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Smoking may increase suicide risk, study says

By MONTE MORIN, Los Angeles Times

It’s well known that cigarettes are bad for your health, but does smoking make you more likely to kill yourself too?

In a paper published Wednesday in the journal Nicotine & Tobacco Research, authors argued that smoking and suicide may be more closely related than previously thought.

The researchers analyzed suicide rates in states that aggressively implemented anti-smoking policies from 1990 to 2004 and compared them to suicide rates in states that had more relaxed policies.

Those states that imposed cigarette excise taxes and smoke-free air regulations had lower adjusted suicide rates than did states with fewer anti-smoking initiatives, authors wrote.
“There does seem to be a substantial reduction in the risk for suicide after these policies are implemented,” said lead study author Richard Grucza, a psychiatric epidemiologist at Washington University School of Medicine in St. Louis.

“For every dollar in excise taxes there was actually a 10% decrease in the relative risk for suicide,” Grucza told Washington University BioMed Radio. “The smoke-free air policies were also very strongly associated with reduced suicide risk.”

Study authors said that states with lower taxes on cigarettes and more lax policies on public smoking had suicide rates that were up to 6% greater than the national average.

This is not the first study to document a correlation between cigarette smoking and suicide, but it is among the first to suggest smoking and nicotine may be specific factors.

Up until now, researchers believed smoking coincided with suicide because people with psychiatric problems or substance abuse problems were more likely to smoke as well as to commit suicide.
“Markedly elevated rates of smoking are found among people with anxiety disorders, alcohol and drug dependence, schizophrenia and other diagnoses, in both clinical and general studies,” authors wrote. “However, it is also possible that smoking is not merely a marker for psychiatric disorders, but rather directly increases the risk for such disorders, which in turn increases the risk for suicide.”

Grucza said that the imposition of anti-smoking rules presented the researchers with a naturally occurring experiment. However, the authors did note that there were limitations on their research.

In particular, they said that since they considered state-imposed anti-smoking efforts only, their research would not account for local-level policies aimed at smoking behavior.

“While further studies may be required to establish a compelling weight of evidence, this study provides strong epidemiological support in its favor of the proposition that smoking is a casual risk factor for suicide,” authors wrote.

http://www.latimes.com/science/sciencenow/la-sci-sn-smoking-suicide-20140716-story.html

Letter to the Editor: The issue with smoking is addiction, not freedom

I am writing in response to the Herald’s editorial on tobacco use in Grand Forks parks (“Too much loss for too little gain,” Page F1, June 1).

Tobacco prevention policies have, throughout history, always been met with some resistance. Tobacco use was so common when I was a child that it was normal to see smokers in grocery stores, movie theaters, school classrooms, teacher’s lounges, doctors’ offices, airplanes, airports and hospital rooms.

Each of those changes was met with the attitude that it was beyond the pale to even consider making changes. But today, it would seem unusual to see someone smoking in their hospital room or at a movie theater.

Tobacco use rates were high, and we all paid the price of the damage tobacco use does to the human body by way of health care costs, Medicaid costs, loss of productivity and sadly, early deaths of loved ones.

As a result of sound evidence-based practices, such as 1) preventing initiation among youth and young adults, 2) promoting quitting among adults and youth, 3) eliminating exposure to secondhand smoke and 4) identifying and eliminating tobacco-related disparities among population groups, headway has been made in reducing tobacco-use rates. But there still is work to be done.

Grand Forks Park District Commissioner Molly Soeby’s column put it well: “Tobacco use kills more people than AIDS, alcohol, car accidents, illegal drugs, murders and suicides combined” (“For health’s sake, Grand Forks parks should ban tobacco use,” Page F1, June 1).

“It is the No. 1 cause of preventable death in our country. Young people in North Dakota use tobacco more than the national averages. They smoke at higher rates (19.4 percent vs. 18.1 percent), and they use more chewing tobacco than adults (13.6 percent vs. 8.2 percent).”

