For 13 years the American Lung Association has published its State of Tobacco Control report by grading states on their tobacco control measures in four areas: Tobacco Prevention, Smokefree Air, Cigarette Tax and Cessation Services. If these were like school grades, the 2015 report would find a lot of states grounded this year!
According to the report, of the 50 states and the District of Columbia, only one state, Vermont, has all passing grades with a “C” in tobacco prevention, an “A” in smokefree air, a “B” in their cigarette tax and a “B” in cessation. If a “D” grade is considered passing then Maine would also have to be included as they received a “D”, “A”, “D” and “B” in the above listed categories. Most states didn’t fare as well. Seven states received all “F” scores: AL, KY, MS, MO NC, TX and VA. However, 12 states only had one “F” score: DE, HI, MD, MA, MN, MT, NM, NY, ND, OK, RI, and D.C. Improvements are being made with baby steps.
In the Tobacco Prevention category, only Alaska and North Dakota received an “A”, which means they spent 80% or more of the CDC recommended level for funding their programs. Delaware received a “B”, and Hawaii, Oklahoma, Vermont and Wyoming received a “C”. Arkansas and Maine received a “D” and 42 other states, Florida included, received a “F.” Florida spent 35.8% of the CDC recommended level of funding in this area. Florida takes in $1,600,000,000 in tobacco-related revenue and spends $69,475,578 for State Tobacco Control Programs. It should be noted that years ago Florida voters approved a provision that would require tobacco settlement money be used to fund tobacco prevention programs.
SMOKEFREE AIR: Smoking restrictions for each state were reviewed for this category. Those states with smoking prohibited in public places, such as restaurants, bars and workplaces, and without state preemption will be at the top of the list. According to the list, 24 states received an “A” grade, seven states received a “B”, and seven received a “C”. Three states, New Hampshire, Oklahoma and West Virginia received a “D” and 10 states received a “F”: AL, AK, KY, MS, MO, NC, SC, TX, VA, and WY. All Americans have the right to breathe clean air. Considering what we now know about the effects of secondhand smoke on our health, smoking should be banned in all public places, including all casinos, with no exemptions. Florida received a “B” in this category because smoking is still allowed in bars that make up 10% of less of their sales from food. Florida also has a pre-emption law that means communities cannot adopt laws that are stronger laws than the state.
CIGARETTE TAX: In order to receive an “A” in this area, the state must have the cigarette tax at $3.08 or higher. According to the report only 2 states achieved this: Massachusetts, at $3.51/pack and Hawaii at $3.20/pack. Unfortunately, the report forgot New York, at $4.35/pack, the highest in the nation. Moving New York to the top of the list means six states received a “B”: CT, MN, RI, VT, WI and D.C. Two states received a “C” grade: Alaska and Washington. Seven states received a “D” grade: ME, MD, MT, NH, NJ, NM, and UT. The other 33 states received a “F”. Florida is in the last group receiving a “F” for their $1.339/pack tax for cigarettes; however, according to the report Florida should have received a “D” because they fall into the $0.77 to $1.539 category. Since the rating is based on a number of points regarding other types of tobacco besides cigarettes, perhaps Florida’s “F” rating was because the state does not tax cigars, according to the website Half Wheel, which makes tobacco very affordable for youth.
CESSATION SERVICES: Cessation services encompasses many areas including medications, counseling services, barriers to coverage (copays or limits), Medicaid coverage, coverage by state employee health plans and private insurance plans and the state Quitline. No state received an “A” for their cessation services. Only four states received a “B” (ME, MN, OK, VT) or a “C” (AZ, DE, NM, ND). Nine states received a “D”: CA, CO, ID, MD, MA, MT, NY, RI, and SC. The remaining 33 received a “F”, including Florida. When comparing Florida to a state that received a “B” grade, Florida would have to increase the amount of NRT’s they provide under the Quitline, perhaps provide more services for Medicaid participants, and invest more per smoker to help them quit. Florida only invest $4.37 with the average being $3.65. The states that received a “B” invested between $12.66 (ME) and $6.22 (VT).
Here in Florida, the adult smoking rate is at 16.8%, but we still lose 28,607 people a year to smoking. While the state takes in $1.6 Billion from tobacco, the economic cost to the state due to smoking is over $12.8 billion. Banning smoking in all public places with no exemptions would provide clean air and healthier work environments for all workers in our state. Increasing taxes on all tobacco products would cause many users to quit or cut back, but it would also increase revenues. Providing tobacco prevention for all students throughout their school years would help educate them about the dangers of tobacco and prevent many students from starting a deadly habit. It would also reduce the amount of youth smoking. Raising the smoking age would also help the youth smoking rates.
Doing everything you can to provide the residents of your state with healthy living environments is a win-win for them and for your state. We are all in this together.
You can see how your state did in the State of Tobacco Control 2015.