Key Findings
Conclusion
Despite the terrible toll tobacco takes on this country, Congress and the Administration have failed the nation by refusing to establish strong federal tobacco control policy. The continuing failure to regulate tobacco products will result in more young people addicted to tobacco products and more lives lost.
At the state level, there is an ongoing disparity in policy responses to tobacco use and addiction. The report found significant victories in stricter smokefree policies and higher cigarette taxes. However, large parts of the country still 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 United States conducted by the Praxis Project found that communities with significant numbers of people of color are less likely to have any municipal tobacco control ordinance in place when compared with communities with fewer people of color. 54
There is 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 32.7 percent compared with 16 percent in California. The California adult prevalence rate (16.2 percent) is almost half that of Kentucky (30.8 percent). The result: More lives lost due to smoking. In Kentucky, there are 387.1 adult deaths attributable to smoking per 100,000 population. In California, the rate is significantly lower at 261.8. 55
In measuring success in tobacco control policy, an important gauge 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 2004 are an excellent road map for other states to follow:
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The smokefree workplace laws in Idaho, Massachusetts, Rhode Island and many local communities will lead to healthier workers and patrons.
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The continued commitment to a comprehensive approach to tobacco prevention and cessation by Arkansas, Delaware, Hawaii, Maine, and Mississippi will have long-term effects on reducing tobacco addiction and related illnesses and deaths.
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The significant increases in tobacco taxes across the states means that fewer children will become addicted to tobacco.
The nation has a new opportunity to make progress in protecting the health of its citizens in 2005. The American Lung Association State of Tobacco Control 2004 report sets a high--but necessary--bar. The American Lung Association knows that only the toughest tobacco control 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 half-hearted 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 children taking their first puff each day and more than one-third becoming daily smokers. This report indicates how much work remains.
As the American Lung Association enters its second century, it is unwavering in its fight against deaths and illnesses caused by tobacco use. The organization was founded in 1904 to combat tuberculosis, decades before antibiotics made TB a curable disease.With tuberculosis, 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 free of charge 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). In 2004, N-O-T became the first tobacco cessation program to be designated an Effective Program by the Substance Abuse and Mental Health Services Administration (SAMHSA). 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 and chronic obstructive pulmonary disease (COPD). The American Lung Association's commitment to tobacco control is stronger than ever. But there is a crucial difference in this fight: tobacco, unlike tuberculosis or asthma, has a strong lobby supporting it.
The American Lung Association State of Tobacco Control 2004 is a call to action for national and state elected officials: Meet the challenge and enact strong tobacco control laws so that everyone in the United States can breathe easier.
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