Tobacco use kills about 480,000 people each and every year in the United States. That equals the number of American deaths in all the U.S. wars since the American Revolution, every 2½ years.

So, what can be done to improve these numbers? What does the research show us works?

The Centers for Disease Control recommends creating tobacco-free social norms through the use of “increasing the unit price of tobacco products, sustaining anti-tobacco media campaigns and making environments smoke-free.”

Tobacco-free parks policies are part of a comprehensive combination of strategies to get our youth tobacco use rates lowered.

Tobacco-free parks policies will keep young people from ever starting. The research is done, the evidence is clear. According to the CDC, comprehensive tobacco-free policies prevent young people from seeing tobacco use as a normal adult activity and show a significant effect on reducing tobacco use initiation among youth.

Our community would not be the first to adopt a tobacco-free parks policy. North Dakota currently has 12 communities with tobacco-free parks, and Minnesota has more than 150.

According to the editorial, “secondhand smoke in indoor areas is a health hazard; secondhand smoke in parks in inconsequential.”

But it’s not about secondhand smoke, which, by the way, many people consider a nuisance that interferes with their personal enjoyment of the parks. It is about what we know will work to keep young people from starting to use tobacco.

The editorial says that this is not a good enough reason to “clamp down on personal freedom.”

But this is not a personal freedom issue, either. Tobacco use is an addiction, and most adult tobacco users report that they started using before age 18.

A policy such at this will not prohibit anyone from using tobacco. It will help to keep children, who do not use tobacco, from starting.

That is a public health issue, not a personal freedom issue.

Recent studies in Grand Forks show overwhelming support in the community for the adoption of tobacco-free policies on all of our Park District properties. (The community-wide study is available on www.tobaccobytes.com)

Tobacco-free parks policies are cost effective. They’re good for the health of North Dakotans now and, as Soeby put it, “for future generations of residents of Grand Forks.”

Knox coordinates the tobacco prevention program for the Grand Forks Public Health Department.

http://www.grandforksherald.com/content/theresa-knox-issue-smoking-addiction-not-freedom

Grand Forks Park District seeks info before acting on tobacco ban

By John Hageman, Grand Forks Herald

Grand Forks Park District Commissioners want to gather some more information before acting on a tobacco-free policy.

Commissioners received the results of a poll last week that showed overwhelming support for adopting a comprehensive tobacco-free policy on Park District property. On Friday, commissioners said they wanted to hear from adult users of park facilities, such as softball league teams, before crafting or acting on a policy.

“If we wanted to implement a policy right now (that says) absolutely no smoking for parts that have anything to do with our youth, we could do that tomorrow,” said Greg LaDouceur, vice president of the Park Board. “I think everybody’s got the same idea on that.”

“We’re just a little bit more cautious with our adult user groups,” he added.

The poll surveyed the Grand Forks community at large and people who use Park District facilities, such as softball team managers and golfers. Users showed more support for a tobacco-free policy, with 82 percent of respondents saying they strongly or somewhat support the idea while 78 percent of the community respondents showed support.

The survey question also mentions electronic cigarettes as being part of the ban. Minneapolis is considering banning all forms of smoking throughout its parks, including e-cigs.

LaDouceur said one concern they have is how a tobacco-free policy would be enforced.

Still, Paul Barta, another commissioner, called the survey an “important first step.”

“I think we learned a lot from that survey,” Barta said. “I think the results were pretty positive to going towards tobacco-free parks. So I think we have a good start to maybe head down that direction.”

