Overview
Executive Summary
The American Lung Association State of Tobacco Control 2004 report grades federal and state tobacco control laws and regulations enacted as of January 1, 2005. New this year are grades on federal tobacco control laws regarding cigarette taxes, regulation of tobacco products by the Food and Drug Administration (FDA), cessation, and the international tobacco control treaty the Framework Convention on Tobacco Control (FCTC). The state tobacco control law section focuses on the areas of tobacco prevention and control spending, smokefree air, cigarette taxes, and youth access to tobacco products.
The American Lung Association State of Tobacco Control 2004 report found the following policy trends:
Each year 440,000 people die of tobacco-related illness in the U.S., costing $157.7 billion in health care costs.5
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Federal Update
In 2004, Congress came extremely close to enacting legislation granting the FDA authority over tobacco products. The U.S. Senate passed strong FDA legislation twice. Unfortunately, the House of Representatives' leadership blocked consideration of FDA legislation, and once again, an opportunity for the federal government to pass strong public health legislation was lost. The failure of FDA legislation is a victory for the tobacco industry and its insidious marketing practices. For example, candy-flavored cigarettes, with names such as Camel Kauai Kolada and Kool Mix Mocha Taboo, are being marketed to children. In 2005, Congress will have another opportunity to consider FDA legislation.
State and Local Smokefree Workplace Laws Spread Across the Country
In 2004, state and local smokefree workplace laws were enacted throughout the country. In the Northeast, Massachusetts and Rhode Island passed comprehensive smokefree air laws prohibiting smoking in workplaces including restaurants and bars. 1 Idaho became the first state in the Rocky Mountain region to go smokefree, prohibiting smoking in most workplaces. The list of smokefree states that prohibit smoking in all workplaces including bars and restaurants is now at six--California, Connecticut, Delaware, Maine, Massachusetts and New York.
At the local level, strong ordinances passed in cities and towns across the country in 2004. Cities including Lawrence, KS, Columbus, OH, Lincoln, NE, and Minneapolis, MN, all passed ordinances banning smoking in workplaces. In a victory for public health, the Kentucky Supreme Court upheld the smokefree air ordinance passed in 2003 in Lexington, KY.
The health risks of secondhand smoke are significant. A study published in The British Medical Journal found that exposure to secondhand smoke is even more dangerous than previously thought and increases the risk of heart disease among nonsmokers by as much as 60 percent.2 There is mounting evidence that state and local comprehensive smokefree air workplace policies have rapid and dramatic health benefits to both patrons and workers. Another study published in the British Medical Journal found that the number of heart attacks reported in Helena, MT, fell by 40 percent during a six-month period in 2002 when the city’s comprehensive smokefree air law was in effect.3,4 In response to this dramatic finding the Centers for Disease Control and Prevention (CDC) warned that people at risk for coronary heart disease should avoid exposure to secondhand smoke.6
State Cigarette Taxes Rose Dramatically--Three States at or above $2 per pack
On average, men who smoke cut their lives short by 13.2 years, and female smokers lose 14.5 years.10
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2004 was another big year for cigarette tax increases. Eleven states increased their cigarette tax, with three--Michigan, New Jersey and Rhode Island--significantly raising their tax to $2.00, $2.40 and $2.46, respectively. In Colorado, Oklahoma, and Montana voters by ballot initiative decided to raise the cigarette tax in order to provide needed income for public health priorities. Seventeen states, the District of Columbia and Puerto Rico now have cigarette taxes at or above $1.00 per pack.
Virginia raised its tax to $0.20 per pack, the first increase since the cigarette tax was established in 1960. Virginia no longer holds the dubious distinction of having the lowest cigarette tax in the country; that distinction now belongs to Kentucky with a cigarette tax of $0.03 per pack. Also in the south, Alabama raised its tax to $0.425 per pack.
Despite Evidence That State Tobacco Prevention Programs Save Lives Cuts Continue
It has been six years since the historic Master Settlement Agreement (MSA) between 46 states and the tobacco industry. In that time well-funded tobacco prevention programs have shown dramatic results in reducing both youth and adult smoking rates. A recent study found that cigarette sales dropped more than twice as much in states with comprehensive tobacco control programs as in the United States as a whole.7
Yet, despite these significant gains, successful programs continue to be either cut or severely under-funded. Model tobacco prevention programs in Florida, Indiana, Maryland, Massachusetts, and Minnesota have sustained enormous cuts in recent years, which have begun to undermine the success of these programs. A recent study conducted after the elimination of Minnesota’s Target MarketTM anti-smoking media campaign shows the immediate effect that funding cuts can have on the effectiveness of these programs. Six months after the elimination of Target MarketTM awareness of the media campaign went from 84.5 percent to 56.5 percent and youth susceptibility to smoking rose by 10 percentage points from 43.3 to 52.9 percent.8
A few states have honored the commitment made at the time of the MSA and have funded the program at or near the minimum level recommended by CDC. Five states Arkansas, Delaware, Hawaii, Maine, and Mississippi--have made this commitment. Maine, which has funded its program at the CDC minimum for a number of years, experienced a dramatic 48% decrease in the rate of smoking by high school students and a 59% decrease in middle school student smoking rates from 1997 to 2003. 9
Previously Maine had one of the highest youth smoking rates in the country.
More than 12 million Americans have died from smoking since the 1964 report of the surgeon general, and another 25 million Americans alive today will most likely die of a smoking-related illness.12
| States Crack Down on Internet Sales of Tobacco Products
In the absence of federal legislation, states are stepping up and passing legislation to regulate Internet sales of tobacco products. An October 2003 study published in The Journal of the American Medical Association (JAMA) found that minors have easy access to cigarettes via the Internet because many Internet vendors don't check ages or don’t have an age verification process. The study concluded "banning Internet and mail order tobacco sales to minors may be the most effective policy strategy."11
States have used this and other evidence to begin closing the loophole on Internet sales of tobacco products by cracking down on companies that circumvent state tax and youth access laws. Currently, Alaska, Connecticut and New York have the strongest Internet laws, prohibiting delivery of tobacco to individual consumers. In addition, Arizona, California, Delaware, Hawaii, Idaho, Illinois, Indiana, Kansas, Louisiana, Maine, Oklahoma, Oregon, Texas, Virginia, Washington, and West Virginia have enacted laws restricting Internet sales in the past two years. While the percentage of cigarettes sold via the Internet is not large, states still lose millions in tax revenue and kids have learned it is an easy way to obtain tobacco products.
Note on federal legislation: In 2004, bipartisan legislation regulating Internet sales of tobacco products and enforcing the states’ excise tax on Internet tobacco sales was considered in the U.S. Congress.
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