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ACS CAN: President Renews Call for Stronger Tobacco Control in FY 15 Budget Proposal

WASHINGTON, D.C. – March 4, 2014 – President Obama today unveiled an FY15 budget proposal that prioritizes tobacco control with an increase in the federal tobacco tax, emphasizes the importance of primary care with an investment in workforce training for new doctors and signals his ongoing support for increased investment in medical research.
A statement from Chris Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN), follows:
“The president’s budget proposal shows that he remains committed to increasing the federal cigarette tax by an unprecedented 94 cents, which would save lives and reduce long-term health care costs. Increasing tobacco taxes is one of the most effective ways to keep kids from smoking and encourage people to quit. ACS CAN estimates that nearly doubling the federal cigarette tax would prevent about 493,000 children from premature death, reduce the number of adult smokers by 2.6 million over 10 years and lower health care costs by $55 billion.
“ACS CAN applauds the President’s proposal to invest more than $14.6 billion to expand and train the nation’s healthcare workforce – and investment that is vital to our ability to emphasize prevention and wellness in the health care system.  This proposal builds upon the efforts included in the health care law and will further help cancer patients and their families, especially those in rural and underserved areas, to get the health care they need.
“We are disappointed that the president’s proposal reduces funding for critical breast, cervical and colorectal cancer screenings, offered through the Centers for Disease Control and Prevention to low-income and uninsured. While the Affordable Care Act makes strides in improving access to these proven prevention measures than can help to detect cancer at its earliest most treatable stages, millions of people will still need access to these critical programs in coming years.
“We are pleased that the budget proposal increases funding for medical research at the National Institutes of Health, but disappointed that the National Cancer Institute would receive only a nominal increase under the President’s budget.  We hope that cancer research will be prioritized as details emerge about the proposed $970 million in supplemental funding for the NIH. Investment in cancer-specific research and proven cancer screening programs for low-income and uninsured are essential to eliminating death and suffering from a disease that will kill an estimated 585,000 people in America and cost the economy $216 billion this year.”
ACS CAN, the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. ACS CAN works to encourage elected officials and candidates to make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer with the training and tools they need to make their voices heard. For more information, visit www.acscan.org.

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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/

US is marking 50th anniversary of surgeon general report that turned the tide against smoking