Any tobacco-free policy wouldn’t affect the Greater Grand Forks Greenway, said Park District Director Bill Palmiscno.

http://www.grandforksherald.com/content/grand-forks-park-district-seeks-info-acting-tobacco-ban

The 50-year war on smoking

By The Times editorial board, Los Angeles Times
The 1964 U.S. Surgeon General’s report on smoking — the first official acknowledgment by the federal government that smoking kills — was an extraordinarily progressive document for its time. It swiftly led to a federal law that restricted tobacco advertising and required the now-familiar warning label on each pack of cigarettes.
Yet there was nothing truly surprising about the conclusion of the report. Throughout the 1950s, scientists had been discovering various ways in which smoking took a toll on people’s health. Britain issued its own report, with the same findings, two years before ours. Intense lobbying by the tobacco industry slowed the U.S. attack on smoking. And even when then-Surgeon General Luther Terry convened a panel before the report was issued to make sure its findings were unimpeachable, he felt compelled to allow tobacco companies to rule out any members of whom they disapproved.
Saturday marks the report’s 50th anniversary. The intervening decades have seen remarkable progress against smoking in the United States, despite the stubborn efforts of the tobacco industry, which lobbied, obfuscated and sometimes lied outright to the public about the dangers of its products. During those years, though, independent research tied smoking and secondhand smoke to an ever-wider range of ailments. According to the U.S. Centers for Disease Control and Prevention, smoking causes cancer of the lungs, larynx, bladder, bone marrow, blood, esophagus, kidneys and several other organs. It increases the risk of stroke, heart disease and cataracts. It can damage fetuses, weaken bones and harm teeth and gums. The list goes on.
The growing body of evidence bolstered important policies to combat tobacco use and the injury to nonsmokers barraged by the damaging effects of secondhand smoke. It can be hard for young Californians today to fathom that smoking was once practically ubiquitous throughout government buildings, restaurants and workplaces. In the 1970s, during hearings on legislation to curb smoking in public buildings, some legislators puffed away even as speakers described the asthma attacks they sometimes suffered from secondhand smoke. New restrictions helped smokers as well; if they could do without a cigarette for hours at a time at their jobs, many discovered, they could do without them entirely.
Limits on cigarette advertisements, rules that prevented sales to minors and new taxes on cigarettes helped bring smoking rates down.
In 1964, 42% of Americans smoked. Half the people on the panel that produced the surgeon general’s report smoked. Today, the U.S. smoking rate is 18%. Teen smoking rates fell to below 10% after the federal tax on cigarettes was increased by 62 cents a pack in 2009.
As smoking rates have declined, lung cancer rates have fallen as well. According to a report this week from the CDC, the rate among men ages 35 to 41 dropped by 6.5% per year from 2005 to 2009. One study just published in the Journal of the American Medical Assn. estimated that 8 million premature deaths from all smoking-related causes have been prevented since the surgeon general’s report was issued in 1964.
Despite the good news, smoking is still the No. 1 cause of preventable death in this country. Smoking-related disease costs $183 billion a year in medical expenses and lost productivity.
We know what works against this: research, education, limits on secondhand smoke and higher cigarette taxes. But the tactics of tobacco companies continue to hold the nation back.
Knowing how heedless of our well-being they have been all along, we should ignore their ads and their lobbyists and take the following steps:
• Raise tobacco taxes, preferably at the federal level to avoid black-market sales across state lines. According to a 2012 report by the U.S. Surgeon General, every 10% increase in the cost of smoking leads to a 4% drop in smoking rates.
President Obama has proposed increasing the federal excise tax by 94 cents a pack, nearly doubling it from the current $1.01, and using the resulting revenue stream — an estimated $78 billion over the next decade — to fund pre-kindergarten education. The tax is a good idea, but we have concerns about using the money for preschool. If smokers are paying the tax, the revenue ideally should go toward education, research, affordable cessation programs, enforcement of existing laws and healthcare costs related to tobacco use.
• Place increased emphasis on reducing teen smoking. If there’s one thing all Americans, including staunch defenders of the right to smoke, should agree on, it’s that minors should be protected from smoking. According to the American Lung Assn., more than two-thirds of adult smokers developed the habit as teenagers. Studies have shown that many retailers don’t check identification and sell even when the ID shows the buyer to be underage.
In addition, the U.S. Food and Drug Administration should immediately impose a ban on sales and marketing of e-cigarettes to minors, including Internet sales. E-cigarettes, which allow users to inhale nicotine-laced vapor rather than tobacco smoke, may turn out to be significantly more healthful than regular cigarettes, but studies are still underway about their long-term effects, and there’s no question that they encourage nicotine addiction. They have been heavily marketed to minors, who are allowed to buy them without restriction in most states. Further research is necessary as the e-cigarette market expands dramatically.
• Push for indoor-smoking restrictions in all states. It may surprise Californians, who now face smoking bans in parks, open eating areas and beaches, to learn that some states lack smoking bans even in workplaces, bars and restaurants. Kentucky, for example, restricts smoking only in government and university buildings.
Smoking is and should remain a personal choice among adults, but the nonsmokers around them have the right not to be sickened by the choices of others.
http://www.latimes.com/opinion/editorials/la-ed-smoking-50th-anniversary-of-surgeon-general–20140110,0,3302586.story#ixzz2q27cKUYc

