Key Findings
Conclusion
There is ongoing disparity in the policy responses to tobacco use and addiction across the United States. In 2003, the report shows a continuation of significant victories in the areas of smokefree policies and cigarette taxes, but these victories disproportionately occurred in eastern and west coast states. Large parts of the country, specifically in the South and Midwest, have failed to adopt the policies necessary to reduce the devastating toll that tobacco takes on their communities. In addition, within states there are disparities in the tobacco policy coverage of specific racial and ethnic groups. An analysis of municipal tobacco control ordinances in the U.S. conducted by the Praxis Project found that communities with significant numbers of people of color are less likely to have any kind of municipal tobacco control ordinance in place when compared to communities with fewer people of color. 37
Maine’s successful tobacco prevention program has resulted in a 48% drop in the rate of smoking by high school students and a 59% decrease in middle school student smoking rates.39
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The effect has resulted in a wide discrepancy in smoking rates, death rates and health care costs across states. Looking at the example of two states—Kentucky with very few tobacco control policies and California with strong tobacco control policies—the difference in health impact is clear. Kentucky’s high school smoking rate is at 37.4 percent compared to the high school smoking rate in California of 21.6 percent. The California adult prevalence rate (17.2 percent) is slightly more than half that of Kentucky (30.9 percent). The result is a larger number of lives lost due to smoking. In Kentucky there are 387.1 smoking-attributable adult deaths per 100,000 population. In California the rate is significantly lower at 261.8.38
In gauging success in tobacco control policy, an important measure will be narrowing the gap between the states with strong policies and those without. All U.S. citizens should benefit from effective tobacco control laws. The successes in 2003 are an excellent road map for other states to follow:
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The smokefree workplace laws in Connecticut, Florida, Maine and New York have sparked interest in other states and localities across the country.
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The continued commitment to a comprehensive approach to smoking prevention and cessation by Arizona, Arkansas, Delaware, Hawaii, Maine and Mississippi will have long-term positive effects on their communities.
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The significant increases in tobacco taxes across the states means that fewer children will become addicted to tobacco.
Every state has a new opportunity to make progress in protecting the health of its citizens in 2004. The American Lung Association State of Tobacco Control 2003 report sets a high—but necessary—bar. The American Lung Association knows that only the toughest laws will help us achieve our mission to prevent lung disease and promote lung health. The tragedy of tobacco addiction, and the disability, disease and death it causes, will not be resolved with a halfhearted response consisting of partial measures and weak policy. The magnitude of the problem is alarming—8.6 million people with at least one serious illness caused by smoking; over 440,000 premature deaths each year; an estimated 6,000 young people taking their first puff each day and one-third becoming daily smokers. This report indicates how much work remains.
As the American Lung Association celebrates its 100th year anniversary in 2004, it is unwavering in its fight against deaths caused by tobacco use. Originally, the organization was founded in 1904 to combat tuberculosis, decades before antibiotics made TB a curable disease.With TB, it was learned that by harnessing political will and using the right tools, a horrible public health scourge can be tamed. The American Lung Association started its campaign against tobacco as one of the first organizations to tell people that smoking can kill—even before the Surgeon General did. Its cessation program for adults, Freedom From Smoking ®, is widely recognized as the gold standard for such programs and is available online at www.ffsonline.org. The American Lung Association was among the first to offer an effective teen smoking-cessation program, Not On Tobacco (N-O-T). From successfully advocating for smokefree airline flights to stopping Big Tobacco’s quest for legal immunity, the American Lung Association also has been a leader in tobacco control advocacy on the national, state and local levels.
In addition, the American Lung Association is in the forefront of the battle against air pollution and its devastating impact on the health of communities. More recently, the American Lung Association has become the leader in responding to the dramatic increase in asthma. The Association’s commitment to tobacco control is stronger than ever. But there is a crucial difference in this fight: tobacco, unlike TB or asthma, has a strong lobby supporting it.
The American Lung Association State of Tobacco Control 2003 is a call to action for state elected officials: Meet the challenge and enact strong tobacco control laws so that your citizens can breathe easier.
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