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CVS stops selling tobacco, offers quit-smoking programs

Jayne O’Donnell and Laura Ungar, USA TODAY

CVS Caremark plans to stop selling tobacco products in all of its stores starting Wednesday — a move health experts hope will be followed by other major drugstore chains.

CVS announced in February that it planned to drop tobacco by Oct. 1 as the sales conflicted with its health care mission. To bolster its image as a health care company, CVS will announce a corporate name change to CVS Health. Retail stores will still be called CVS/Pharmacy.

CVS, which has 7,700 retail locations, is the second-largest drugstore chain in the USA, behind Walgreens. It manages the pharmacy benefits for 65 million members and has 900 walk-in medical clinics.

The American Pharmacists Association called on drugstores to stop selling tobacco in March 2010 and several small, independent chains have done so, APA spokeswoman Michelle Spinnler says. CVS is the first large chain to stop tobacco sales.

“CVS’ announcement to stop selling tobacco products fully a month early sends a resounding message to the entire retail industry and to its customers that pharmacies should not be in the business of selling tobacco,” said Matthew Myers, president of the Washington-based Campaign for Tobacco-Free Kids. “This is truly an example of a corporation leading and setting a new standard.”

CVS is also launching a smoking-cessation campaign that will include an assessment of the smoker’s “readiness to quit,” education, medication support to help curb the desire to use tobacco and coaching to help people stay motivated and avoid relapses.

CVS says research shows its decision will have a big impact. A study the company is releasing Wednesday in the journal Health Affairs shows bans at pharmacies in Boston and San Francisco led to more than 13% fewer purchasers. Smokers didn’t just switch where they bought cigarettes and other tobacco products, some stopped buying them altogether. About 900 households in the two cities recorded everything they bought after the bans went into effect.

Troyen Brennan, CVS’ chief medical officer, says if the results were extrapolated for pharmacies across the USA, it would lead to 65,000 fewer deaths a year.

Ellen Hahn of the Tobacco Policy Research Program at the University of Kentucky says one chain not selling tobacco will have a limited effect, and other tobacco control strategies, such as price and tax increases and smoking bans, have been shown to be more effective.

Still, she said, “every little bit helps because they are such a large chain. If every pharmacy would follow suit, that would be best. But this sends a clear message that pharmacies should not be selling tobacco.”

Audrey Silk, founder of Citizens Lobbying Against Smoker Harassment, or CLASH, a national smokers’ rights group based in New York City, says CVS has every right to change what it sells, but she believes the company is falling for the anti-smoking “crusade.”

Pharmacies no longer sell just medicines, she said, “they have turned into grocery stores. They sell candy. They sell beer. CVS Health? It’s a perception war. … Tobacco is legal. They’re engaging in public coercion by not selling cigarettes.”

CVS says its tobacco sales total about $2 billion a year.

The U.S. Centers for Disease Control and Prevention calls tobacco “the single most preventable cause of disease, disability and death in the United States,” saying 443,000 people die from smoking or exposure to secondhand smoke each year.
Tobacco deaths are very personal to two top CVS executives. CEO Larry Merlo’s father died of tobacco-related cancer at age 57 and the mother of CVS/Pharmacy President Helene Foulkes died five years ago of lung cancer from smoking.
After its announcement in February, Foulkes says CVS was deluged with personal stories from customers who had quit smoking. Many said it was the “hardest thing they had ever done,” she says. The company is determined to make it easier for them, she says, because it simply makes sense.
“The contradiction of selling tobacco was becoming a growing obstacle to playing a bigger role in health care delivery,” Merlo says.
http://www.usatoday.com/story/news/nation/2014/09/03/cvs-steps-selling-tobacco-changes-name/14967821/

WHO urges stiff regulatory curbs on e-cigarettes

BY STEPHANIE NEBEHAY, Geneva
(Reuters) – The World Health Organization (WHO) stepped up its war on “Big Tobacco” on Tuesday, calling for stiff regulation of electronic cigarettes as well as bans on indoor use, advertising and sales to minors.

In a long-awaited report that will be debated by member states at a meeting in October in Moscow, the United Nations health agency also voiced concern at the concentration of the $3 billion market in the hands of transnational tobacco companies.

