The South Gets an "F"

LYNNE JETER

The South Gets an "F" | American Lung Association, Philip Morris, Supreme Court, cigarette taxes, Altria Group, Charles Connor, James Rohack, tobacco

Tobacco Control Report Card Shows Needed Work

A new report card gives the South consistently failing grades for not protecting southerners from illnesses caused by tobacco. Alabama, Kentucky, North Carolina, South Carolina, Virginia and West Virginia were among the states receiving the worst marks.

Yet those below the Mason-Dixon Line are not alone. Missouri also shared bottom grades. And the United States as a whole flunked the test as well.

According to the American Lung Association's (ALA) State of Tobacco Control 2008, the federal government—and most states—lacked enacting critical policy measures, such as placing higher taxes on cigarettes and satisfactorily regulating tobacco products.

"Effective tobacco control saves both lives and money," said ALA CEO Charles D. Connor. "Tobacco use is the number one preventable cause of death in America."

Tobacco-related diseases such as lung cancer and COPD (chronic obstructive pulmonary disease) result in the deaths of nearly 400,000 Americans annually. Another 50,000 deaths result from exposure to secondhand smoke.

"All the while, tobacco companies continue to find new ways to keep smokers hooked," Connor said. "Each day, the tobacco industry lures 1,100 kids into becoming regular daily smokers. Also each day, 1,000 people die from tobacco-related diseases. It's easy to see from this arithmetic that the tobacco industry is motivated to attract new young replacement smokers."

Paul Billings, ALA vice president of national policy and advocacy, called the 2008 report card "abysmal."

Specifically, the report card graded the federal government:
  • "F" for FDA regulation of tobacco products. Before adjourning for 2008, the U.S. Senate failed to take action on a bill authorizing FDA regulation of tobacco products that the U.S. House of Representatives had passed overwhelmingly.
  • "F" for cigarette tax. The federal government taxes cigarettes at 39 cents a pack, well below the failing grade standard of 60 cents per pack.
  • "D" for failing to ratify the World Health Organization's Framework Convention on Tobacco Control, a treaty designed to limit health risks associated with smoking. The report criticized the Bush Administration for neglecting again "to submit the treaty to the Senate for ratification."


The report card also held the federal government responsible for not taking action to increase access to smoking-cessation programs.

"While the Medicare drug program covers smoking-cessation drugs, the federal government does not require state Medicaid programs to cover cessation treatments and services for Medicaid recipients," said Billings, pointing out that people receiving Medicaid smoke at a 60 percent higher rate than the national average.

On the state level, no state received an "A," even though Hawaii, Maine, Massachusetts and Rhode Island received the highest marks. But those states flunked at least one grading category, such as smoke-free air laws, funding for tobacco-cessation programs, and covering tobacco-cessation treatments for Medicaid recipients and state employees.

The District of Columbia and Puerto Rico, along with 23 states, have recently enacted comprehensive smoke-free air laws that protect workers from exposure to secondhand smoke. Fourteen states flunked this category.

The average state tax is $1.19 a pack. New York has the highest rate at $2.75 per pack; South Carolina has the lowest at 7 cents a pack. Last year, only Massachusetts, New Hampshire, New York and the District of Columbia raised cigarette taxes.

Only Alaska and Delaware funded tobacco-cessation programs to the level recommended by the U.S. Centers for Disease Control and Prevention (CDC), a category in which 42 states failed. The CDC estimates that every year, smoking is responsible for $96 billion in healthcare costs and $97 billion in lost productivity.

Enacting strong tobacco control laws will stem this loss, said Connor, adding that he hopes the Obama Administration plans to aggressively support tobacco control.

"Congress must give the U.S. Food and Drug Administration authority over tobacco products," Connor insisted. "State governments must step up and fully fund tobacco-cessation programs, increase cigarette taxes, and pass comprehensive smoke-free air laws."

James Rohack, MD, president-elect of the American Medical Association (AMA), said the report "confirms that weak government tobacco policies fail to support smokers' efforts to quit, and fail to discourage teens from smoking."

He said the AMA encourages federal and state lawmakers to pass legislation that invests in tobacco prevention programs and will help Americans stop using tobacco and protect them from exposure to second-hand smoke.

Vince Willmore, spokesperson for the Campaign for Tobacco-Free Kids, said the report "underscores that we know how to win the fight against tobacco use in the United States, but need strong political leadership to implement proven solutions at all levels of government."

The report provides a roadmap, added Willmore, "for the federal and state governments to follow, beginning with congressional enactment of FDA regulation of tobacco products."

Others are weighing in on tobacco use. In a January ruling that could pave the way for mega lawsuits against tobacco companies, the Supreme Court gave smokers the go-ahead to sue over the allegedly deceptive marketing of "light" cigarettes.

Despite the report card and legal action impacting the tobacco industry, tobacco giant Philip Morris is "opposed to excise taxes on cigarettes and tobacco products because they unfairly burden adult tobacco consumers," said spokesperson David Sutton, adding that Altria Group, Inc., the parent company of Philip Morris, supports the efforts of smokers who want to quit and endorses having the FDA regulate tobacco products.