American Lung Assn. gives mixed reception to tobacco control efforts

An annual report lauds graphic warning labels for cigarettes but takes the federal government to task for squandering "a huge opportunity to help smokers quit."

By — Posted Jan. 27, 2012

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The federal government took important steps to combat tobacco use in 2011, including extending quit-smoking benefits to federal employees, providing partial payment for states that offer tobacco counseling for Medicaid recipients and pushing graphic warning labels for cigarettes.

States, however, did a poor job of tackling tobacco-related issues, said the American Lung Assn.'s 10th annual report on tobacco-control initiatives (link). No states enacted strong smoke-free-air laws in 2011, and some cut funding to smoking prevention and cessation programs.

"We're talking about a vast, ongoing health crisis," said American Lung Assn. President and CEO Charles D. Connor.

In addition to its impact on individual lives, tobacco use costs the country nearly $193 billion annually in health care costs and lost productivity, he said.

In June 2011, the Food and Drug Administration released images of nine graphic warning labels, including a man smoking through a tracheotomy hole and a small child being exposed to cigarette smoke. The labels were scheduled to appear on cigarette packs in 2012, but a federal judge issued a preliminary injunction against the FDA in November 2011. The federal government is appealing the decision.

Despite its progress in several areas, the report criticized the federal government for failing to require one comprehensive smoking cessation benefit nationwide. Instead, states will determine their own quit-smoking benefits for insurance exchanges to be offered under the Patient Protection and Affordable Care Act.

"The federal government squandered a huge opportunity to help smokers quit," said Erika Sward, director of national advocacy for the American Lung Assn.

Meanwhile, the tobacco industry continued to fight the FDA about implementation of the Family Smoking Prevention and Tobacco Control Act with several lawsuits and by promoting use of dissolvable "smoke-free" products that resemble breath mints and strips. The FDA is debating how to regulate such products, Sward said.

"The consequence of this is that they're much easier for kids to hide and stick in their pockets," she said. "They are very discreet, because they just dissolve in your mouth."

Of the states, only Delaware, Hawaii, Maine and Oklahoma received passing grades in the four areas studied in 2011, said Thomas Carr, the report's lead author and director of national policy for the American Lung Assn. The poor economy played a role, as several states reduced funding for tobacco control programs. No states raised tobacco taxes significantly, and New Hampshire lowered its cigarette tax by about a dime per pack, the report said.

"There is a growing disparity between progress made at the federal level and weak efforts at the state level," Carr said. "The state report cards were plastered with F's."

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Tobacco's impact on the nation

In its annual report rating tobacco control initiatives nationwide, the American Lung Assn. cites the annual costs of tobacco use in dollars and lives lost.

$192.8 billion: Economic costs due to smoking

19.3%: Adult smoking rate

19.5%: High school smoking rate

5.2%: Middle school smoking rate

392,681: Smoking-related deaths

125,522: Smoking-related lung cancer deaths

103,338: Smoking-related respiratory disease deaths

Source: "American Lung Association State of Tobacco Control 2012," American Lung Assn., Jan. 19 (link)

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