The WHO launched a public health campaign against tobacco a decade ago, clinching the WHO Framework Convention on Tobacco Control. Since entering into force in 2005, it has been ratified by 179 states but the United States has not joined it.

The treaty recommends price and tax measures to curb demand as well as bans on tobacco advertising and illicit trade in tobacco products. Prior to Tuesday’s report the WHO had indicated it would favor applying similar restrictions to all nicotine-containing products including smokeless ones.

In the report, the WHO said there are 466 brands of e-cigarettes and the industry represents “an evolving frontier filled with promise and threat for tobacco control”.

It urged a range of regulatory options, including banning e-cigarette makers from making health claims such as that they help people quit smoking, until they provide convincing supporting scientific evidence.

Smokers should use a combination of already-approved treatments for kicking the habit, it said.

While evidence indicates that they are likely to be less toxic than conventional cigarettes, the use of e-cigarettes poses a threat to adolescents and the fetuses of pregnant women using them, it said.

“NOT MERELY WATER VAPOR”

E-cigarettes also increase the exposure of bystanders and non-smokers to nicotine and other toxicants, it said regarding Electronic Nicotine Delivery Systems that it calls ENDS.

“In summary, existing evidence shows that ENDS aerosol is not merely ‘water vapor’ as is often claimed in the marketing for these products,” the WHO said in the 13-page report.

E-cigarettes should be regulated to “minimize content and emissions of toxicants”, and those solutions with fruit, candy-like and alcohol-drinks flavors should be banned until proven they are not attractive to children and adolescents, it said.

Adolescents are increasingly experimenting with e-cigarettes, with their use in this age group doubling between 2008 and 2012, it said.

Vending machines should be removed in almost all locations, it added.

Scientists are divided on the risks and potential benefits of e-cigarettes, which are widely considered to be a lot less harmful than conventional cigarettes.

One group of researchers warned the WHO in May not to classify them as tobacco products, arguing that doing so would jeopardize an opportunity to slash disease and deaths caused by smoking.

Opposing experts argued a month later that the WHO should hold firm to its plan for strict regulations.

Major tobacco companies including Imperial Tobacco (IMT.L), Altria Group (MO.N), Philip Morris International (PM.N) and British American Tobacco (BATS.L) are increasingly launching their own e-cigarette brands as sales of conventional products stall in Western markets.

A Wells Fargo analyst report in July projected that U.S. sales of e-cigarettes would outpace conventional ones by 2020.

Uptake of electronic cigarettes, which use battery-powered cartridges to produce a nicotine-laced inhalable vapor, has rocketed in the last two years and analysts estimate the industry had worldwide sales of some $3 billion in 2013.

But the devices are controversial. Because they are so new there is a lack of long-term scientific evidence to support their safety and some fear they could be “gateway” products to nicotine addiction and tobacco smoking.

The American Heart Association said in a report on Monday that it considered e-cigarettes that contain nicotine to be tobacco products and therefore supports their regulation under existing laws on the use and marketing of tobacco products.

“Although the levels of toxic constituents in e-cigarette aerosol are much lower than those in cigarette smoke, there is still some level of passive exposure,” the AHA said.

(Reporting by Stephanie Nebehay in Geneva; additional reporting by Ben Hirschler and Martinne Geller in London, Editing by Angus MacSwan)

http://www.reuters.com/article/2014/08/26/us-health-who-ecigarettes-idUSKBN0GQ0PF20140826

Why Can’t the Pentagon Stop Smoking?

By The Editors

Even the most oblivious member of Congress knows that smoking is bad for you. As it turns out, it’s even worse for you if you happen to be a soldier. So why would Congress insist that the Pentagon sell cigarettes — at a discount, no less?

The rationale has long been that members of the military have to smoke because their jobs are so stressful. There’s no denying the stress of military service, or that troops who smoke experience more of it than their comrades who don’t (though it may come more from their nicotine addiction than from their work).

Yet soldiers who smoke are not immune to lung cancer and the other lethal pulmonary illnesses that smoking causes. And like all smokers, they face an increased risk of cardiovascular disease. In fact, as an article in the current New England Journal of Medicine points out, smoking is especially harmful to soldiers because it lowers their fitness for service: It makes them more susceptible to injuries and infections, slows the time it takes for their wounds to heal, and leads them to take more frequent breaks than nonsmoking soldiers take.

