Cigarette smoking continues to be the leading cause of preventable disease and death in the U.S. claiming approximately 443,000 lives prematurely every year (1). Smoking not only takes lives of those who use tobacco, but also those exposed to secondhand smoke. Smokeless tobacco has been linked to greater incidence of fatal heart attacks and strokes (2). The bottom line is that no tobacco product is safe to use.
Tobacco control efforts by the American Heart Association have contributed to a decline in U.S. cigarette consumption by nearly 25% since 1998 (3). The American Heart Association advocates for:
Studies from around the world have provided evidence for the reduced incidence of heart attacks and hospitalizations after implementation of smoke-free air laws (4). The hospitality and tobacco industries often promote the idea that business will suffer after these laws are passed. However, increasing evidence from municipalities, states, and countries where these laws have been passed show no significant impact on sales data and in many instances business actually increases (5). In order to reduce the burden of second hand smoke, AHA advocates for:
- Smoke-free air laws that are comprehensive and apply to all workplaces and public environments.
- No preemption of local ordinances.
- No exemptions for hardship, opting out, or ventilation.
- No exemptions for casinos and gaming organizations, bars, or private clubs.
Many studies have found that cigarette tax increases reduce consumption, especially cessation rates in young smokers (6). The general consensus is that for every 10% increase in the real price of cigarettes, the increased cost reduces overall cigarette consumption by approximately 3-5%, lowers the number of young-adult smokers by 3.5%, and cuts the number of kids who smoke by 6-7% (7). To achieve these results, the American Heart Association advocates for:
- Significant increases in tobacco excise taxes at the state, county, or municipal levels that cover all tobacco products.
- Allocation of at least some of these revenues generated toward tobacco control, prevention, and cessation programs, as well as other health-related initiatives.
Tobacco Control Funding
In 1998, the four largest U.S. tobacco companies and the attorneys general of 46 states signed the Tobacco Master Settlement Agreement (MSA), settling the states' Medicaid lawsuits against the tobacco industry for recovery of their tobacco-related health care costs. Under the agreement states received up-front payments of $12.74 billion with the promise of an additional $206 billion over the next 25 years. Additionally, in 2010 and 2011, some states increased excise taxes on cigarettes, generating millions of dollars in new revenue. Ideally, states would use these funds to fully fund tobacco control programs that follow Centers for Disease Control and Prevention (CDC) best practices. However, revenue from the MSA and tobacco taxes continues to flow toward other parts of state budgets despite the fact that state tobacco control program expenditures have been shown to be independently associated with overall reductions in smoking prevalence (8). To protect these funds, the American Heart Association advocates for:
- Sustainable funding for state tobacco prevention and cessation programs that meet or exceed CDC recommendations.
- Tobacco control programs that are comprehensive in accordance with CDC recommendations, staffed appropriately, and administered effectively with periodic evaluation.
1 - Dube SR, McClave, A., James, C., Caraballo, R., Kaufmann, R., Pechacek, T. Vital signs: current cigarette smoking among adults > 18 years - United States 2009. MMWR. September 7, 2010;59:1-6
2 - Piano MR, Benowitz NL, Fitzgerald GA, Corbridge S, Heath J, Hahn E, Pechacek TF, Howard G. Impact of smokeless tobacco products on cardiovascular disease: implications for policy, prevention, and treatment. Circulation. 2010 Oct 12;122(15):1520-44. Epub 2010 Sep 13.
3 - Go A, et al. Heart Disease and Stroke Statistics 2014 Update: A Report from the American Heart Association. Circulation. Published online December 18, 2013.
4 - Secondhand smoke exposure and cardiovascular effects: making sense of the evidence. Committee on Secondhand Smoke Exposure and Acute Coronoary Events. Board on Population Health and Public Health Practice Institute of Medicine. October 15, 2009. Washington, DC
5 - U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General - Executive Summary. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.
6 - Carpenter C, Cook PJ. Cigarette taxes and youth smoking: New evidence from national, state, and local Youth Risk Behavior Surveys. Journal of Health Economics. Mar 2008;27(2):287-299
7 - Chaloupka, F, "Macro-Social Influences: The Effects of Prices and Tobacco Control Policies on the Demand for Tobacco Products," Nicotine and Tobacco Research, 1999.
8 - Farrelly MC, Pechacek TF, Thomas KY, et al. The impact of tobacco control programs on adult smoking. Am J Public Health. Feb 2008;98(2):304-309.
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