Stronger action needed against tobacco

Despite progress in some areas, government oversight of smoking is slipping. FDA regulation of tobacco, and more funding of prevention programs, is necessary to ensure that the use of cigarettes is extinguished.

Posted Feb. 4, 2008.

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As 2008 gets started, we can see progress in snuffing out tobacco use. A statewide ban on indoor smoking went into effect in Illinois. In Colorado, the statewide indoor smoking ban was extended to the last holdouts, casinos. Now, 14 states have smoking bans that cover all indoor public places, while another six have very limited exceptions. More bans, at the state and local level, are on the way.

But that's only part of the story. While states are rightly doing more to limit where people can smoke, they are backsliding in funding programs that would reduce how many people are smoking.

Only three states -- Colorado, Delaware and Maine -- are funding tobacco prevention programs at levels recommended by the Centers for Disease Control and Prevention, according to a December 2007 report from the Campaign for Tobacco-Free Kids, the American Heart Assn., the American Lung Assn. and the American Cancer Society Cancer Action Network. In January, the American Lung Assn. issued its own report that gave 18 states and the federal government failing grades for their anti-smoking efforts, while 32 states received F's for their funding of tobacco control and prevention.

The result is that after steady declines from 1997 to 2004, the smoking rate is stuck in neutral. About 20.8% of U.S. adults smoked in 2006, according to the CDC, virtually the same level as in 2004.

What's needed is action at two levels of government to get more Americans to kick the habit. First, on the federal level, the FDA must be given the green light to regulate tobacco, and tobacco taxes need to rise from their current 39 cents per pack of cigarettes. Second, on the state level, legislatures have to spend more on tobacco prevention and cessation to help those who want to quit smoking and make sure that those who might start, don't.

Combined, those efforts would increase smoking education and prevention, while counteracting the intense marketing by tobacco companies of products that kill 440,000 Americans per year -- the largest cause of preventable death in the U.S. -- and add 1,000 new smokers every day.

Legislation is pending that would give the FDA authority to restrict more severely tobacco makers' advertising and promotions, put stronger warning labels (including photos of cancerous effects of smoking) on packs and lower the levels of addictive nicotine, among other things. There are more consumer health protections for dog food than there are for tobacco. This bill is essential to improve the health of all Americans.

As that is considered, states should reverse course on funding tobacco prevention and cessation. For fiscal year 2008, it appears they have done just that, spending a collective $717.2 million, up from only $538.2 million two years earlier. But that money still does not reach the 2002 peak of $749.2 million. It doesn't come close to what tobacco companies spend to market their products: $13.4 billion in 2005, a rate that doubled since 1998, according to the December 2007 report.

That same report noted that states are spending only 3% of an expected $24.9 billion that has been received in tobacco taxes and settlements. They would need to spend just 6.4% of that total to reach CDC minimum levels. Besides the three states that already meet the CDC minimum, only 17 others fund smoking prevention and cessation at even half that level. Connecticut is providing zero funding.

While some states have made progress, and the federal legislation on FDA oversight has strong bipartisan support, all stakeholders in tobacco prevention must remain vigilant to ensure that governments do the right thing. It's not only nonsmokers who will benefit from this year's smoke-free laws -- losing a place to light up also prods smokers to quit. Now they must be given the means to do so.

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