The Pentagon, to its credit, has been trying for decades to restrict smoking. Most recently, Navy Secretary Ray Mabus said he’s considering banning tobacco sales on Navy ships and Navy and Marine Corps bases. Defense Secretary Chuck Hagel has asked for a Defense Department-wide review of tobacco policies.

Sadly and predictably, political forces are fighting back. In response to the Navy’s possible sales ban, Representative Duncan Hunter, Republican of California, has inserted language in the defense authorization bill that would require military commissaries to keep selling tobacco products. Congress responded the same way in the early 1990s after the captain of the USS Roosevelt said he planned to make that aircraft carrier smoke-free.

So it’s little wonder the military has continued to have a smoking problem. The Defense Department spends more than $1.6 billion a year on medical care and lost days of work due to smoking, and the Veterans Administration spends billions more treating ex-soldiers with lung disease.

About 1 in 4 members of all branches of the U.S. military smoke, compared with about 1 in 5 of the general population. But the percentages differ across the military: While about 30 percent of Marines smoke, members of the Air Force and Coast Guard smoke less than the national average, as do officers in all branches.

Millions of troops, in other words, have found more healthy ways to deal with the stress that inevitably accompanies military service. Nor are smoking bans especially difficult to impose or enforce: There is no smoking allowed during basic training, for example, and a 2010 ban on smoking on submarines — instituted after a warning period, to allow sailors time to quit — went off with no trouble.

The policy review Hagel has requested is expected to be finished within a couple of months, and it can be expected to take account of the Institute of Medicine’s 2009 recommendation to work toward a tobacco-free military. That need not result in an immediate ban on all smoking. But gradual limitations on where and when troops are allowed to smoke are necessary, as are greater efforts to help them quit.

In the meantime, the military is right to want to get out of the cigarette-sales business — and Congress should let it.

To contact the senior editor responsible for Bloomberg View’s editorials: David Shipley at davidshipley@bloomberg.net.

Letter: Tobacco taxes should be raised

By Jay Taylor from Durbin, N.D.

Hey! I have a great idea! Let’s raise a tax on something,” said no North Dakota legislator ever.

Wow! Raising a tax on anything, with North Dakota being so flush from oil money, just doesn’t make any sense at all.

And yet, taxes (or fees if you want a more politically correct term) do continue to inch up here and there.

During the 2013 legislative session, North Dakota lawmakers passed a bill that increased fees for many hunting and fishing licenses.

A tax is generally imposed to gain funds to pay for specific services or products: “It is a compulsory contribution to state revenue, levied by the government on workers’ income and business profits or added to the cost of some goods, services, and transactions.”

As said, to raise a tax in North Dakota today just doesn’t seem to make any sense, unless it’s a tax to protect the health of our residents, prevent disease and thwart kids from starting a path of extremely unhealthy behavior.

OK, I’ve beat around the bush long enough. I have read a lot about the idea of increasing the tobacco tax in North Dakota, and I am totally in favor of such an action. Here’s why:

The tobacco tax in North Dakota is one of the lowest in the nation (we are 46th at 44 cents per pack of 20 cigarettes), the lower-than-us states include: Missouri at 17 cents; Louisiana at 36 cents; Georgia at 37 cents and Alabama at 42 cents.

Our tobacco tax hasn’t increased since 1993.

The effects of North Dakotans’ tobacco use also affects the wallets of those who don’t use tobacco. North Dakota’s annual health care costs directly caused by smoking are $326 million. The portion covered by state Medicaid is $47 million.

But the most important reason is that a higher tobacco tax encourages people to quit and discourages younger folks from starting. According to the Tobacco Free Kids organization, “tobacco tax increases are one of the most effective ways to reduce smoking and other tobacco use, especially among kids. Every 10 percent increase in cigarette prices reduces youth smoking by about seven percent and total cigarette consumption by about four percent.”

For all the work being done by public health and health advocacy organizations, raising the tobacco tax is win-win.

