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Comprehensive smoke-free laws, if enacted in the 27 states that do not have them, would result in 624,000 fewer smoking-related deaths and prevent 398,700 youths from starting to smoke, according to estimates in a new report commissioned by the American Cancer Society (ACS) Cancer Action Network (CAN).

In addition, a second report on the health and economic benefits of tobacco taxes found that a $1-per-pack cigarette tax increase in every state and Washington, DC, would result in 1.4 million adults quitting smoking and a reduction of 1.32 million smoking-related deaths.

“The reports provide a snapshot across the states so our advocates across the country can use the information,” says Angela Jones, associate director of policy for ACS CAN. “We lacked information on what the benefits could be, and now we'll have the actual numbers behind us to make our advocacy stronger.”

ACS CAN's Goals

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  2. ACS CAN's Goals
  3. Many Obstacles to Reducing Smoking

The reports, titled “Saving Lives, Saving Money,” are the result of the organization's first effort to analyze data from all 50 states and release the information widely to the public. They are part of ACS CAN's “Red to Green” initiative that indicates which states are making progress in smoke-free legislation. Those states with comprehensive smoke-free laws (100% smoke-free in workplaces, restaurants, and bars) are considered “green.” They include New York and Montana. Those states with no 100% smoke-free laws, such as Texas and Wyoming, are considered “red.” The yellow states, meanwhile, are smoke-free in some locations but not others (see Figure 1). ACS CAN's goal is to get all states to progress to green. Leaders also want smoke-free laws to cover all workplaces and ensure that venues are 100% smoke-free with no exceptions, such as smoking in certain places at certain times.

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Figure 1. Smoke-Free Legislation at the State, County, and City Level In effect as of July 1, 2011

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“One of the great findings of the report is that when they ran all the numbers, and you apply these tobacco control policies, there were positive health and economic benefits for every single state,” says Jones.

The reports also are guiding ACS CAN in prioritizing which critical states they should direct their resources toward. In Texas, for example, more than 110,000 smokingrelated deaths could be avoided if smoke-free laws were enacted, whereas North Carolina would have 78,100 fewer adult smokers by adopting a comprehensive law that would close the current loophole that allows smoking in nonhospitality workplaces.

In addition to increasing tobacco taxes and passing more smoke-free laws, ACS CAN advocates for improving access to smoking cessation services. “Most smokers want to quit, but they try to do it by themselves,” says Jones. “We want people to understand that there is help out there, and you're more likely to be successful if you use it.” Getting legislators to pay attention to these issues in difficult economic times is a challenge, particularly when the tobacco industry has significantly greater resources, she adds. At the same time, many state tobacco control programs are losing their funding. Still, the new reports will help highlight how much money such legislation will save over time. “We were surprised by the amount of benefits—in the billions of dollars in health care savings and revenues as well as the magnitude of the number of deaths prevented,” says Jones.

Many Obstacles to Reducing Smoking

  1. Top of page
  2. ACS CAN's Goals
  3. Many Obstacles to Reducing Smoking

Frank Chaloupka, PhD, professor of economics at the University of Illinois at Chicago, was the lead researcher for the reports. He has focused on the tobacco control arena for nearly 25 years and in recent years has researched tobacco control efforts in developing countries.

The 2006 Surgeon General Report on the Health Consequences of Involuntary Exposure to Tobacco Smoke jump-started much of the smoke-free legislation in the United States, and while every state now has some restrictions, certain states such as Georgia and Alabama have weak policies, notes Dr. Chaloupka.

Furthermore, he adds, although polls show two-thirds of the population would support increasing tobacco taxes, there is a general antitax sentiment in most states. At the same time, only 2 states (Alaska and North Dakota) are funding what the Centers for Disease Control and Prevention recommends for tobacco prevention programs, while only a tiny fraction of states are spending any of what they received from the 1998 multistate tobacco settlement on tobacco control.

According to a 2010 report issued by the Campaign for Tobacco-Free Kids, American Heart Association, ACS CAN, American Lung Association, and Robert Wood Johnson Foundation, states have cut funding for tobacco prevention and cessation programs to the lowest level since 1999, when they first received tobacco settlement funds.

In Fiscal Year 2011, the states will collect $25.3 billion in revenue from the tobacco settlement and tobacco taxes, but are spending only 2% of it, or $517.9 million, on programs to prevent children from smoking and to help smokers quit. The 2010 report notes that states had cut funding for such programs by 9%, or $51.4 million, within the past year and by 28%, $199.3 million, within the past 3 years Meanwhile, many other countries are far ahead of the United States in their tobacco control policies, notes Dr. Chaloupka, adding that the United States is one of a handful of countries that have not ratified the World Health Organization (WHO) Framework Convention on Tobacco Control treaty. The treaty outlines measures to reduce tobacco use and exposure to tobacco smoke.

Many low-income countries, for example, have found that increasing tobacco taxes has had a greater impact for them than such policies have had in the United States. “Those governments are concerned it will hurt their economy, but what they lose in the tobacco sector they make up for with a healthier workforce and improved productivity,” says Dr. Chaloupka.