Fitful Progress in the Antismoking Wars

By THE EDITORIAL BOARD, New York Times
Fifty years ago this Saturday, on Jan. 11, 1964, a myth-shattering surgeon general’s report on smoking and health brushed aside years of obfuscation by tobacco companies and asserted, based on 7,000 scientific articles, that smoking caused lung cancer and was linked to other serious diseases. Those findings expanded as more data was gathered.
Research since then has shown that tobacco can cause or exacerbate a wide range of diseases, including heart disease, stroke, multiple kinds of cancer, chronic obstructive pulmonary disease, emphysema, asthma and diabetes, and can injure nonsmokers who breathe in the toxic fumes secondhand. The death toll from tobacco remains stubbornly high but can be driven down by using a range of new and proven tactics.
By some measures, the 50-year campaign to rein in tobacco use has been an enormous success. The percentage of American adults who smoke dropped from 42 percent in 1965 to 18 percent in 2012. A study published in the Journal of the American Medical Association this week estimated that tobacco control measures adopted since 1964 have saved eight million Americans from premature death and extended their lives by an average of almost 20 years.
Experts attribute the gains to vigorous campaigns to educate people about the dangers of smoking; increases in cigarette taxes; state and local laws that protect half the nation’s population from tobacco fumes in workplaces, bars and restaurants; restrictions on advertising; prohibition of sales to minors; and various prevention and cessation programs financed by states or private insurance.
Despite these gains, nearly 44 million American adults still smoke, more than 440,000 Americans die every year from smoking, and eight million Americans live with at least one serious chronic disease from smoking. Medical costs connected to smoking are nearly $96 billion a year, with an additional $97 billion lost in productivity because of illness.
On Wednesday, several health organizations, including the American Heart Association, the American Lung Association, the American Cancer Society, the American Academy of Pediatrics, and the Campaign for Tobacco-Free Kids called for a new national commitment to drive smoking among adults down to less than 10 percent over the next decade; protect all Americans from secondhand smoke within five years by having every state enact laws against smoking in all workplaces, bars and restaurants; and ultimately eliminate death and disease caused by tobacco.
It won’t be easy. The tobacco industry spends more than $8 billion a year to market cigarettes and other tobacco products in this country, with much of its marketing slyly aimed at young people.
The industry is also invading foreign markets, often in less developed countries, in an effort to make addicts of millions more customers to replace those in industrialized nations. Although smoking rates among adults around the globe have fallen sharply since 1980, the number of smokers has increased significantly along with population growth and will continue to increase as national incomes and populations rise. The United States government must help counter the tobacco industry’s efforts to spread its noxious products around the world.
http://www.nytimes.com/2014/01/10/opinion/fitful-progress-in-the-antismoking-wars.html?_r=0

