Federal Overview: Poor Results in 2013
With 3 Ds and a C, the federal government’s record on tobacco control in 2013 might best be described as poor. The federal government made progress in helping smokers quit here in the U.S., but internationally, the U.S government succumbed to industry-backed pressure by weakening its position on tobacco control in the Trans Pacific Trade Partnership negotiations.
Centers for Disease Control and Prevention (CDC) Director Thomas Frieden, MD has aptly described tobacco as a “winnable battle.” However, for the battle to be won, the Obama Administration must overcome its recent backtracking and delays and renew its commitment to pursue aggressive measures to reduce tobacco use.
The White House Must Give FDA the Green Light for Meaningful Oversight of All Tobacco Products
The proposed regulation to give the Food and Drug Administration (FDA)’s Center for Tobacco Products authority over all tobacco products, including cigars, little cigars, hookah, pipe tobacco, some dissolvable products and e-cigarettes, has yet to be released. As a result, these products remain entirely without federal oversight. The proposed regulation is now under review at the White House Office of Management.
- In July, FDA issued its long-awaited report that found menthol in cigarettes is more likely to lead to new users, primarily youth, starting to smoke as well as them becoming regular users. The report also found that menthol in cigarettes leads to increased smoking dependence; and makes it harder for existing smokers, especially African Americans, to quit. The American Lung Association immediately called on FDA to begin regulatory action to prohibit menthol cigarettes and with partners, submitted comments in November urging FDA to move forward quickly.
- New York City, the Lung Association and the public health community, filed a citizen petition that urges FDA to move forward with an anti-smuggling effort known as track and trace which would track tobacco products from the factories through distributors to retail outlets.
- In June, 140 tobacco industry substantial equivalence applications were either rejected by FDA or withdrawn, keeping new products off the market because it found the products’ introduction would not improve public health.
“The wild, wild west” How FDA Center for Tobacco Products director Mitch Zeller describes the U.S. e-cigarette marketplace.
Congress Fails to Advance President’s Tobacco Tax Proposal
In his Fiscal Year 2014 budget proposal, President Obama called for a 94 cent cigarette tax increase and a proportionate increase on other tobacco products, which would bring the federal cigarette tax up to $1.95 per pack, as a way to pay for early childhood education initiatives. In 2013, Congress failed to act on the President’s proposal.
- The public health and early childhood education communities issued a report “Raising Smart, Healthy Kids in Every State” in September, calling on Congress to pass the proposal by the President that would be a win-win for smart and healthy kids in the U.S.
- The American Lung Association strongly supports Senator Richard Durbin’s (D-IL) proposal for federal tobacco tax parity. Tax parity – taxing other tobacco products at a rate equivalent to cigarettes – would result in more smokers quitting instead of switching to cheaper tobacco products and would eliminate tobacco industry incentives to manipulate their products.
Tips Campaigns Prompt Smokers to Quit but Still No Defined Quit Smoking Benefit to Assist Them
- CDC launched the second round of its highly successful Tips from Former Smokers media campaign in the spring of 2013. A number of the featured personal stories highlighted the devastating lung health consequences that are the tragic result of tobacco use. A study was published in The Lancet in September that found over 100,000 Americans quit smoking as a result of the initial Tips campaign ads that aired in 2012. The study finds another 1.5 million Americans made quit attempts.
- However, because the Administration again failed to issue guidance to health insurance companies on defining a comprehensive tobacco cessation benefit, millions of Americans do not have access to all of the tools proven to successfully help smokers quit.
- In February 2013, the Department of Defense released its final rule confirming that military personnel and their families enrolled in TRICARE will have access to a comprehensive quit smoking benefit.
- For the last three years, federal workers have had access to the gold-standard of quit smoking benefits. Unfortunately, in his Fiscal Year 2014 budget, the President proposed to weaken this benefit by charging federal employees who use tobacco more for their health insurance (called a “tobacco surcharge”). No evidence exists that such increased premiums are successful in helping smokers quit.
- HHS issued regulations implementing provisions in the Affordable Care Act that increases the amount of tobacco surcharges allowed in certain health insurance plans. The regulations require small employer plans to give tobacco users the option of participating in a quit smoking program to avoid the extra charges.
