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KFYR-TV: ND Gets 'F' Grade for Tobacco Taxes on State of Tobacco Control Report

By: Amanda Skrzypchak, KFYR-TV
When it comes to taxes on tobacco North Dakota gets an F from the American Lung Association.
Released in it’s annual State of Tobacco Control Report Wednesday, North Dakota’s overall grades didn’t change from last year. The report shows the state received A’s for smoke free air, as well as prevention and control program spending. A C for access to cessation and an F for tobacco taxes.
Cigarette taxes are at 44 cents per pack making it one of the lowest in the nation.
The CDC best practices show that increasing the price of tobacco is the most effective way to reduce the amount of kids smoking.
For a complete look at the report and compare our state to others visit stateoftobaccocontrol.org.
http://www.kfyrtv.com/home/headlines/ND-Gets-F-Grade-for-Tobacco-Takes-367523391.html

Bismarck Tribune Editorial: N.D. becomes leader in tobacco fight

North Dakota has garnered praise for its spending efforts to reduce tobacco use. There’s a little irony in this since the Legislature in the past has questioned the amount of spending.
The Campaign for Tobacco-Free Kids looked at how states used the billions of dollars received from lawsuits settled with major tobacco companies in 1998.
According to the Centers for Disease Control and Prevention, North Dakota is the only state to spend at levels it recommended. The state also was one of five states to spend at least 50 percent of what the CDC recommends.
Spending by states on tobacco prevention programs bottomed out at $459.5 million in 2013, according to the campaign’s report, and is expected to reach $468 million in 2016. At the same time, an estimated $25.8 billion will be collected in settlement funds and tobacco taxes. Tobacco companies reportedly spend about $9.6 billion a year on marketing. North Dakota has $10 million planned for fiscal year 2016.
The anti-tobacco campaign appears to be working.
A survey conducted by the state Department of Public Instruction and the Department of Health shows 80 percent of the students responding said they did not use cigarettes, cigars or smokeless tobacco, an increase from 74 percent two years ago. The percentage of high school students who said they had smoked a cigarette at least once in the month dropped from 19 percent to 12 percent. The percentage of high school students who said they had ever tried to smoke a cigarette was 35 percent, down from 41 percent in 2013. Smokeless tobacco use declined from 14 percent to 11 percent this year.

The anti-tobacco effort emphasizes keeping kids from using tobacco and if they do, getting them to quit. The numbers indicate they are being successful. Some have questioned the amount of money being spent and how it’s being used. While the campaign may appear heavy-handed at times, it’s getting the point across. In the past some legislators wanted to spend less on anti-tobacco efforts and divert the tobacco settlement money to other programs. In 2008 North Dakotans passed a measure requiring a portion of the settlement funds be used for tobacco prevention.
Even a tobacco company favors the spending. “We believe states should use (settlement) payments to fund tobacco cessation and underage tobacco prevention programs at levels recommended by the Centers for Disease Control,” Brian May, a spokesman for Philip Morris, told the Forum News Service.
The anti-tobacco effort has been successful in other areas with smoking banned in public areas. And now the efforts go beyond traditional forms of tobacco to vaporing products. The dangers of second-hand smoke is another focus, with apartment residents being urged to demand a smoke-free environment. Some may think this is going too far, but anti-tobacco campaign is on a roll and has the money to keep going.
Society is getting closer to being smoke-free, too fast for some and too slowly for others.
http://bismarcktribune.com/news/opinion/editorial/n-d-becomes-leader-in-tobacco-fight/article_ed7dc472-6eb0-5e6d-b63b-51c4cd23e599.html

Fargo Forum editorial: Tobacco cessation succeeds

There is good news in the war against tobacco use: North Dakota is winning.
The Campaign for Tobacco-Free Kids said last week that North Dakota is the only state spending at levels recommended by the U.S. Centers for Disease Control and Prevention on tobacco cessation programs. That level is 50 percent of funds designated from the 1998 tobacco settlement lawsuits.

