Overview continued...

This report grades states in four areas: program funding, smokefree air, cigarette taxesand youth accessto tobacco. States did not receive one overall grade because it would be impossible to assign relative weights to each of the four areas and to determine whether one area of tobacco control is more important than another. All four areas of tobacco control are needed to save lives. Only a comprehensive approach will work. These grades measure laws at the state level. The grades do not reflect local ordinances, which also play a critical role in tobacco control. Some states received poor grades even though they are making very strong, meaningful progress on the local level. For instance, although Massachusetts received an F in Smokefree Air—this is only a reflection of its state law - more than 200 communities in the state have enacted their own smokefree air policies, including many with total or near total bans on smoking in the workplace, including restaurants and bars.

Overview: The Toll of Tobacco

Smoking-related diseases claim an estimated 440,000 American lives each year, including those affected indirectly, such as babies born prematurely due to prenatal maternal smoking and some of the victims of “secondhand” exposure to tobacco carcinogens. Smoking costs the United States approximately $150 billion each year in health-care costs and lost productivity. 2 Cigarettes contain at least 43 distinct cancer- causing chemicals. Smoking is directly responsible for 87 percent of lung cancer cases and causes between 80% and 90% of emphysema and chronic bronchitis. (see the American Lung Association Tobacco Control Fact Sheets.)

Smoking is also a major factor in coronary heart disease and stroke; may lead to malignancies in other parts of the body; and has been linked to a variety of other conditions and disorders, including slowed healing of wounds, infertility and peptic ulcer disease.3 Smoking in pregnancy accounts for an estimated 20 to 30  percent of low-birth weight babies, up to 14 percent of preterm deliveries and some 10 percent of all infant deaths. Even apparently healthy, full-term babies of smokers have been born with curtailed lung function.4 Smoking by parents is also associated with a wide range of adverse effects in their children, including exacerbation of asthma, increased frequency of colds and ear infections, and sudden infant death syndrome. An estimated 150,000 to 300,000 cases of lower respiratory tract infections in children less than 18 months of age, resulting in 7,500 to 15,000 annual hospitalizations, are caused by secondhand smoke.5

Compounding the tragic toll of tobacco is the knowledge that all of these illnesses and deaths could have been prevented. That is why the American Lung Association is working hard for strong tobacco control laws that will reduce the number of new smokers, give current smokers new reasons and the help they need to quit and protect the lungs of nonsmokers. Fewer smokers will mean fewer deaths and illnesses caused by tobacco.

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