I think it’s about time the North Dakota legislators started having a serious talk about this rather serious idea.

http://www.westfargopioneer.com/content/letter-tobacco-taxes-should-be-raised

Letter: Tobacco taxes should be raised

“Hey! I have a great idea! Let’s raise a tax on something,” said no North Dakota legislator ever.

Wow! Raising a tax on anything, with North Dakota being so flush from oil money, just doesn’t make any sense at all.

And yet, taxes (or fees if you want a more politically correct term) do continue to inch up here and there.

During the 2013 legislative session, North Dakota lawmakers passed a bill that increased fees for many hunting and fishing licenses.

A tax is generally imposed to gain funds to pay for specific services or products: “It is a compulsory contribution to state revenue, levied by the government on workers’ income and business profits or added to the cost of some goods, services, and transactions.”

As said, to raise a tax in North Dakota today just doesn’t seem to make any sense, unless it’s a tax to protect the health of our residents, prevent disease and thwart kids from starting a path of extremely unhealthy behavior.

OK, I’ve beat around the bush long enough. I have read a lot about the idea of increasing the tobacco tax in North Dakota, and I am totally in favor of such an action. Here’s why:

The tobacco tax in North Dakota is one of the lowest in the nation (we are 46th at 44 cents per pack of 20 cigarettes), the lower-than-us states include: Missouri at 17 cents; Louisiana at 36 cents; Georgia at 37 cents and Alabama at 42 cents.

Our tobacco tax hasn’t increased since 1993.

The effects of North Dakotans’ tobacco use also affects the wallets of those who don’t use tobacco. North Dakota’s annual health care costs directly caused by smoking are $326 million. The portion covered by state Medicaid is $47 million.

But the most important reason is that a higher tobacco tax encourages people to quit and discourages younger folks from starting. According to the Tobacco Free Kids organization, “tobacco tax increases are one of the most effective ways to reduce smoking and other tobacco use, especially among kids. Every 10 percent increase in cigarette prices reduces youth smoking by about seven percent and total cigarette consumption by about four percent.”

For all the work being done by public health and health advocacy organizations, raising the tobacco tax is win-win.

I think it’s about time the North Dakota legislators started having a serious talk about this rather serious idea.

http://www.westfargopioneer.com/content/letter-tobacco-taxes-should-be-raised

Ebola-fighting compound created using tobacco

Laura Ungar, USA TODAY

LOUISVILLE, Ky. — A Kentucky company used local tobacco to help produce an experimental serum to fight Ebola, which may help save two American aid workers stricken with the deadly disease.

David Howard, a spokesman for Reynolds American Services, said Owensboro-based Kentucky BioProcessing complied with a request from Emory University Hospital in Atlanta and Samaritan’s Purse this week “to provide a limited amount” of the compound, called ZMapp.

Kentucky BioProcessing, which was acquired by North Carolina-based Reynolds American Inc. in January, does contract work for many clients, including ZMapp maker Mapp Biopharmaceutical of San Diego.

Howard couldn’t confirm that the compound was used on the aid workers, and Emory officials didn’t respond by deadline to a call or email seeking confirmation. But The Associated Press, CNN and other media outlets reported that the aid workers have gotten the serum and have improved.

The fact that a Kentucky company focused on plant-based science played a part “is fantastic,” said Kenneth Palmer, a University of Louisville professor who is involved in tobacco-based research in Owensboro but not in this project. “The more that (medicines) made in plants are used, the better the acceptance. … It gives tangible evidence of how what we do can be applied to help people.”

Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, pointed out that ZMapp is not a proven treatment for Ebola but said it’s a good example of the intriguing science of growing medicines in tobacco plants.

“We’d love to see tobacco used for health,” said Frieden, who was in Hazard, Ky., on Tuesday for a series of talks on health problems in Appalachia. But he added, “We don’t have proven treatments or vaccines against Ebola. … This Ebola outbreak is the biggest, worst, most complicated one that the world has ever seen.”

Howard said tobacco helps in the production of ZMapp, acting like a “photocopier” to mass-produce proteins used to make the serum. Palmer said three, single-gene antibodies are put into trays of plants at Kentucky BioProcessing and replicate the antibodies after about 10 days.

Palmer likened it to antibodies being produced in the bodies of people or animals after an infection.

“What the plants are doing is pumping out the antibodies,” Palmer said. “The plants are used to make the antibodies, and then they purify the antibodies.”