But it’s about more than spending dollars where they were meant to be spent. It’s about results, and on that score North Dakota is a leader. For example, a portion of the money was spent to fund a study of secondhand smoke’s effects in Grand Forks, the results of which were pivotal in that city passing a 2010 law that outlawed smoking in bars, casinos and truck stops. Several North Dakota cities, using information compiled locally and by the North Dakota Center for Tobacco Prevention and Control Policy, easily approved ordinances directed at ending secondhand smoke in public places and businesses. Most of the cities were ahead of a Legislature that remained in the thrall of the state’s tobacco lobby, and it took a 2012 ballot measure to impose statewide restrictions on smoking and secondhand smoke.
There has been some grousing and whining about how tobacco settlement money is being spent in North Dakota. It’s come mostly from special interests that lost the tobacco cessation battle years ago. They were wrong then and are wrong now about the effects of the expenditures. For example, during the time that education and public service efforts were ratcheted up, smoking among youths plunged to 11.7 percent this year after hovering at about 20 percent the eight previous years.
Anti-tobacco programs work. The statistics are unambiguous. Tobacco settlement money has been well-spent in North Dakota, and the CDC and others recognize the state’s success. That’s good news.
Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board
http://www.inforum.com/opinion/editorials/3903588-forum-editorial-tobacco-cessation-succeeds

Grand Forks Herald: Report: North Dakota only state spending enough on tobacco prevention

By John Hageman, Grand Forks Herald
A report released this week argues almost every state in the country is not spending enough money on tobacco prevention and cessation programs—every state, that is, except for North Dakota.
The report, released by the Campaign for Tobacco-Free Kids, focuses in part on the billions of dollars states have received since they settled lawsuits against major tobacco companies in 1998. With $10 million set aside for fiscal year 2016, North Dakota is the only state to spend at levels recommended by the Centers for Disease Control and Prevention and was one of five states to spend at least 50 percent of what the CDC recommends.
 
“It’s so frustrating because it’s such a critical investment, and we’re talking about such a small amount of money,” said John Schachter, director of state communications for the Campaign for Tobacco-Free Kids. “When there’s a pot from which to draw from logically—tobacco taxes and the settlement—as we say, it’s a no-brainer.”
States spent as much as $717.2 million on tobacco prevention programs in fiscal year 2008, but that dropped during the recession and bottomed out at $459.5 million in 2013, according to the campaign’s report. Spending will reach $468 million in fiscal year 2016, a fraction of the estimated $25.8 billion they will collect in settlement funds and tobacco taxes, though the budgets for two states were not yet available.
Tobacco companies spend about $9.6 billion a year on marketing, according to the campaign’s report.
“We believe states should use (settlement) payments to fund tobacco cessation and underage tobacco prevention programs at levels recommended by the Centers for Disease Control,” Brian May, a spokesman for tobacco giant Philip Morris, wrote in an email to the Herald.
While tobacco companies cannot advertise on television or the radio, Schacter said “it’s pretty clear the industry is out there in force.” He said the industry spends most of its marketing dollars at “point of sale,” such as displays at convenience stores and gas stations.
“The states still know it’s an issue, but for whatever reason, they’re deciding to spend the money elsewhere,” Schachter said.

N.D. in the lead

The campaign’s report highlights North Dakota as an example for the rest of the states to follow, citing a drop in high school student smoking rates in recent years.
But North Dakota hasn’t always been a leader in tobacco prevention spending. In fiscal year 2009, it spent just $3.1 million on those programs, or one-third of CDC-recommended funding. That changed with the passing of a measure in 2008 requiring a portion of the settlement dollars be used to reduce tobacco use.
“The settlement did not dictate how the money from the settlement was spent, but it did point out that the settlement was entered into because of the unacceptable behavior of the tobacco industry,” said Jeanne Prom, executive director of the North Dakota Center for Tobacco Prevention and Control Policy.
North Dakota’s tobacco tax revenue is not used for prevention efforts, she said.
Minnesota will receive $791.7 million in total tobacco revenue in fiscal year 2016 but will spend only $21.5 million on prevention programs, less than half of what the CDC recommends, according to the campaign’s report.
Laura Oliven, the tobacco control manager at the Minnesota Department of Health, called the CDC recommendations “aspirational.” She also pointed out the campaign’s figures don’t capture Blue Cross Blue Shield’s Center for Prevention in Minnesota.
Minnesota’s adult smoking rate has dropped to 14.4 percent, the lowest it has ever recorded, the health department announced in January.
“We do a lot to maximize the funds we have,” Oliven said. “I guess the theme here really is that while we’ve made a lot of great strides, there’s still considerable work to be done.”