Article by: MIKE STOBBE , Associated Press
ATLANTA — Fifty years ago, ashtrays seemed to be on every table and desk. Athletes and even Fred Flintstone endorsed cigarettes in TV commercials. Smoke hung in the air in restaurants, offices and airplane cabins. More than 42 percent of U.S. adults smoked, and there was a good chance your doctor was among them.
The turning point came on Jan. 11, 1964. It was on that Saturday morning that U.S. Surgeon General Luther Terry released an emphatic and authoritative report that said smoking causes illness and death — and the government should do something about it.
In the decades that followed, warning labels were put on cigarette packs, cigarette commercials were banned, taxes were raised and new restrictions were placed on where people could light up.
“It was the beginning,” said Kenneth Warner, a University of Michigan public health professor who is a leading authority on smoking and health.
It was not the end. While the U.S. smoking rate has fallen by more than half to 18 percent, that still translates to more than 43 million smokers. Smoking is still far and away the leading preventable cause of death in the U.S. Some experts predict large numbers of Americans will puff away for decades to come.
Nevertheless, the Terry report has been called one of the most important documents in U.S. public health history, and on its 50th anniversary, officials are not only rolling out new anti-smoking campaigns but reflecting on what the nation did right that day.
The report’s bottom-line message was hardly revolutionary. Since 1950, head-turning studies that found higher rates of lung cancer in heavy smokers had been appearing in medical journals. A widely read article in Reader’s Digest in 1952, “Cancer by the Carton,” contributed to the largest drop in cigarette consumption since the Depression. In 1954, the American Cancer Society announced that smokers had a higher cancer risk.
But the tobacco industry fought back. Manufacturers came out with cigarettes with filters that they claimed would trap toxins before they settled into smokers’ lungs. And in 1954, they placed a full-page ad in hundreds of newspapers in which they argued that research linking their products and cancer was inconclusive.
It was a brilliant counter-offensive that left physicians and the public unsure how dangerous smoking really was. Cigarette sales rebounded.
In 1957 and 1959, Surgeon General Leroy Burney issued statements that heavy smoking causes lung cancer. But they had little impact.
Amid pressure from health advocates, President John F. Kennedy’s surgeon general, Dr. Luther Terry, announced in 1962 that he was convening an expert panel to examine all the evidence and issue a comprehensive, debate-settling report. To ensure the panel was unimpeachable, he let the tobacco industry veto any proposed members it regarded as biased.
Surveys indicated a third to a half of all physicians smoked tobacco products at the time, and the committee reflected the culture: Half its 10 members were smokers, who puffed away during committee meetings. Terry himself was a cigarette smoker.
Dr. Eugene Guthrie, an assistant surgeon general, helped persuade Terry to kick the habit a few months before the press conference releasing the report.
“I told him, ‘You gotta quit that. I think you can get away with a pipe — if you don’t do it openly.’ He said, ‘You gotta be kidding!’ I said, ‘No, I’m not. It just wouldn’t do. If you smoke any cigarettes, you better do it in a closet,'” Guthrie recalled in a recent interview with The Associated Press.
The press conference was held on a Saturday partly out of concern about its effect on the stock market. About 200 reporters attended.
The committee said cigarette smoking clearly did cause lung cancer and was responsible for the nation’s escalating male cancer death rate. It also said there was no valid evidence filters were reducing the danger. The committee also said — more vaguely — that the government should address the problem.
“This was front-page news, and every American knew it,” said Robin Koval, president of Legacy, an anti-smoking organization.
Cigarette consumption dropped a whopping 15 percent over the next three months but then began to rebound. Health officials realized it would take more than one report.
In 1965, Congress required cigarette packs to carry warning labels. Two years later, the Federal Communications Commission ordered TV and radio stations to provide free air time for anti-smoking public service announcements. Cigarette commercials were banned in 1971.
Still, progress was slow. Warner recalled teaching at the University of Michigan in 1972, when nearly half the faculty members at the school of public health were smokers. He was one of them.
“I felt like a hypocrite and an idiot,” he said. But smoking was still the norm, and it was difficult to quit, he said.
The 1970s also saw the birth of a movement to protect nonsmokers from cigarette fumes, with no-smoking sections on airplanes, in restaurants and in other places. Those eventually gave way to complete smoking bans. Cigarette machines disappeared, cigarette taxes rose, and restrictions on the sale of cigarettes to minors got tougher.
Tobacco companies also came under increasing legal attack. In the biggest case of them all, more than 40 states brought lawsuits demanding compensation for the costs of treating smoking-related illnesses. Big Tobacco settled in 1998 by agreeing to pay about $200 billion and curtail marketing of cigarettes to youths.
In 1998, while the settlement was being completed, tobacco executives appeared before Congress and publicly acknowledged for the first time that their products can cause lung cancer and be addictive.
Experts agree the Terry report clearly triggered decades of changes that whittled the smoking rate down. But it was based on data that was already out there. Why, then, did it make such a difference?
For one thing, the drumbeat about the dangers of smoking was getting louder in 1964, experts said. But the way the committee was assembled and the carefully neutral manner in which it reached its conclusion were at least as important, said Dr. Tim McAfee, director of the Office on Smoking and Health at the Centers for Disease Control and Prevention.
At the same time, he and others said any celebration of the anniversary must be tempered by the size of the problem that still exists.
Each year, an estimated 443,000 people die prematurely from smoking or exposure to secondhand smoke, and 8.6 million live with a serious illness caused by smoking, according to the CDC.
Donald Shopland finds that depressing.
Fifty years ago, he was a 19-year-old who smoked two packs a day while working as a clerk for the surgeon general’s committee. He quit cigarettes right after the 1964 report came out, and went on to a long and distinguished public health career in which he wrote or edited scores of books and reports on smoking’s effects.
“We should be much further along than we are,” the Georgia retiree lamented.
http://www.startribune.com/lifestyle/health/238716101.html?page=all&prepage=1&c=y#continue