Landmark Report Marks 50th Anniversary

ND Center for Tobacco Prevention & Control Policy
January 11 is the 50th anniversary of the landmark Surgeon General’s report that first linked smoking as a cause of lung cancer. North Dakota’s Center for Tobacco Prevention and Control Policy (the Center) and other tobacco prevention groups across the country are using the anniversary to note the important progress in tobacco prevention.
According to surgeongeneral.gov, the prevalence of smoking among U.S. adults has been reduced by 50 percent since the release of the first Surgeon General’s report on smoking and health in 1964. A new study published in the “Journal of the American Medical Association” claims that approximately 8 million lives have been saved by U.S. tobacco prevention measures. The same study also concludes tobacco control efforts have extended the average American life span by 19 to 20 years.
In North Dakota, voter initiatives are responsible for the state’s successful tobacco prevention efforts. In 2008, voters chose to fund a comprehensive tobacco prevention program. Then, in 2012, voters chose to implement a comprehensive smoke-free law, which took effect a year ago in December. These initiatives improve the public’s health by protecting people from secondhand smoke in all indoor workplaces, preventing youth from starting to use tobacco and helping tobacco users quit.
The comprehensive program has shown positive results across the state. North Dakota now has 131 school districts-representing 60 percent of the state’s K-12 students-that have implemented comprehensive tobacco-free policies. And, according to the 2013 Youth Risk Behavior Survey, high school smoking rates have dropped to 19 percent from 22.4 percent in 2009.
“We’ve made a lot of progress towards reducing the devastating toll tobacco use has on our state and across the country, but we still have more work to do,” said Jeanne Prom, executive director for the Center. “Tobacco companies spend billions each year marketing their deadly products to hook our youth to a life-time addiction to nicotine.”
Smoking kills 800 North Dakotans each year, and costs the state $247 million in healthcare and $192 million in lost productivity. Across the country, those numbers jump to 440,000 annual smoking-related deaths, $96 billion in healthcare costs and $97 billion in lost productivity. Tobacco prevention measures are essential in eliminating the harmful effects caused by the epidemic of tobacco use.
According to Prom, one of the most effective ways to keep kids from using tobacco and convince people to quit is to make tobacco less affordable by increasing the tobacco tax.
“North Dakota’s current tobacco tax is one of the lowest in the country at $0.44; it hasn’t increased since 1993,” said Prom. “Raising the tax from $0.44 to $2, a $1.56 increase per pack, would go a long way in reducing tobacco use in North Dakota.”
A fact sheet produced by the Campaign for Tobacco-Free Kids and the Cancer Action Network shows the positive impact a $1.56 tobacco tax increase would have in North Dakota. The higher tax would save approximately 5,400 lives that would otherwise have been lost to smoking-related causes. The youth smoking rate would decline by 24 percent, 9,900 kids in North Dakota would be kept from becoming addicted adult smokers and 8,200 current adult smokers would quit. Over the next five years, that amounts to about $7.3 million saved in healthcare costs.
“The health benefits of a higher tobacco tax are clear because higher taxes are proven to reduce tobacco use,” Prom said. “Ultimately, it’s about saving lives and improving health for the people of North Dakota.”
http://www.breathend.com/news/detail.asp?newsID=312

