The State of Tobacco Control 2014 has been released from the American Lung Association giving grades to states in four categories: tobacco prevention, smokefree air, cigarette tax, and cessation coverage. While Florida received an above average grade of “B” for smokefree air, it received a below average mark (D) for cigarette tax, and failing grades in two categories – tobacco prevention and cessation coverage.
Current smoking rates for adults, which range between 17.1% to 17.7%, are below the national average of 19.0%. Smoking rates in 2013 for middle school and high school students are reported at 2.6% and 8.6% respectively, which is also below the national average. But while the numbers are dropping, the economic cost in Florida due to smoking is a staggering $12,879,031,000.
Since 2003 cities and towns in Florida have had restrictions on smoking in workplaces, schools, and restaurants. Smoking in bars is only allowed if the bar makes 10% or less of their sales from food. And while many Florida parks, beaches and outdoor venues have smoke-free ordinances, “Florida’s Clean Indoor Air Act preempts local government from enacting laws stronger than the state.” However, the Act was amended in 2011 to authorize district school boards to “adopt rules prohibiting any person from smoking tobacco on, or in, any district-owned or district-leased facility or property.” This year’s legislative sessions will be addressing restoring “local control by giving municipalities and counties the right to restrict outdoor smoking in playground areas owned by the municipality or county,” (HB309) and prohibiting “smoking in a vehicle when a minor is present in the vehicle (HB341).
Florida received a below average grade of “D” for its cigarette tax which is currently at $1.339 per pack of 20 cigarettes. Our state ranks 27th out of 51, slightly below the U.S. Median of $1.36. Considering tobacco is the only legal consumer product that kills one third to one half of those who use it as intended, raising taxes would help encourage current users to quit and discourage future users from picking up the habit.
A failing grade was given to Florida in the area of cessation coverage. The state Medicaid program provides medications and counseling, but coverage varies by health plan. Quit attempt limits, co-payments, trying one cessation treatment before using another, and requiring counseling to receive medication are all seen as barriers to coverage. State employee health plans are similar to the Medicaid program, but co-payments are required. There is no provision mandate for private insurance. Currently Florida invests $4.86 per smoker to help them quit, less than half of the CDC recommendation of $10.53. One part of the barrier to coverage is the required use of counseling to receive medications, although they don’t explain the extent of the counseling. Some of the nicotine replacement therapies (NRT) are available to the general public and sold over the counter, however, those NRTs needing a prescription will need to be monitored by a doctor.
Florida has a “constitutional amendment requiring the Legislature to allocate at least 15% of the state’s annual tobacco settlement payments to a tobacco prevention program.” That percentage does not include money Florida receives as tobacco generated revenue which is listed at $1.6 billion for FY2014. The $65.6 million actually spent on tobacco prevention is up from FY2013, but is still far below the $210.9 million the CDC recommends spending. Florida only spends 31.1% of the CDC’s recommended spending, earning itself a failing grade in this category.
Florida has a lot of work ahead to protect all its citizens from the damage tobacco and secondhand smoke causes. We can’t take baby steps when the tobacco industry is charge ahead. Reducing tobacco use now will reduce health care costs in our future. Raising tobacco taxes significantly at one time rather than small amounts over time will discourage more teens from smoking and encourage more adults to quit. While only a minority of people in Florida smoke, 100% of the population breathes air. Let’s show America that Florida is serious about the health of its citizens.