest at 7 cents a pack.

Billings said that only Alaska and Delaware funded tobacco-cessation programs to the level recommended by the U.S. Centers for Disease Control and Prevention. "Tragically, 42 states received "Fs" in this category," he said.

The CDC estimates that smoking costs the U.S. economy more than $193 billion each year, including $96 billion in health-care costs and $97 billion in lost productivity, Connor said.

The way to stem this loss of lives and money is through strong tobacco control laws, Connor said. But not enough is being done, he said, adding that he hopes the new Obama administration will be more active in supporting tobacco control.

"Firstly, the Congress must give the U.S. Food and Drug Administration authority over tobacco products," Connor said. "State governments must step up and fully fund tobacco-cessation programs, increase cigarette taxes, and pass comprehensive smoke-free air laws."

Reaction to the report was strong.

Dr. James Rohack, president-elect of the American Medical Association, said in a prepared statement, "This new report confirms that weak government tobacco policies fail to support smokers' efforts to quit, and fail to discourage teens from smoking."

He added, "The AMA encourages federal and state lawmakers to pass legislation that invests in tobacco prevention programs and will help Americans quit using tobacco and protect them from exposure to second-hand smoke."

Vince Willmore, vice president for communications at the Campaign for Tobacco-Free Kids, said: "This report underscores that we know how to win the fight against tobacco use in the United States, but need strong political leadership to implement proven solutions at all levels of government."

"This report lays out a roadmap for the federal and state governments to follow, beginning with Congressional enactment of FDA regulation of tobacco products," he added.

David Sutton, a spokesman for Altria Group Inc., the parent company of the tobacco giant Philip Morris, said: "We sell our products only to adult consumers. We are looking for folks who choose to smoke who are of legal age to do so. We are going to compete for their business, but we are not looking to recruit new smokers and we certainly don't want anyone under age using tobacco products of any kind."

Sutton said Philip Morris is "opposed to excise taxes on cigarettes and tobacco products because they unfairly burden adult tobacco consumers." The company supports the efforts of smokers who want to quit and endorses having the FDA regulate tobacco products, he said.

More information

To see more on the public priorities suggested in the report, visit the American Lung Association.



SOURCES: Jan. 12, 2009, teleconference with Charles D. Connor, president and CEO, and Paul Billings, vice president, national policy and advocacy, American Lung Association, New York City; Jan. 13, 2009, American Lung Association report; Vince Willmore, vice president for communications, Campaign for Tobacco-Free Kids, Washington, D.C.; prepared statement, James Rohack, M.D., president-elect, American Medical Association; David Sutton, spokesman for Altria Group Inc., parent company of Philip Morris


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