“It’s faster than more traditional methods,” Howard added. “It allows for rapid growth of proteins … on a reasonably large scale.”

At the direction of Mapp, the Kentucky company developed a precursor to ZMapp, called MB-003, which was tested in non-human primates and showed good results, published last August in the journal Science Translational Medicine.

Researchers said the treatment previously had been shown to protect all the primates when it was given an hour after exposure to Ebola, and two-thirds of them when given 48 hours after exposure.

ZMapp was never tested in humans, but even before the latest Ebola outbreak, the companies had planned later this year to begin the federal process to get the drug approved, Howard said.

Meanwhile, tobacco plants also will be used to develop a gel to prevent the transmission of HIV, the virus that causes AIDS. University of Louisville researchers announced this week they will lead the international effort, which is being funded by a five-year, $14.7 million grant from the National Institutes of Health.

The gel — designed to be used during sexual intercourse by people at risk for HIV — is developed using a synthetic copy of a protein found in red algae shown to act against HIV in the lab.

Research is also underway at Louisville using tobacco plants to produce a cheaper version of the vaccine against human papillomavirus, which causes most cervical cancer.

University of Louisville President James Ramsey said all of the tobacco-based research is exciting, particularly in a state where smoking kills at the highest rate in the nation.

“It is ironic,” Ramsey said in an interview Tuesday. “We’ve been a tobacco state, and it’s been such a part of our economy, and it’s pretty amazing that they can take tobacco and potentially solve some of the biggest health problems around the world.”

Laura Ungar also reports for The (Louisville, Ky.) Courier-Journal

http://www.usatoday.com/story/news/nation/2014/08/05/ebola-fighting-compound-created-using-tobacco/13642819/

The Post's View: Raising all federal tobacco taxes can stop tax avoidance

By Editorial Board, Washington Post

ENACT A LAW, and companies will find loopholes to exploit. That was the fear which drove lawmakers in 2009 to raise cigarette taxes together with taxes for roll-your-own tobacco and small cigars, both easy substitutes for cigarettes. To prevent manufacturers from shifting toward lesser-taxed alternatives, Congress equalized taxes between all three products — hiking the existing roll-your-own tobacco tax by over 24 times and small cigars by over 27 times.

These products have plunged in sales since 2009. But tobacco manufacturers, unfazed in their quest to fatten their purses, found a new loophole. Unlike these three highly taxed tobacco products, post-2009 taxes on pipe tobacco and large cigars are relatively low. All it took to shift consumers to those products was relabeling roll-your-own tobacco as pipe tobacco, and slightly adding weight to qualify small cigars as large cigars. As evidence from a recent Senate finance committee hearing shows, the popularity of pipe tobacco and large cigars have exploded.

That market shift has cost the federal government up to $3.7 billion in forgone revenue. Even worse, it’s hampered the effect of high tobacco prices on preventing teen smoking.

The first instinct might be to blame the Alcohol and Tobacco Tax and Trade Bureau, which has yet to sharpen definitions of many of these products. While action by the bureau could help close the loopholes, it faces a daunting task. For example, where should it draw the line between roll-your-own and pipe tobacco? In many cases, “it is difficult to establish objective physical standards for differentiating between the two products,” the bureau’s chief said in his testimony. Sometimes the difference is virtually nothing at all.

So forget rewriting definitions. The foolproof solution is for Congress to pass a law equalizing all tobacco taxes. That would raise taxes for pipe tobacco and large cigars to the same level as cigarette taxes, preventing any market shift. A bill introduced by Sen. Richard Durbin (D-Ill.) in 2013, still stuck in committee, would accomplish this task.

Better yet, Congress should hike all tobacco taxes — not just the lower ones — up to higher and equal levels. State taxes vary widely, from $4.35 per cigarette pack in New York to $0.17 per pack in Missouri, making smuggling a big problem for law enforcement. The current cigarette and small cigar federal tax is a meager $1.01 per pack of 20; a higher federal tax would diminish the effect of inconsistency between states and allow for a more uniform response.