Working against tobacco

By Nick Smith, Bismarck Tribune
Members of an interim legislative committee heard testimony about tobacco prevention efforts on reservations throughout the state Wednesday.
The interim Health Services Committee heard from health department officials as well as tribal leaders and tobacco prevention coordinators from on and off the state’s reservations.
Krista Fremming, Tobacco Prevention and Control Program director for the state Health Department, said the department collaborates with tribal tobacco program officials and in some cases shares facilities.
“On Dec. 13, 2013, the North Dakota Department of Health coordinated a tribal tobacco strategic session to discuss effective processes to reduce tribal tobacco use,” Fremming said. “Attendees agreed formal tribal tobacco strategic planning is needed to identify the best strategy to address tobacco use on the reservations.”
She said the North Dakota Indian Affairs Commission will be taking the lead on the strategic planning process.
Fremming said due to cessation and prevention programs nearly all schools and colleges on reservations now have tobacco-free and smoke-free policies in place.
Smoke-free tribal buildings are now a staple on reservations, she said, but housing and casinos are another matter.
“The North Dakota Department of Health is partnering with the Intertribal Tobacco Abuse Coalition to address the issue of smoke-free casinos on a statewide level,” Fremming said.
The Sky Dancer Casino in Belcourt has a no-smoking policy and the Four Bears Casino in New Town has a designated room for smoking.
Fremming said the idea is in the planning stages and it would likely take a year or two for any implementation to take place.
Another area of note, Fremming said, is enrollment in the NDQuits program. The NDQuits program pushes to keep people from starting to smoke and help people quit, using online sources, counselors andother services.
“In fiscal year 2013, a total of 152 enrollees were American Indian. In fiscal year 2014 there have already been 125 enrollees who were American Indian during the months of July through November,” Fremming said.
Also testifying Wednesday was Beth Hughes. She serves as executive committee chairman for the North Dakota Center for Tobacco Prevention and Control Policy.
Hughes said two-thirds of its $15.8 million budget is spent on a trio of statewide and community grant programs.
“The policies are to serve all residents both on and off American Indian reservations,” Hughes said. “The Center requires that funded programs show policy and health outcomes that can be documented by adoption of model comprehensive policies and, over time, show reduction in tobacco use.”
Hughes said among the center’s recommendations are continued funding of programs using the federal Centers for Disease Control and Prevention’s recommended best practices.
Chairman Sen. Judy Lee, R-West Fargo, questioned the recommendation. Lee said she believes the center comes off at times as being focusing too explicitly on CDC recommendations and not working as collaboratively as it could with other departments.
“The center is viewed as being a bit heavy-handed,” Lee said.
Lee said the reservations are sovereign nations and cultural sensitivity also needs to be kept in mind.
Hughes said she understood the criticism and it was something she would relay to center staff. She added that there is already a level of collaboration with other departments.
“There is no way that the center could do the work that it does without the other entities in the state,” Hughes said.
http://bismarcktribune.com/news/state-and-regional/working-against-tobacco/article_6ba98b3e-78e6-11e3-a21c-001a4bcf887a.html

Leading Health Groups Call for Bold Action to End the Tobacco Epidemic In the United States

Nation Challenged to Cut Smoking Rates to Under 10 Percent in 10 Years and Protect All Americans from Secondhand Smoke within 5 years

 
The seven groups issuing the call to action are the American Academy of Pediatrics, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, Americans for Nonsmokers’ Rights, Campaign for Tobacco-Free Kids and Legacy®.
WASHINGTON, DC – As the United States marks the 50th anniversary of the first Surgeon General’s Report on Smoking and Health, seven leading public health and medical organizations today called for a new national commitment to end the tobacco epidemic for good.
At a press conference today, the organizations called for bold action by all levels of government to achieve three goals:

  • Reduce smoking rates, currently at about 18 percent, to less than 10 percent within 10 years;
  • Protect all Americans from secondhand smoke within five years; and
  • Ultimately eliminate the death and disease caused by tobacco use.

These seven organizations issued the following joint statement:  American Academy of Pediatrics, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, Americans for Nonsmokers’ Rights, Campaign for Tobacco Free Kids, and Legacy for Longer Healthier Lives
The first Surgeon General’s Report on Smoking and Health, issued on January 11, 1964, was a historic turning point in the nation’s fight against tobacco use.
Our organizations celebrate the remarkable progress of the past 50 years.  The United States has cut smoking rates by more than half (from 42.4 percent in 1965 to 18 percent today) and per capita consumption of cigarettes by more than 70 percent.  While smoking was allowed almost everywhere in 1964, today nearly half the nation’s population is protected by smoke-free laws that apply to all workplaces, restaurants and bars.  Reductions in smoking have saved millions of lives and are responsible for 30 percent of the increase in the life expectancy of Americans since 1964, according to a study published today in the Journal of the American Medical Association (JAMA).  The fight against tobacco has been a tremendous public health achievement.
However, the battle is far from over.  Tobacco use is still the number one cause of preventable death in the United States.  Smoking kills more than 440,000 Americans each year, sickens millions more and costs the nation $193 billion annually in health care expenditures and lost productivity.  About 44 million adults still smoke, and more than 3,000 kids try their first cigarette each day.  It is unacceptable that tobacco still kills so many Americans, lures so many children, devastates so many families and places such a huge burden on our nation’s health care system.
On the 50th anniversary of the first Surgeon General’s report, it is time for a new national commitment to end the tobacco epidemic for good.  Today our organizations call for bold action by all levels of government to achieve three goals: 1) Reduce smoking rates, currently at about 18 percent, to less than 10 percent within 10 years; 2) protect all Americans from secondhand smoke within five years; and 3) ultimately eliminate the death and disease caused by tobacco.
Over the past 50 years, we have developed proven strategies that can achieve these goals if they are fully and effectively implemented.  These strategies include tobacco tax increases, comprehensive smoke-free workplace laws, hard-hitting mass media campaigns, health insurance coverage to ensure smokers have access to quit-smoking treatments, and well-funded, sustained programs to prevent kids from smoking and help smokers quit.  In 2009, these measures were supplemented with a powerful new tool when the Food and Drug Administration was granted authority to regulate the manufacturing, marketing and sale of tobacco products, for the first time empowering a federal agency to rein in the tobacco industry’s harmful practices.
We have the tools to end the tobacco epidemic for good.  We cannot afford to wait another 50 years.
Related materials: Downloadable charts showing progress since 1964