Local outcomes

Haley Thorson, a tobacco prevention coordinator at the Grand Forks Public Health Department, said tobacco settlement dollars helped fund a study asking residents about second-hand smoke. She called that a “pivotal piece of information” in Grand Forks passing a law in 2010 that outlawed smoking in bars, casinos and truck stops.
“That policy was passed by the City Council because we really did have the pulse of how the community supported that policy,” she said.
North Dakota passed a similar statewide law in 2012.
The health department receives about $300,000 annually from the Center for Tobacco Prevention and Control Policy, or BreatheND. Thorson said it focuses much of its efforts on tobacco-related policies.
“We used to go into schools and educate kids on the harms of tobacco use, but the better bang for our buck is to establish a comprehensive tobacco-free school policy that allows them to be educated in an environment where they’re not exposed to tobacco use,” she said.
Those efforts appear to be working.
The percentage of North Dakota high school students who smoked at least once in the past month plunged to 11.7 percent this year after hovering around 20 percent for the eight previous years, according to survey results provided by Thorson.
“For the states that aren’t spending anything or next to nothing, they need to see results like these,” Thorson said.
http://www.grandforksherald.com/news/region/3900310-report-north-dakota-only-state-spending-enough-tobacco-prevention

States Most Impacted by Tobacco Do Least to Reduce Smoking’s Toll

From Parnership for Drug-Free Kids
States most impacted by tobacco use often do the least to reduce the toll of smoking, according to an analysis by USA Today. Kentucky, Tennessee, Missouri, West Virginia and Mississippi are doing the worst job in terms of tobacco control, the newspaper found.
USA Today found big tobacco-growing states, including Kentucky, Georgia and Tennessee, have the poorest and sickest residents, but spend less than one-fifth of the federal government’s recommended minimum for tobacco education and enforcement.
States hardest hit by tobacco use are the least likely to restrict smoking in restaurants and workplaces, the analysis found. These states impose penalties of $100 or less on businesses that sell tobacco to children, compared with $10,000 in states with the most aggressive enforcement.
Tobacco taxes in states with the most smokers are 60 cents or less, compared with $4.35 in New York and $3.75 in Rhode Island, the newspaper found.
USA Today created two scores for states. States’ “impact score” combined youth and adult smoking rates with public perception about the risks of smoking. States’ “aggressiveness score” combined cigarette taxes, smoking bans, how state spending compares with federal recommendations, ad restrictions, and penalties on cigarette sales to young people.
The states that scored high on aggressiveness and low on tobacco impact included Hawaii, New York and Utah. States scoring low on aggressiveness and high on tobacco impact included Kentucky, Tennessee, Missouri, West Virginia and Mississippi.
According to Brian King, a Deputy Director in the Centers for Disease Control and Prevention’s Office of Smoking and Health, the most effective ways to reduce smoking are to regulate it, increase cigarette taxes, run powerful anti-tobacco campaigns and adequately fund tobacco control efforts. He notes that government anti-smoking efforts are “outgunned” by the tobacco industry, which spends about $1 million an hour advertising tobacco.
http://www.drugfree.org/join-together/states-impacted-tobacco-least-reduce-smokings-toll/

Today's Smokers Are Having a Harder Time Quitting — What Changed?

Dr. Daniel Seidman,  Smoking cessation expert | From HuffPost Healthy Living Blog

Over the last 25 years, cigarette consumption by smokers in the United States decreased by almost one-third. Over that same period, however, many tobacco companies reengineered cigarettes to more efficiently deliver the nicotine that keeps their customers coming back (1,2). This is called the “yield.” Increased yield means smokers, even if they smoke fewer cigarettes per day, still get plenty of nicotine. In other words, most of today’s cigarettes are not the same ones your mother or father smoked.