These are two common-sense solutions to close tobacco tax loopholes. But the problem of tobacco manufacturers exploiting definitions has another dimension. The Food and Drug Administration, the other arm of the U.S. public health response, has proposed a long-awaited rule to expand its regulatory authority over “all” tobacco products. But premium cigars may be exempted from these regulations, potentially allowing manufacturers to “sweep other cigar products under its umbrella,” as the FDA has admitted before. This proposed exemption, as demonstrated by the tax avoidance case, is a disaster waiting to happen.

http://www.washingtonpost.com/opinions/raising-all-federal-tobacco-taxes-can-stop-tax-avoidance/2014/08/02/4b542a76-180d-11e4-9349-84d4a85be981_story.html

Tobacco tax law reportedly cost U.S. billions in revenue

By Reuters Media
WASHINGTON – A 2009 law that raised federal taxes to discourage smoking cost the U.S. government billions of dollars in lost revenue as manufacturers relabeled products and consumers shifted to cheaper pipe tobacco and large cigars, the U.S. Government Accountability Office said in a report released on Tuesday.

The GAO estimated $2.6 billion to $3.7 billion in lost revenue from April 2009 to February 2014 as manufacturers exploited loopholes in the Children’s Health Insurance Program Reauthorization Act which raised taxes for smoking-tobacco products.

“Each of the three tobacco manufacturers that agreed to speak with us explained that their companies switched from selling higher-taxed roll-your-own tobacco to lower-taxed pipe tobacco to stay competitive,” the congressional watchdog agency said in the report, which was the focus of a Senate hearing on Tuesday.

At the hearing, Liggett Vector Brands LLC Chief Executive Ronald Bernstein urged lawmakers to take action against abuses by manufacturers.

He held up two seemingly identical, but differently labeled non-Liggett bags of tobacco. Showing a third sample, he pointed out that a label saying “all-natural pipe tobacco” covered up a statement that the bag “makes approximately 500 cigarettes.”

“Everyone knows this is cigarette tobacco,” Bernstein said. “The manufacturer knows. The consumer knows. And I know. I know because I tried smoking it in a pipe and it was not a pleasant experience.”

Some manufacturers also add a few ounces of tobacco to small cigars so they qualify as the larger product. Others even mix in clay or kitty litter to increase the weight, Michael Tynan, policy officer at the Oregon Public Health Division, told the hearing.

The GAO said the tobacco market shifted accordingly. Yearly sales of pipe tobacco rose more than eight-fold from fiscal 2008 to 2013, while sales of roll-your-own tobacco declined almost six-fold.

Over the same period, large cigar sales doubled, while small cigar sales dropped to just 700 million from 5.7 billion.

Senate Finance Committee Chairman Ron Wyden, who convened the hearing, criticized the Treasury Department’s Alcohol and Tobacco Tax and Trade Bureau (TTB), which is responsible for collecting tobacco taxes and cracking down on evasion, for “footdragging.”

In recent years, the agency has pushed to apply “advanced investigative techniques to uncover illicit trade and fraudulent activity,” including deploying about 125 auditors and investigators, the TTB wrote in its Senatetestimony.

Responding to a push to better differentiate between roll-your-own and pipe tobacco, the agency published an “advanced notice of proposed rule making” in 2010 and 2011. But no rule had yet been issued, the GAO wrote.

In 2015, the TTB will issue a proposed regulation cracking down on the illegal activities, TTB Administrator John Manfreda said on Tuesday.

But Wyden, an Oregon Democrat, said it was not enough. He said the problem reminded him of “the old marquee at the movie house that says: ‘Coming soon,’ and it never gets there.”

http://www.inforum.com/content/tobacco-tax-law-reportedly-cost-us-billions-revenue

Taxes on cigarettes help reduce number of smokers

By Matthew L. Myers, president of the Campaign for Tobacco-Free Kids
The Hill
Science and experience have demonstrated conclusively that cigarette tax increases are highly effective at reducing smoking, especially among kids. Thus, the conclusions in a Gallup poll The Hill recently wrote about (“High cigarette prices aren’t stopping smokers,” July 18) are inconsistent with what happens in the real world every time cigarette taxes are increased.

The most recent surgeon general’s report on tobacco concludes that “raising prices on cigarettes is one of the most effective tobacco control interventions.” The report called for additional cigarette tax increases “to prevent youth from starting smoking and encouraging smokers to quit.” The Congressional Budget Office has also reviewed the evidence and concluded that an increase in the federal cigarette tax would significantly reduce the number of adult smokers.