Triple tobacco taxes? Researchers say yes to save 200M lives

By Cheryl K. Chumley – The Washington Times
Tripling tobacco taxes would save 200 million smokers around the world from premature deaths over the course of the next century, researchers say.
That’s because the higher costs would make it nearly impossible for many to afford the habit and at the same time serve as a deterrent to youth from taking their first puffs, scientists said, AOL Money reported.
The scientists said they reviewed 63 different studies about the causes and effects of tobacco smoking around the world — and discovered a link between lower smoking statistics and higher priced product. Raising the price of cigarettes by 50 percent lowers the rate of smoking by about a fifth, the scientists found.
So now study authors suggest that prices of tobacco should be raised significantly, by boosting taxes of the product by three times the present amount.
“The two certainties in life are death and taxes,” said study co-author Professor Sir Richard Peto, from the nonprofit Cancer Research UK, in the AOL Money report. “We want higher tobacco taxes and fewer tobacco deaths. It would help children not to start, and it would help many adults to stop while there’s still time.”
They estimate the death rate could be cut by almost half if the tax rate increase is accepted.
“Globally, about half of all young men and one in 10 of all young women become smokers and, particularly in developing countries, relatively few quit,” Mr. Peto said, in AOL Money. “If they keep smoking, about half will be killed by it. But if they stop before 40, they’ll reduce their risk of dying form tobacco by 90 percent.”
The researchers say that in the European Union alone, 100,000 lives per year of those under the age of 70 could be saved by doubling the cost of cigarettes.
http://www.washingtontimes.com/news/2014/jan/2/triple-tobacco-taxes-researchers-say-save-lives/

Trebling [tripling] tobacco tax 'could prevent 200 million early deaths'

By: Kate Kelland, Reuters
LONDON (Reuters) – Trebling [tripling] tobacco tax globally would cut smoking by a third and prevent 200 million premature deaths this century from lung cancer and other diseases, researchers said on Wednesday.
In a review in the New England Journal of Medicine, scientists from the charity Cancer Research UK (CRUK) said hiking taxes by a large amount per cigarette would encourage people to quit smoking altogether rather than switch to cheaper brands, and help stop young people from taking up the habit.
As well as causing lung cancer, which is often fatal, smoking is the largest cause of premature death from chronic conditions like heart disease, stroke and high blood pressure.
Tobacco kills around 6 million people a year now, according to the World Health Organization (WHO), and that toll is expected to rise above 8 million a year by 2030 if nothing is done to curb smoking rates.
Richard Peto, an epidemiologist at CRUK who led the study, said aggressively increasing tobacco taxes would be especially effective in poorer and middle-income countries where the cheapest cigarettes are relatively affordable.
Of the 1.3 billion people around the world who smoke, most live in poorer countries where often governments have also not yet introduced smoke-free legislation.
But increasing tobacco tax would also be effective in richer countries, Peto said, citing evidence from France, which he said halved cigarette consumption from 1990 to 2005 by raising taxes well above inflation.
“The two certainties in life are death and taxes. We want higher tobacco taxes and fewer tobacco deaths,” he said in a statement. “It would help children not to start, and it would help many adults to stop while there’s still time.”
While smokers lose at least 10 years of life, quitting before age 40 avoids more than 90 percent of the increased health risk run by people who continue smoking. Stopping before age 30 avoids more than 97 percent of the risk.
Governments around the world have agreed to prioritize reducing premature deaths from cancer and other chronic diseases in the United Nations General Assembly and in the WHO’s World Health Assembly in 2013. They also agreed to a target of reducing smoking by a third by 2025.
The CRUK analysis found that doubling the price of cigarettes in the next decade through increased taxes would cut worldwide consumption by about a third by that target, and at the same time increase annual government revenues from tobacco by a third from around $300 billion to $400 billion.
This extra income, the researchers suggested, could be spent on boosting health care budgets.
Peto noted that the international tobacco industry makes about $50 billion in profits each year, saying this equated to “approximately $10,000 per death from smoking”.
“Worldwide, around half a billion children and adults under the age of 35 are already – or soon will be – smokers, and many will be hooked on tobacco for life. So there’s an urgent need for governments to find ways to stop people starting and to help smokers give up,” said Harpal Kumar, CRUK’s chief executive.
He said the study, which examined 63 research papers on the causes and consequences of tobacco use in many different countries, showed tobacco taxes are “a hugely powerful lever”.
They are also potentially a triple win, Kumar said, cutting the number of people who smoke and die from their addiction, reducing the health care burden and costs linked to smoking and at the same time increasing government income.
(Reporting by Kate Kelland; Editing by Janet Lawrence)
http://www.grandforksherald.com/event/article/id/281348/

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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