Tobacco Control: A Winnable BattleU.S. Department of Health and Human ServicesCenters for Disease Control and Prevention
Tobacco use damages virtually every part of the bodySmoking Secondhand Smoke
Tobacco use is still the leading preventable cause of death in the U.S. 46.6 million U.S. adults smoke Tobacco causes nearly 1 in 5 deaths in U.S. • >440,000 deaths/year, >1,200/day For each death, it is estimated that 20 more suffer tobacco-related illnesses Annual costs: $96 billion in medical expenses plus $97 billion in lost productivity Many Americans left unprotected, especially service industry workers • 26 states still lack comprehensive smoke-free laws
Tobacco kills about 443,000 in the U.S. every yearAverage annual number of deaths, 2000-2004.Source: Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses – United States, 2000-2004. MMWR 2008;57(45):1226-1228.
The decline in adult cigarette smoking has stalledCivilian, non-institutionalized adults, aged 18 years of age and over, who currently smoked cigarettes.Source: National Health Interview Surveys, 1965-2009.
Smoking rates vary widely by race/ethnicityNote: Question wording changed in 1992 in order to identify smokers who smoked less than daily. This graph includes all smokers, regardless of frequency.Source: National Health Interview Survey, 1978-2009; data aggregated for selected years.
Smoking rates vary widely by state/regionNote: Persons who have smoked at least 100 cigarettes in lifetime and currently smoke everyday or some days.Source: Behavioral Risk Factor Surveillance Survey, NCCDPHP, CDC, 2009.
Heart disease deaths are closely aligned with smoking Heart Disease Death Rates, 2000-2004 Adults ages 35 Years and Older by CountySource: Vital Records; National Center for Health Statistics, CDC, 2000-2004.Division for Heart Disease and Stroke Prevention: Data Trends & Maps Web site. U.S. Department of Health and Human Services, Centersfor Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, 2010.Available at http://www.cdc.gov/dhdsp/.
Short-term impact of a comprehensive approach: Youth and adult smoking rates in NYCSource: BRFSS 1993-2001; NYC Community Health Survey 2002-2009; NYC YRBS 2001-2009.
Long-term impact of a comprehensive approach: Lung and bronchus cancer incidence rates in CA California: A 15 year investment of $1.8 billion in tobacco control reduced health care costs by $86 billionRates are per 100,000 and age-adjusted to the 2000 U.S. standard (19 age groups).* The annual percent change is significantly different from zero (p<0.05).Source: Cancer Surveillance Section. Prepared by: California Department of Public Health, California Tobacco Control Program, 1988-2005. 2010.
We know what works Sustained funding of comprehensive programs Excise tax increases 100% smoke-free policies Aggressive media campaigns Cessation access Comprehensive advertising restrictions
The tobacco industry is outspending tobacco prevention efforts 20:1Sources: Campaign for Tobacco Free Kids; Federal Trade Commission; CDC Office on Smoking and Health.
When tobacco control funding increases, high school smoking decreasesSource: Project ImpacTEEN; University of Illinois at Chicago; State University of New York at Buffalo; Youth Risk Behavior Survey, 1993-2009.* Adjusted to 2009 CPI.† High school students (grades 9-12) who smoked on 1 or more of the 30 days preceding the survey.
When cigarette prices increase, cigarette sales decreaseSource: ImpacTeen Chartbook: Cigarette Smoking Prevalence and Policies in the 50 States.
Increased tobacco excise taxes increase price 10% increase in cigarette prices 4% drop in adult cigarette consumption Youth much less likely to start smoking when prices are high Adjust taxes to offset inflation and tobacco industry attempts to control retail prices • E.g., promotional discounts for retailers who reduce cigarette prices Tobacco taxes are the single most effective component of a comprehensive tobacco control program
Smoke-free policies save lives Prevent heart attacks • Up to 17% average reduction in heart attack hospitalizations in places that enact smoke-free laws Help motivate smokers to quit Worker safety issue – not “personal nuisance” • All workers deserve equal protection • Only way to protect non-smokers from secondhand smoke Smoke-free workplace laws don’t hurt business No trade-off between health and economics
25 states and D.C. have comprehensive smoke-free indoor air laws Laws in effect as of November 10, 2010Source: CDC, Office on Smoking and Health. State Tobacco Activities Tracking and Evaluation (STATE) System.
Almost 50% of U.S. population is covered by comprehensive state or local smoke-free lawsPopulation figures are as of December 31 of each given year; July for 2010. All population figures are from the United States Census.Source: American Nonsmokers’ Rights Foundation, 2000-2010.
Aggressive media campaigns workMedia campaigns work to: Reduce youth initiation Encourage cessation Increase negative attitudes toward tobacco use Increase support for policy change
The impact of cessation services Currently: 46.6 million U.S. smokers • 70% of smokers want to quit • 40% try to quit each year • Only 2% call state or national quitlines • Medicaid coverage for cessation varies widely among states Tobacco cessation can be achieved through: • Significant tax and price increases • Comprehensive smoke-free policies • Aggressive counter-advertising
State and federal policy activities (2009-2010) Excise Tax Increases • 21 state increased cigarette taxes Smoke-Free Policies • 10 additional states achieved comprehensive status Federal Legislation • Federal excise tax increase • Family Smoking Prevention and Tobacco Control Act • Prevent All Cigarette Trafficking (PACT) Act • Affordable Care Act
Closing StatementFor more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: firstname.lastname@example.org Web: www.cdc.govThe findings and conclusions in this report are those of the authors and do not necessarily represent the officialposition of the Centers for Disease Control and Prevention. U.S. Department of Health and Human Services Centers for Disease Control and Prevention