War on smoking, at 50, turns to teens: Our view

The Editorial Board, USATODAY

Want kids to quit? Raise cigarette taxes. It works.

The war on smoking, now five decades old and counting, is one of the nation’s greatest public health success stories — but not for everyone.
As a whole, the country has made amazing progress. In 1964, four in ten adults in the U.S. smoked; today fewer than two in ten do. But some states — Kentucky, South Dakota and Alabama, to name just a few — seem to have missed the message that smoking is deadly.
Their failure is the greatest disappointment in an effort to save lives that was kick-started on Jan. 11, 1964, by the first Surgeon General’s Report on Smoking and Health. Its finding that smoking is a cause of lung cancer and other diseases was major news then. The hazards of smoking, long hidden by a duplicitous industry, were just starting to emerge.
The report led to cigarette warning labels, a ban on TV ads and eventually an anti-smoking movement that shifted the nation’s attitude on smoking. Then, smokers were cool. Today, many are outcasts, banished from restaurants, bars, public buildings and even their own workplaces. Millions of lives have been saved.
The formula for success is no longer guesswork: Adopt tough warning labels, air public service ads, fund smoking cessation programs and impose smoke-free laws. But the surest way to prevent smoking, particularly among price-sensitive teens, is to raise taxes. If you can stop them from smoking, you’ve won the war. Few people start smoking after turning 19.
Long before health advocates discovered this, the tobacco industry knew that high taxes kill smoking as surely as cigarettes kill smokers. “Of all the concerns … taxation … alarms us the most,” says an internal Philip Morris document, turned over in a gaggle of anti-smoking lawsuits in the 1990s.
The real-life evidence of taxing power is overwhelming, too. The 10 states with the lowest adult smoking rates slap an average tax of $2.42 on every pack — three times the average tax in the states with the highest smoking rates.
New York has the highest cigarette tax in the country, at $4.35 per pack, and just 12% of teens smoke — far below the national average of 18%. Compare that with Kentucky, where taxes are low (60 cents), smoking restrictions are weak and the teen smoking rate is double New York’s. Other low-tax states have similarly dismal records.
Foes of high tobacco taxes cling to the tired argument that they fall disproportionately on the poor. True, but so do the deadly effects of smoking — far worse than a tax. The effect of the taxes is amplified further when the revenue is used to fund initiatives that help smokers quit or persuade teens not to start.
Anti-smoking forces have plenty to celebrate this week, having helped avert 8 million premature deaths in the past 50 years. But as long as 3,000 adolescents and teens take their first puff each day, the war is not won.
USA TODAY’s editorial opinions are decided by its Editorial Board, separate from the news staff. Most editorials are coupled with an opposing view — a unique USA TODAY feature.
http://www.usatoday.com/story/opinion/2014/01/08/war-on-smoking-50th-anniversary-cigarette-tax-editorials-debates/4381299/