Not only are today’s cigarettes different — so are smokers. They are more likely to experience stress, worry, and depression regardless of their income (3). Recent research shows that it is quitting that brings stress relief rather than the other way around; cigarette addiction itself is a source of stress, anxiety, and depression (4,5) As the number of smoke-free environments increased, and because smokers smoke fewer cigarettes on average, today’s smokers generally wait longer between cigarettes. This delay increases the psychological and emotional reward value of each cigarette. At the same time, because they can’t smoke whenever they want, the timing is often uncertain, and the payoff — being able to light up — is irregular. Paradoxically, this sort of “intermittent” sporadic or random reinforcement is actually the strongest form of psychological reinforcement, thus making current patterns of smoking behavior harder to extinguish. Waiting to smoke is not quitting smoking!

Another factor making it harder to quit smoking today is that funding for tobacco prevention has been cut significantly. This illustrates the diminished importance society places on efforts to help smokers. Meanwhile, tobacco companies spend $18 to market their products for every dollar spent to support smokers and reduce smoking (6). Ostracized from private homes, work, cars, and public spaces, many smokers report high levels of shame when they leave social gatherings to get a nicotine fix. Our cultural norm of self-help places the burden of quitting, and blame of failure, squarely on smokers’ shoulders. Self-help, however, is clearly not working for many struggling to quit.

The United States has made remarkable progress against smoking, but most of that progress occurred in the 40 years before 2004, when the adult smoking rate was cut about in half to 20.9 percent. The most recent data, released by the Centers for Disease Control (CDC) on May 22, 2015 (7), is that the median prevalence of cigarette smoking in 2011 was 21.2 percent. Even adjusting for changes in the way smoking rates are being measured, this is higher, not lower, than the 20.9 percent reported 7 years earlier! For 2012, the smoking rate was 19.6, and for 2013 it was 19.0, barely budging from a decade earlier!

As we observed World No Tobacco Day 2015 this past Sunday, May 31, many smokers continued to find themselves in a trap set for them by cigarettes. Cigarettes are designed for addiction and not for recreational “take it or leave it” use. Many of today’s smokers therefore find themselves caught between a lack of constructive social and psychological support, and the destructive effects of highly nicotine-efficient cigarettes, creating a tobacco control stalemate.

What can be done?

We can start by requiring manufacturers to limit or taper permitted nicotine levels in cigarettes. All tobacco and nicotine products should be standardized and openly disclose their nicotine levels, and how much is absorbed into smokers’ bodies the same way people track calories or carbohydrates.

Here are five quick tips for smokers trying to quit:

  • Try to challenge beliefs that justify smoking. Beliefs such as “I smoke because I’m stressed,” “I’ll quit tomorrow,” “I’ll only smoke one,” and “I’m not strong enough to quit” are common and tend to cement smoking as a behavior.
  • Consider these three “triggers” to smoking, and be prepared with strategies to cope with them: 1) Other smokers: Avoid other smokers or ask them not to smoke around you, 2) Alcohol: Avoid alcohol or limit drinks as necessary, and 3) Emotional stress: Learn to adjust to situations without smoking.
  • With cigarettes delivering a stronger dose of nicotine, consider using two forms of NRT. The combined NRT approach not only delivers nicotine more aggressively to replace that from cigarettes, the U.S public Health Service 2008 update (8) found this to be the best of the medical options available for helping smokers quit.
  • Beware of cutting down as a strategy to quit unless you schedule your reduction of smoking in advance for a limited and specific amount of time prior to a target quit date. Stalling, delaying, or reducing smoking are tactics to avoid smoking, but are also ways to avoid quitting. Randomly reducing to quit is a common cessation strategy which recent research suggests is associated with lower cessation success rates. A 2013 Gallup poll (9) found smokers who succeed are more likely to quit abruptly (48 percent) vs. gradually (2 percent). A short-term technique for building confidence to prepare a successful quit day is smoking by the clock, otherwise known as “scheduled smoking” (10).
  • Download an app on your smartphone so you always have access to scientifically supported psychological and behavioral techniques. Such an app should help you prepare for and plan a successful quit day, as well as offer relapse prevention tools. It is critical that the app address not only the physical ties to your smoking addiction, but also the emotional side. Of course, I would like to highlight my own Up in Smoke app for iPhone, iPad Android, and the web!

Dr. Daniel Seidman, a clinical psychologist, is director of smoking cessation services at Columbia University Medical Center. He is author of the book Smoke-Free in 30 Days and of the “Up in Smoke” app from Mental Workout for iPhone, iPad, Android, Mac, and PC.