In the year after a 62-cent increase in the federal cigarette tax in 2009, cigarette sales declined by a historic 11.1 percent. Adult and youth smoking rates also declined. “This single legislative act — increasing the price of cigarettes — is projected to have reduced the number of middle and high school students who smoke by over 220,000 and the number using smokeless tobacco products by over 135,000,” the surgeon general’s report noted.

Even the poll The Hill wrote about reported that more than a quarter of adult smokers surveyed said they smoked less due to tax increases. As there are 42 million smokers in the United States, this translates into millions of smokers whose behavior is affected by cigarette tax increases. And this survey of current smokers would not have included former smokers who have already quit due to increased tobacco taxes.
Tobacco tax increases don’t have to cause every smoker or even a majority of smokers to quit or cut back in order to have a big impact on public health. As the scientific evidence and even the new Gallup poll show, such tax increases will impact the behavior of large numbers of smokers, saving many from a premature death.
From Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, Washington, D.C.

Read more: http://thehill.com/opinion/letters/213571-taxes-on-cigarettes-help-reduce-number-of-smokers#ixzz38sdK91IE
Follow us: @thehill on Twitter | TheHill on Facebook

Report: Smoking bans, cigarette taxes linked to lower suicide rates

SALT LAKE CITY — Utah mental health and public health officials say a new report that links stronger anti-smoking initiatives to lower suicide rates suggests an added benefit of states’ prevention and cessation efforts.

The report, published in the journal Nicotine & Tobacco Research, found that public health interventions, such as raising cigarette taxes and imposing indoor smoking bans, could reduce risk of suicide by as much as 15 percent.

Janae Duncan, coordinator of the Utah Health Department’s Tobacco Prevention and Control Program, said Utah’s Indoor Clean Air Act “is really strong.”

While the state’s rate of adult smoking of 10.6 percent is the lowest in the nation, Utah’s tobacco taxes are relatively low at $1.70 per pack of cigarettes, Duncan said. Utah’s rate is higher than the national average but well below the rates of some East Coast states such as New York, which imposes a tax of $4.35 per pack.

“The study said each dollar increase in cigarette taxes was associated with a 10 percent decrease in (the relative risk of) suicide,” she said. “Even though we have a low tobacco use rate, it may be a good reason to look at raising our excise tax for tobacco.”

Other Utah officials say the report lends credence to mental health and substance abuse treatment practices that encourage wellness across the spectrum.

The state’s 2013 Recovery Plus initiative, for instance, required all publicly funded substance abuse and mental health treatment facilities to be tobacco free by March 2013.

“When we first started talking about doing this, there was a lot of talk such as, ‘You can’t expect someone with substance abuse or mental illness to also give that up. It’s too much on a person.’ They found that’s not the case. It actually helps with their recovery,” said Teresa Brechlin, coordinator in the Utah Department of Health’sViolence and Injury Prevention Program.

Kim Myers, suicide prevention coordinator with the Utah Division of Substance Abuse and Mental Health, said Utah officials have long observed that clients in publicly funded substance abuse and mental health facilities smoke at substantially higher rates than the general population.

The authors of the report noted that clinical and general studies have likewise documented elevated rates of smoking among people with anxiety disorders, alcohol and drug dependence, and schizophrenia, among other diagnoses.

“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,” the study’s authors wrote.

Myers said the study raises the question whether nicotine itself raises suicide risk.

“How do we use that information on a population level, but also on an individual level, to reduce someone’s risk, especially when it comes to people who have some of those other risks such as serious mental illness or substance use disorders?” she asked.

The study also determined that smokers’ risk for suicide is two to four times greater than nonsmokers.

Duncan said more research is needed to understand how the link applies to Utah. Utah’s suicide rate has been consistently higher than the national rate for the past decade, according to state health department statistics, while smoking rates are very low.

“The study doesn’t give those clear answers. I think what it does do, it helps us see we should be looking at whole health, and it’s important to look at it across the board, not just issue by issue, but how all these things are tying together,” Duncan said.

http://www.ksl.com/?nid=157&sid=30887197