It's no surprise that when the Centers for Disease Control and Prevention listed the most important public health achievements in American history, tobacco control landed near the top. After all, tobacco use negatively impacts every organ in your body, and is linked to a staggering range of diseases and early death. Any reduction in tobacco use and exposure to secondhand smoke saves lives, and the American Lung Association's "State of Tobacco Control" report has been chronicling our nation's progress in enacting policies proven to reduce tobacco use for 16 years. Each year we ask, did the federal government and states do all they could in the past year to save lives by reducing tobacco use? In some cases, yes, but in most cases, no.
The good news is that tobacco use is at an all-time low, with just over 15 percent of adults smoking, compared to the 42 percent who smoked back in 1964, when the first Surgeon General's report on smoking and health set off the national alarm on the dangers of smoking. Yet, tobacco use remains the leading cause of preventable death and disease in the U.S. "State of Tobacco Control" also reports that not all Americans are benefiting equally from this decline. Certain parts of the country and populations continue to smoke at high rates, highlighting the uneven progress and where we need to do a better job of preventing and reducing tobacco use.
Communities who continue to smoke at higher rates include those with lower income and/or education levels, rural communities, Native Americans and Alaskan Natives, the LGBTQ population and persons with behavioral health conditions. And with more than one in five high school students still using at least one tobacco product, our nation's youth are in continued danger of a lifetime of addiction and tobacco-caused disease, unless more is done to prevent and reduce tobacco use and protect against the harms of secondhand smoke.
What can we do to reduce use of deadly tobacco products and protect more people from exposure to hazardous secondhand smoke? The great irony is that we've had the answers for years. What we haven't had are federal and state leaders with the political will to enact policies proven to work! Implementation of these public health policies also help create the basis for our "State of Tobacco Control" grades. Curious? See what grades the federal government and your state earned.
To continue reducing rates of smoking and other tobacco use for all communities, especially those that have disproportionately higher smoking rates, we need states to dramatically increase their efforts in these areas:
Tobacco Prevention Programs: The best way to stop tobacco addiction is to prevent tobacco use before it starts. Only two state fund their tobacco prevention programs near the levels recommended by the Centers for Disease Control and Prevention (CDC). All states must fund their tobacco prevention programs at these recommended levels in order to prevent youth use.
Tobacco Taxes: Increases in tobacco taxes are highly effective at preventing youth tobacco use, but only three states increased taxes on cigarettes in 2017, and by only 50 cents or less per pack, not the minimum $1.00 per pack increase recommended to reduce youth smoking.
Tobacco 21: Studies show that increasing the age for tobacco sales to 21 would decrease tobacco use by 12 percent. Nationwide, it could prevent 223,000 deaths among those born between 2000 and 2019. We made considerable progress on this issue in 2017 with three states – Maine, New Jersey and Oregon – passing laws increasing their minimum age for tobacco products to 21. However, only five states overall have done so thus far.
Helping Smokers Quit: It's imperative that all state Medicaid programs cover a comprehensive tobacco cessation benefit with no barriers, to help smokers quit, including all seven FDA-approved medications and three forms of counseling. In 2017, only three states – Kentucky, Missouri and South Carolina – provided this coverage.
Smokefree Air: Exposure to secondhand smoke is still a serious health risk, accounting for more than 41,000 deaths in the U.S. per year. Still, 22 states have yet to pass comprehensive smokefree laws that eliminate smoking in public places and workplaces. Unfortunately, progress in states has completely stalled with no states passing comprehensive smokefree laws since 2012.
"State of Tobacco Control" recommends more actions to take, including how the federal government can do its part to reduce tobacco-caused disease and death.
We know what works to save lives by preventing and reducing tobacco use. "State of Tobacco Control" provides a clear blueprint for what state and federal policymakers must do to create a healthier, tobacco-free future for all Americans. It also serves as a guide on how to ensure that the health benefits of reduced tobacco use are shared equally with all our diverse communities. You can help, and join us as we call on lawmakers, both state and federal, to consider the lives that could be saved if they put in place the proven tobacco control policies called for in "State of Tobacco Control" 2018.