Last year, the American Lung Association urged U.S. government officials to take the steps necessary to reduce smoking rates to less than 10 percent by 2024, protect all Americans from secondhand smoke by 2019, and end smoking-related deaths. A recent report by the organization, however, shows that states have made little to no progress in meeting those goals, even with billions of dollars at their disposal.
Researchers found that tobacco cessation funding in most states didn’t reach levels recommended by the Centers for Disease Control and Prevention (CDC). While Alaska and North Dakota followed the CDC’s suggestions, more than 40 states and the District of Columbia spent less than half of what the agency advised, according the American Lung Association’s State of Tobacco Control Report. At the time of the report’s release, only Indiana and Massachusetts provided a smoking cessation benefit to Medicaid enrollees. Similar programs in several states have yet to get off the ground.
“Despite cutting U.S. smoking rates by half in the last 51 years, tobacco’s ongoing burden on America’s health and economy is catastrophic,” Harold Wimmer, president and CEO of the American Lung Association, told reporters this week. “Tobacco use remains the leading preventable cause of death and it [affects] almost every system in the body, contributing to lung cancer, heart attacks, stroke, chronic obstructive pulmonary disease (COPD) and even sudden infant death syndrome.”
Tobacco smoking causes more than 480,000 deaths in the United States — nearly 41,000 of which are caused by secondhand smoke — according to the CDC. The United States spends more than $289 billion annually in medical costs and lost productivity that results from prolonged tobacco use. More than 5.6 million young people who pick up the habit are expected to die prematurely if states don’t curb tobacco use among that demographic.
But many states have not heeded those warnings. A small percentage of these funds raised by tobacco excise taxes and settlement fees have been allocated toward tobacco control programs. In fiscal year 2014, states spent less than two percent of the $25.7 billion available to help people quit smoking. A CDC report showed that every state tobacco control program would have funding at recommended levels if states invested at least 15 percent of that amount.
In recent years, an increasing number of people have turned to cessation programs to kick the habit, especially as they have felt the financial strain of tobacco excise taxes. Meeting this demand among smokers would be of great benefit to states, and ultimately smokers and nonsmokers alike. Research has also found that investment in these programs reduces smoking and other tobacco use, saves thousands of lives and millions of dollars, and improves public health.
That’s why the Obama administration recently took steps to make it easier for people to quit. In May 2014, the White House issued guidance on smoking cessation benefits available through the Affordable Care Act. Insurance plans now cover comprehensive quit smoking benefits which include medication approved by the Food and Drug Administration and phone counseling, all without copays or deductibles. Smokers could also use the benefits at least twice a year, a provision that came out of a realization of the difficulty of quitting.
“By itself, a significant increase to a state’s excise tax on cigarettes will directly reduce smoking, especially among youth,” the Campaign for Tobacco Free-Kids said in a report last year. “But combining tobacco tax increases with a comprehensive statewide tobacco prevention campaign will accelerate, expand, and sustain the tobacco use declines in the state, thereby saving more lives and saving more money. The rise in smokers’ calls to quit lines following state cigarette tax increases shows how important it is to have cessation resources available to smokers who wish to quit in response to cigarette tax increases.”
Some state executives, however, want to see that money used in other ways, dimming any hope that funding levels for cession programs will ever reach what the CDC has recommended.
Maine Governor Paul LePage, for example, recently announced his plans to slash $20 million from the Fund for a Healthy Maine, an effort to expand smoking cessation, stating that the amount spent now does nothing to treat smoking-related illnesses. Some people, like Ed Miller who serves as executive director of the American Lung Association of Maine, say that the LePage administration’s move would exacerbate a significant public health issue.
“We don’t feel that cutting off funding for community-based prevention programs which go well beyond tobacco, these community interventions are not just dealing with tobacco,” Miller told MPBN News, an NPR affiliate. “In fact, in our opinion they’re not doing enough — they’re only spending about 50 percent of what the federal Centers for Disease Control say should be spent on tobacco. To cut that off and then say that the way to address this problem is through primary care is a false choice.”