Obama Administration’s International Tobacco Control Record Continues to Lag
- May 2013 marked the 9th anniversary of the U.S. signing but failing to ratify the global tobacco control treaty known as the Framework Convention on Tobacco Control (FCTC). Almost 180 different nations have ratified the treaty, putting 88 percent of the world’s population under its protections.
- The Administration abandoned its plan to protect millions of people around the world when it failed to put forward its original proposal that would have made it more difficult for tobacco companies to use international trade agreements to their advantage to challenge domestic tobacco control measures.
“Why is Obama Caving on Tobacco” Michael Bloomberg in a New York Times op-ed, August 22, 2013
- Centers for Disease Control and Prevention. “Electronic Cigarette Use Among Middle and High School Students — United States, 2011–2012.” Morbidity and Mortality Weekly Report. September 6, 2013; 62(35):729-30. King BA, Alam S, Promoff G, Arrazola R, Dube SR. “Awareness and Ever Use of Electronic Cigarettes Among U.S. Adults, 2010–2011.” Nicotine & Tobacco Research. February 2013; 15:1623-7.
- Framework Convention Alliance. www.fctc.org. Accessed on September 13, 2013.
American Lung Association Remembers Lung Health Champion Senator Frank Lautenberg
Senator Frank Lautenberg (D-NJ) passed away in June. His many accomplishments in protecting public health included passage of the Smokefree Skies Act, protecting everyone from the dangers of secondhand smoke while flying. Senator Lautenberg was honored with the American Lung Association’s lung health champion award in 2013.
Did You Know
2014 is the 50th anniversary of the historic 1964 Surgeon General’s report on smoking and health, which linked smoking to lung cancer and other deadly diseases for the first time.
A recent article in the Journal of the American Medical Association found that about 8 million lives have been saved through tobacco control efforts since 1964, including 800,000 lung cancer deaths between 1975 and 2000.
Smoking is the number one preventable cause of death in the U.S., killing over 1,200 people per day.
Secondhand smoke kills almost 50,000 people each year.
28 states and Washington DC have passed laws prohibiting smoking in almost all public places and workplaces, including restaurants and bars.
New York has the highest cigarette tax in the country at $4.35 per pack.
Missouri has the lowest cigarette tax in the country at 17 cents per pack.
The average of all state plus the District of Columbia cigarette taxes is $1.53 per pack.
Alaska and North Dakota are the only two states that fund their tobacco control programs at or above the CDC-recommended level (in Fiscal Year 2014).
Massachusetts and Minnesota approved cigarette tax increases large enough to impact public health in 2013.
2 states – Indiana and Massachusetts – offer a comprehensive cessation benefit to tobacco users on Medicaid.
2 states – Alabama and Georgia – offer virtually no help with quitting to most tobacco users on Medicaid.
In 2009, the American Lung Association played a key role in the passage of the Family Smoking Prevention and Tobacco Control Act, which gives the U.S. Food and Drug Administration authority over tobacco products.
The American Lung Association played a key role in airplanes becoming smokefree in the 1990s.
40 states and Washington DC spend less than half of what the CDC recommends on their state tobacco prevention programs.
States spend less than two cents of every dollar they get in tobacco-related revenue to fight tobacco use.
Each day, almost 3,900 kids under 18 try their first cigarette and more than 1,000 kids become new, regular smokers.
Each day, 3,000 kids try their first cigar.
Smoking costs the U.S. economy $263 million in direct health care costs and $266 million in lost productivity each day.
The five largest cigarette companies spent over $22.9 million dollars a day marketing their products in 2011.
The American Lung Association has been fighting smoking and tobacco use since the 1950s.
Smoking rates for Medicaid recipients are over 50 percent higher than the general population.
Only 4 states – Maine, North Dakota, South Dakota and Wyoming – fund their quitlines at or above CDC-recommended levels.
A 2013 study of California’s tobacco prevention program shows that the state saved $55 in healthcare costs for every $1 invested from 1989 to 2008.
A 2012 study of Massachusetts’ comprehensive Medicaid quit smoking benefit found that Massachusetts saved $3 for every $1 spent helping smokers quit in just over a year.
Spread the Word
The American Lung Association’s annual "State of Tobacco Control" report was released nationwide on Wednesday, January 22, 2014.Learn More
Surgeon General’s Report
Despite the great progress of the past, in the last few years, tobacco control efforts have slowed and in some areas, even stalled.Learn More