References:

  • Variation in nicotine intake in U.S. Cigarette smokers Over the Past 25 Years: evidence From nHanes surveys. Martin J. Jarvis, Gary A.Giovino, Richard J. O’Connor, Lynn T. Kozlowski, John T. Bernert.
  • SRNT Journal Research Advance Access published July 25, 2014
  • Recent increases in efficiency in cigarette nicotine delivery:implications for tobacco Control. Thomas Land, Lois Keithly, Kevin Kane, Lili Chen, Mark Paskowsky , Doris Cullen, Rashelle B. Hayes, Wenjun Li. SRNT Journal Advance Access published January 13, 2014
  • 2013 Gallup-Healthways Well-Being Index.
  • Tanya R. Schlam, Megan E. Piper, Jessica W. Cook, Michael C. Fiore and Timothy B. Baker. “Life 1 Year After a Quit Attempt: Real-Time Reports of Quitters and Continuing Smokers.” Annals of Behavioral Medicine, Vol. 44, Issue 3, 309-319. December, 2012.
  • West R, Brown J (2015) How much improvement in mental health can be expected when people stop smoking? Findings from a national survey, Smoking in Britain, 3,6. http://www.smokinginbritain.co.uk/read
  • Campaign for Tobacco Free Kids. Broken Promises to Our Children: The 1998 State Tobacco Settlement Fourteen Years Later (Updated in 2014).
  • State-Specific Prevalence of Current Cigarette Smoking and Smokeless Tobacco Use Among Adults Aged ≥18 years -United States, 2011-2013. CDC, Morbidity and Mortality Weekly Report (MMWR) May 22, 2015 / Vol. 64 / 19. See Table 1. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6419a6.htm?s_cid=mm6419a6
  • The 2008 update to Treating Tobacco Use and Dependence, U.S. Department of Health and Human Services Public Health Service May 2008. See page 109 http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/clinicians/update/treating_tobacco_use08.pdf
  • http://www.gallup.com/poll/163763/smokers-quit-tried-multiple-times.aspxhttp://www.gallup.com/poll/163763/smokers-quit-tried-multiple-times.aspxThe effects of smoking schedules on cessation outcome: Can we improve on common methods of gradual and abrupt nicotine withdrawal? Cinciripini, Paul M.; Lapitsky, Lynn; Seay, Sheila; Wallfisch, Annette; Kitchens, Karen; Van Vunakis, Helen. Journal of Consulting and Clinical Psychology, Vol 63(3), Jun 1995, 388-399.

http://www.huffingtonpost.com/daniel-seidman/todays-smokers-are-having_b_7471194.html

Forum editorial: Minnesota tobacco use down

The anti-tobacco work of ClearWay Minnesota in conjunction with other tobacco cessation efforts has had remarkable results in reducing smoking rates among all age groups in Minnesota. It’s a record worthy of high praise. It’s unambiguous evidence that focused, science-based anti-tobacco campaigns can work.

Numbers released last week by ClearWay show only 14.4 percent of Minnesotans smoke cigarettes, down from 22.1 percent in 1999. The decline through the time period has been steady, and corresponds to increased education and imposition of legal restrictions on smoking in public places. Add new medical research about second-hand smoke, and graphic anti-smoking television advertising, and it appears the multi-faceted message is getting through.

But not to every age cohort.

In ClearWay statistics from 2010 to 2014, smoking hardly dipped at all (1 percent) in the 25-44 year-old group, from 19.7 percent to 18.7 percent. A similar slight improvement was measured in the 45-64 year-old cohort, compared with a huge drop (from 21.8 percent to 15.3 percent) in Minnesotans age 18-24. Which could lead to the conclusion that some Minnesotans don’t get smarter as they age. But whatever the reason, the overall percentages of all Minnesotans who smoke is down over the longer study period, and that’s good news for smokers who quit, non-smokers and reduced impacts on health costs associated with tobacco use. The trends are good.

ClearWay is not resting on its excellent record. In the eight years it has left in its mandate (funded by the national tobacco settlement of a few years back), the agency’s agenda includes raising cigarette taxes, which all studies show discourage young people from purchasing tobacco, and raising the age for tobacco purchases from 18 to 21. Again, research finds that raising the age to beyond high school age contributes to fewer high school students trying tobacco. New York City and Hawaii have already taken that step.

