Smoking Still Takes a Heavy Toll in U.S., CDC Finds

Varying state policies expose many Americans to secondhand smoke

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Friday, January 25, 2013

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FRIDAY, Jan. 25 (HealthDay News) -- Even though proven anti-smoking strategies exist, more than 440,000 Americans still die each year from cigarette smoking or exposure to secondhand smoke, federal health officials said Friday.
And 8.6 million suffer from serious smoking-related illnesses, the U.S. Centers for Disease Control and Prevention report.
One reason: the implementation of policies to deter smoking is spotty across the country, officials said.
"We are seeing a large geographic disparity in smoking developing," said Dr. Tim McAfee, director of CDC's Office on Smoking and Health. Regional differences existed 20 years ago, "but nothing like what we are seeing today," he noted.
For example, about twice as many people in Kentucky smoke as in Utah and California, he said. Lung cancer rates are starting to mirror this pattern too, with higher rates in the states with more smokers and faster-declining rates in states with fewer smokers, McAfee said.
The differences are likely based on "the degree to which states have instituted policies that either promote or don't promote keeping kids from starting and encouraging adults to quit," McAfee said.
Some states have strict anti-smoking laws and high cigarette taxes, while other states, such as Texas, have no tobacco laws, he said.
A proven, multi-pronged strategy to curb smoking combines higher tobacco taxes, smoke-free laws, media campaigns, limits on tobacco advertising and promotions and restricted access to tobacco products and programs, the CDC said.
Dollars spent by the states on these programs vary widely, and no state spends the total amount the CDC recommends.
Maine spends about 80 percent of the recommended amount on these programs, while Tennessee spends 1.1 percent of the recommended amount, McAfee said.
The new report is designed for state officials and others to assess states' implementation of tobacco-control programs.
Overall, the picture is not encouraging.
States have billions to create policies that discourage smoking, collected from tobacco taxes and tobacco industry legal settlements. However, overall, states only use a small portion of these funds for anti-smoking programs, the CDC stated.
In 2013 alone, states will collect $25.7 billion from tobacco taxes and legal settlements, but plan to use less than 2 percent of that to develop programs that deter smoking, according to the agency.
Meanwhile, the cost of smoking-related illnesses approaches nearly $96 billion a year, and another $97 billion is lost in productivity each year, the report notes.
Other highlights of the Tobacco Control State Highlights 2012 report include:

Utah has the fewest smokers (about 12 percent), and Kentucky the most (29 percent).
Across all states, about 21 percent of residents smoke.
Among high school students, about 18 percent smoke.
26 states and the District of Columbia have comprehensive smoke-free laws that ban smoking in restaurants, bars and workplaces.
24 states have inadequate smoke-free laws.
Kentucky, Mississippi, South Carolina, Texas, West Virginia and Wyoming have no laws to protect residents from secondhand smoke.
Cigarette taxes average $1.34 a pack nationally, ranging from $4.35 in New York to 17 cents in Missouri.
No states implemented CDC recommendations for smoking-cessation campaigns in 2010.

Health advocates hope that state legislators take note of the findings.
"As state legislatures convene across the country, the CDC report is a timely reminder both that tobacco use remains a huge public health problem and that it is an entirely winnable battle if elected officials implement proven strategies that prevent kids from smoking and help smokers quit," said Danny McGoldrick, vice president of the Campaign for Tobacco-Free Kids.
But states have gone backwards in recent years, McGoldrick said.
"They've cut funding for tobacco prevention programs by 36 percent and have slacked off in enacting tobacco-tax increases and smoke-free laws," McGoldrick said. New Hampshire went even further and reduced its tobacco tax last year.
"We urge state leaders to side with kids over 'Big Tobacco' and accelerate their efforts to reduce tobacco use," McGoldrick said.

SOURCES: Tim McAfee, M.D., M.P.H., director, Office on Smoking and Health, U.S. Centers for Disease Control and Prevention; Danny McGoldrick, Vice President, Campaign for Tobacco Free Kids; Jan. 25, 2013, report, Tobacco Control State Highlights 2012

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