'State of Tobacco Control' Report: Indiana Gets Failing Grades for Work to Prevent Tobacco Use, Prioritize Public Health

Today, the American Lung Association released the 18th annual “State of Tobacco Control” report, which finds that in 2019 Indiana earned failing grades on its efforts to reduce and prevent tobacco use, including e-cigarettes. The Lung Association finds opportunities in 2020 for Indiana officials to take action by enacting stronger enforcement for retailers who sell to minors, increasing tobacco taxes, and ending sales of all flavored tobacco products in order to support public health and save lives in 2020.

This year’s “State of Tobacco Control” calls for proven tobacco control policies in light of the fact that the country’s youth vaping epidemic worsened in 2019. The need for Indiana to take action to protect youth from all tobacco products, including e-cigarettes, is more urgent than ever, with the youth vaping epidemic continuing its alarming rise to 27.5%. This is a staggering 135% increase in high school e-cigarette use in just the past two years, and close to three million more kids started vaping in that time period, setting them up for a lifetime of addiction.

“In Indiana, our smoking rates remain at 21%. Sadly, with the youth vaping epidemic still rising, we may have squandered an opportunity to make the current generation of kids the first tobacco-free generation. Tobacco use is a serious addiction and Indiana needs to implement the proven measures to prevent and reduce tobacco use outlined in ‘State of Tobacco Control,’” said Nick Torres, advocacy director for the Lung Association. 

The “State of Tobacco Control” report grades states and the federal government on policies proven to prevent and reduce tobacco use. The report finds that while Indiana has taken significant steps to reduce tobacco use, including implementing smokefree laws on the municipal level, elected officials should do more to ensure all Indiana residents benefit from reductions in tobacco use and exposure to secondhand smoke.

Indiana’ Grades:

• Funding for State Tobacco Prevention Programs – Grade F
• Strength of Smokefree Workplace Laws - Grade C
• Level of State Tobacco Taxes - Grade F
• Coverage and Access to Services to Quit Tobacco - Grade F
• Minimum Age of Sale for Tobacco Products to 21 – Grade F

The Lung Association encourages Indiana to put in place all the public policies called for in “State of Tobacco Control.” This year’s report noted the need to focus on enacting stronger enforcement and penalties for tobacco retailers that violate the law, prohibiting the sales of all flavored tobacco products, raising tobacco taxes and passing a comprehensive smokefree law.

One of the most effective ways to reduce tobacco use, not only among low-income individuals but also for youth is to significantly increase the tax on all tobacco products, including e-cigarettes. Multiple studies have shown that every 10% increase in the price of cigarettes reduces consumption by about 4% among adults and about seven percent among youth. 

“To protect kids from a lifetime of nicotine addiction, the Lung Association in Indiana encourages Indiana to increase cigarette taxes by $2.00 per pack and equalize the tax on other tobacco products, including e-cigarettes with its cigarette tax. These steps are critical to Indiana as current tobacco use, including vaping, among youth is 22.9%,” said Torres.

The U.S. Surgeon General has concluded there is no safe level of exposure to secondhand smoke. If Indiana passed a comprehensive smokefree law that eliminates smoking in all public places and workplaces, including restaurants, bars and casinos, workers across the state would be protected from deadly secondhand smoke. E-cigarettes should also be included in comprehensive smokefree laws. This health protection would benefit everyone and is especially critical for those who work in the service and manufacturing sectors who are often exposed to secondhand smoke and e-cigarette aerosol daily. 

One powerful tool to address the youth vaping epidemic is increasing the minimum age of sale for tobacco products, including e-cigarettes, to 21. The U.S. Congress finished off 2019 with a huge victory passing a federal law to increase the national tobacco sales age to 21. This law will ensure that all states have a sales age of 21 in 2020.

However, Congress failed to pass legislation to eliminate all flavored tobacco products, making the need for state action to end the sale of all flavored products critical. Massachusetts took that historic step by prohibiting the sale of all flavored tobacco products, including menthol cigarettes in November 2019, becoming the first such state to do so. The Lung Association urges more states to follow Massachusetts’ lead and pass comprehensive laws eliminating flavored tobacco products in 2020.

The question remains, will 2020 be the year that public health is prioritized over tobacco product manufacturers so that another generation is spared the addiction to dangerous tobacco products? As the result of successful lawsuits filed by the American Lung Association and several public health partners, FDA will be required to take several important and long overdue actions to protect the public health from tobacco products in 2020. These include finalizing graphic warning labels on all cigarette packs by March 15, and requiring all e-cigarette, and most cigar, hookah, pipe and other manufacturers of deemed products to submit applications to FDA by May 12, 2020 to remain on the market in the U.S.