There is still much to be accomplished to achieve as smoke-free a society as possible. A lot has been done, often led by private sector companies that banned smoking from the workplace before cities and states enacted overall smoking bans in buildings and, in many instances, outdoor public spaces. Decades of research into smoking-related illness and death, and the proven health hazards of secondhand smoke, have been the underpinnings of changing public policy. ClearWay’s work and similar complementary efforts have been pivotal in changing the way enlightened Americans view tobacco use.

Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.

http://www.inforum.com/opinion/editorials/3751883-forum-editorial-minnesota-tobacco-use-down

Press Release: Heitkamp Announces Significant Federal Funding for Tobacco Prevention

WASHINGTON, D.C. – U.S. Senator Heidi Heitkamp today announced nearly $914,000 in federal funding to support statewide efforts to prevent tobacco use.

These funds, awarded to the North Dakota Department of Health, will be used to support its Tobacco Prevention and Control program, which includes information for schools and health care providers, programs to help North Dakotans quit smoking, data collection and trainings.

“Over the past several decades, the devastating health effects caused by tobacco use have become more and more clear,” said Heitkamp. “As North Dakota’s Attorney General in the 1990s, I led the charge to hold tobacco companies responsible for what their products were doing to North Dakotans, so I understand the importance of investing in tobacco prevention efforts and providing resources to help folks quit smoking. These funds will help the North Dakota Department of Health continue its great work to stop tobacco use and help make sure the next generation of North Dakotans are tobacco-free.”

While Attorney General, Heitkamp helped to broker an agreement between 46 states and the tobacco industry, which forced the tobacco industry to tell the truth about smoking and health. The settlement resulted in the award of about $336 million to North Dakota taxpayers to date and was one of the largest civil settlements in U.S. history.

###

Smoking Rates Continue to Decline

MMWR – MORBIDITY AND MORTALITY WEEKLY REPORT

The CDC recently updated its statistics about current cigarette smoking among adults. In its MMWR article of November 28, 2014, it tracked changes in smoking between 2005 and 2013. In general, the trends of previous years continued. Here are some of the results:

  • The proportion of U.S. adults who smoke declined from 20.9% to 17.8%, a 15% decline during that period. The 17.8% is a modern low in adult smoking prevalence.
  • The proportion of daily smokers declined from 16.9% to 13.7%, a 19% decline and another all time low.
  • Among daily smokers, the proportion who smoked at least one pack per day decreased from 52.1% to 36.4%, a 30% decline. And daily smokers now average 14.2 cigarettes, down from 16.7, a 15% decline.

Thus, there has been a decline in overall smokers, a slightly greater decline in daily smokers and in number of cigarettes smoked by daily smokers, and a major decline in the number of cigarettes consumed by daily smokers.

The profile of smokers is relatively unchanged:

  • Men (20.5%) are more likely to be smokers than women (15.3%)
  • Smoking prevalence is higher among adults aged 25-44 years (20.1%) and lowest among those over age 65 (8.8%)
  • Among ethnic groups, multiple race groups had the highest rates (26.8%), followed by American Indian/Native Alaskan (26.1%), Whites (19.4%), Blacks (18.3%), Hispanics (12.1%), and Asians (9.6%).
  • Smokers continue to be stratified by education level, often used as a marker for social class. Those without a high school diploma had smoking rates of 24.2%, followed by those with high school diplomas (22%), undergraduate college degrees (9.1%), and graduate degrees (5.6%). Those who obtained General Education Development (GED) certificates in lieu of high school graduation had the highest rates (41.4%). It is likely that many of these persons were incarcerated and thus also had medical conditions associated with high smoking rates, such as mental illness and substance use disorders.
  • Persons living below the federal poverty level had higher rates (29.2%) than those above that level (16.2%).
  • LGB adults were more likely to be smokers (26.6%) than straight adults (17.6%).

Thus, the trend of smoking to be concentrated among the less educated, the poor, and the LGB population continued. Not included in this report, but summarized previously by a special MMWR are recent data documenting the much higher rates among persons with behavioral health issues, the groups with the highest smoking rates in the entire population. Notably, those working in the health professions in the United States have some of the lowest smoking rates in the world, with some surveys showing that only 1% of physicians are smokers.