Quiet Anniversaries That Resound Loudly with North Dakotans

By: Erin Hill-Oban
Submitted to: ND Physician, December 2013 publication from the North Dakota Medical Association – pg. 30
With all the chaos and busy-ness in our everyday lives, milestones like birthdays and anniversaries pass by so quickly that, once in a while, we forget
to celebrate the day itself, let alone the importance that occasion brought to our lives. There were two anniversaries that just passed on the calendar, and while we are not upset, as a spouse or child might be upon being forgotten, we thought the occasions provided a great opportunity to remind NDMA members of the progress North Dakota has made in the past five years in tobacco prevention and control.
November 4 and November 6 marked, respectively, the anniversaries of the passages of Measure #3 in 2008 and Measure #4 in 2012. Measure #3 received 54% of the vote and thus implemented and fully funded North Dakota’s comprehensive tobacco prevention and control program. Measure #4 earned 67% approval at the polls and created the strongest statewide smoke-free law in the nation.
These publicly (rather than legislatively) initiated and passed measures have a direct impact on the health of North Dakotans and support for each has only grown stronger since their passages.
In February of 2013, Tobacco Free North Dakota (TFND) commissioned a public poll of North Dakota voters, conducted by Keating Research, Inc., to gauge the public’s feelings toward the aforementioned measures. Results showed support for continuing to fund a comprehensive program had grown from 54% of the voters in 2008 to 89% of those polled, and the statewide smoke-free law, just three months into its implementation, had already reached 72% support, up from 67% of voter support. It is difficult to argue with numbers like that, and it is even more difficult to argue with the effects produced by policies like these.
Medical professionals know of, and many educate, about the harmful role tobacco use plays in the health of their patients and future patients. TFND
has great respect and overwhelming appreciation for the tobacco prevention and cessation efforts our medical professionals practice in their offices. In fact, a recent study showed that physicians and other medical professionals are the best and most effective messengers for advising individuals to quit tobacco use. Though obesity has climbed the ranks, tobacco use still remains one of the leading causes of preventable disease and death, contributing to more than 800 deaths each year right here in North Dakota. Reducing, and even better yet, preventing, tobacco use provides the greatest benefits in reducing the incidences of so many chronic diseases – from lung cancer and diabetes to heart disease and stroke.
While the health benefits of reducing and preventing tobacco use are fairly obvious, a topic often overlooked when discussing the impacts of successful tobacco prevention is the potential savings in annual health care costs. In North Dakota, annual health care costs directly caused by smoking alone is estimated at $247 million, and smoking- related costs covered by the state Medicaid program total $47 million annually. If we, as a nation, and in North Dakota, as a fiscally conservative state, are truly concerned with bringing down our health care costs, we would double- down on tobacco prevention efforts.
According to the Centers for Disease Control (CDC), best practices for comprehensive tobacco control programs is a three-legged stool: 1.) fully-funding the program at CDC recommendations; 2.) implementing strong smoke-free laws; and 3.) passing high tobacco tax rates. North Dakota is one of very few states to successfully enact two of the three, but with a dangerously low tobacco tax, ranking 46th lowest in the nation, North Dakota will struggle to bring tobacco use down much further. Although an obvious source of revenue, we view tobacco tax as a public health measure to reduce tobacco use and save millions in future health care costs. Proven as one of the most effective ways to prevent young people from ever starting and to encourage current users to quit or reduce use, raising the tobacco tax is a lofty, yet achievable goal that organizations like TFND are dedicated to addressing through legislative action in 2015.
Years of research show time and time again the indisputable effects that tobacco prevention and control policy has on public health, so your work in the doctor’s office, combined with TFND and NDMA’s efforts on statewide policy, are certainly making a difference. We are grateful to your organization for your past support, commend you for going on record with us by adopting a resolution of support to raise North Dakota’s tobacco tax, and look forward to opportunities to provide information and education to your members, the public, and policymakers throughout the coming year.
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