Blowing Smoke: What's Happening to Tobacco Control Programs?
The release of a major new CDC report on states' tobacco control programs, the first in 5 years, is a great peg for taking a look at what's happening in your state and community. The CDC report gives state-by-state breakdowns of smoking rates by age and other demographics and provides a snapshot of current state regulations on smoking.
I'm a little concerned about whether the CDC report has the most up-to-date information on state smoking bans, though: it lists California as NOT banning smoking in workplaces, bars and restaurants:
California does not have a statewide smoke-free law that provides adequate protection against exposure to secondhand smoke in public places.
Huh? In fact, California banned smoking in most workplaces in 1995 and bars and restaurants in 1998, although some exemptions exist. Maybe I'm missing something here (define "adequate"), but stay tuned for a response from the CDC.
Below is a post I wrote late last year about reporting on your state and local tobacco control programs. My point about these programs being an easy target for budget cuts? It's getting worse. Just ask your local public health department.
December 1, 2008
Cigarette prices keep rising. The stigma surrounding smoking has never been greater. So why are Americans smoking at slightly higher rates for the first time in 15 years?
You could blame the recession, or more sophisticated tobacco advertising. You also could look at cutbacks in your state's tobacco control program. All 50 states have these programs, many funded by a 1998 settlement with tobacco companies estimated at $246 billion over 25 years. Some states, like California, also have funded tobacco control programs by raising cigarette taxes. The CDC has a good overview of these programs, with lots of state-specific stats, here.
While health advocates have urged state lawmakers to devote a big chunk of that settlement money toward preventing people from starting to smoke and helping them quit if they do, the lawmakers have had other ideas. States have spent just over 3 percent of their tobacco money on tobacco prevention and stop-smoking programs, according to a 2008 report released by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Cancer Action Network, American Lung Association and Robert Wood Johnson Foundation.
Tobacco control programs have been shown to be effective, not only in preventing and reducing smoking but in preventing deaths from heart disease. Yet they've long been an easy target for budget cuts, and the current recession is hitting some of them hard. In Wisconsin, for example, lawmakers have cut the state's tobacco control program's budget by more than half, prompting an editorial plea from the Ashland Daily Press newspaper to reverse that decision. New Jersey's program also faces cuts, as does Massachussetts'.
In addition, while Medicaid coverage for stop-smoking treatments such as Chantix or nicotine gum has increased over the past decade, some states are restricting the length of treatment or requiring copayments for it, potentially making it harder for low-income smokers to quit. Check out this MMWR report for more information on this angle.
There's a lot of fodder here for stories. What's going on with your state's tobacco control program? Is it being affected by state budget cuts? How might program cuts affect stop-smoking and prevention activities in your community? How is your state's Medicaid program paying for treatment for smokers?
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