This new report should encourage us that progress, indeed, is happening. But, the slow rate of decline, in the face of all the evidence about the harms of smoking and the accumulating tobacco control policies such as taxes, clean indoor air laws, counter-marketing, and coverage for smoking cessation therapies, is sobering. As smokers increasingly resemble members of marginalized parts of the American community, the risk is that resources for tobacco control will be diverted to other causes. Yet, over 40 million people still smoke, including many of the most vulnerable of us. And close to 500,000 people die each year from smoking-associated illnesses. We need to capture better the sense of urgency buried in those statistics.

Finally, it is important to recognize two new potential threats to the health of the nation—electronic cigarettes and marijuana. Right now the rhetoric about the benefits and harms of these two commodities outstrips the evidence. We do know that the use of the e-cigarette is climbing, and it is highly likely that marijuana use is also increasing in the wake of state legalization efforts. We also know that because these commodities contain immense potential for profit, marketing efforts to promote usage are certain to increase. As we continue our efforts against the harm from using combustible tobacco, we need to track the use of these new potential threats, as well as to assemble evidence about what happens to those who use them.

LLOYD OMDAHL: Legislature questions intelligence of voters

By: Lloyd Omdahl, Grand Forks Herald
Measure 4 on the November ballot is the latest attempt by the Legislature to restrict citizen use of the initiative process by which voters can propose measures for a vote of the people.
If passed, it would prohibit the secretary of state from putting on the ballot any citizen proposal that would direct the expenditure of money for a specific purpose. Apparently, legislators question the intelligence of the voters.
This is the latest in a never-ending series of attempts by the Legislature to make it more difficult for North Dakotans to use the initiative. In the past, most attempts have been aimed at raising the number of signatures required for filing petitions. They all failed.
This time, the Legislature wants to be sure that it has exclusive control over the huge surpluses in the state treasury. It is afraid that citizens who see neglected needs will win the support of the electorate to appropriate money.
The Legislature should be reminded that these surpluses would not exist without the adoption in 1980 of a measure initiated by the people to add a 6½ percent tax on oil production. The Legislature was doing nothing about the puny oil tax it had levied 25 years earlier.
Let’s look at the Legislature’s track record.
First, there’s the Legislature’s mismanagement of the money from the tobacco settlement in which North Dakota was awarded over $800 million. Even though Former Attorney General Heidi Heitkamp won the lawsuit, the Legislature was quick to grab the money for programs other than fighting tobacco addiction.
To get the Legislature back on track, Heitkamp and other tobacco fighters initiated a measure directing the Legislature to spend tobacco settlement money on tobacco addiction. The voters approved the measure.
But the 2013 Legislature, in a petulant fit, refused to accept the decision of the voters. It started stripping out key provisions of the initiated measure. The effort failed only when the leadership could not muster the two-thirds vote needed to change an initiated measure.
Meanwhile, the Legislature held the appropriation hostage until the last day of the session when it relented and belligerently approved funding the program to fight tobacco addiction.
By proposing Measure 4, the Legislature is telling North Dakotans that they are not to be trusted with money. Many residents feel the same way about the Legislature. That is why we have provisions in the state constitution for the initiative and the referendum.
There are pressing needs that have been neglected by the Legislature and may require initiative petitions to appropriate money in the future.
One is the need for more support for clean water, conservation and parks. Even if Measure 5 proposing a significance increase in such funding is defeated, the need will not go away. A new initiated measure may be necessary.
A recent public opinion poll revealed strong public support for such programs.
Another critical need is funding for statewide preschool education. The last session did nothing except authorize cash-strapped school districts to raise their own money for preschool. There is wide public support for preschool education. This may require an initiated measure.
Generally speaking, the governor and the Legislature have done quite well with state money. Nevertheless, the Legislature sometimes develops blind spots when it comes to new needs and new opportunities.
Historically, North Dakota voters have been very responsible in dealing with money issues on the ballot. There is no justification for questioning their intelligence. Measure 4 is an unnecessary restriction on citizens participating in their government.
http://www.grandforksherald.com/content/lloyd-omdahl-legislature-questions-intelligence-voters