According to the U.S. Surgeon General, secondhand smoke has immediate adverse effects on the cardiovascular system and causes lung cancer and coronary heart disease.18

State Overview

Each day, an estimated 1,200 Americans die from tobacco-caused diseases.¹⁶ Despite the overwhelming evidence that states can significantly reduce the number of kids who start to smoke and help current smokers quit by implementing proven tobacco control measures, very few states have taken the necessary action. The state section of this report looks at four areas: Smokefree air, tobacco prevention and control funding, cigarette taxes and youth access.

The methodologies and standards used to evaluate state tobacco control policies are fully explained in the Methodology section starting on page 46.

Smokefree Air
In June 2006, the U.S. Surgeon General released a report that ended the debate about the health hazards of secondhand smoke. The report declared that no amount of exposure to secondhand smoke is safe and that 100 percent smokefree legislation is the only way to fully protect citizens from the dangers of secondhand smoke.¹⁷ Comprehensive smokefree air laws de-normalize smoking, increase the number of people who quit and discourage kids from starting to smoke.

Everyone has the right to breathe clean, smokefree air in all public places and workplaces. The momentum toward a smokefree society will continue as more states and communities adopt comprehensive laws prohibiting secondhand smoke in public places.

2007 Highlights
2007 saw an additional seven states significantly strengthen their smokefree laws – Illinois, Maryland, Minnesota, New Hampshire, New Mexico, Oregon and Tennessee. All passed legislation to further protect workers and citizens from the dangers of secondhand smoke. Tennessee became the first traditional tobacco-growing state to strengthen its smokefree workplace law. While the legislation contains loopholes that prevent it from being considered comprehensive, this is a significant step forward for the Volunteer State. Illinois defeated legislation that would have carved out casinos from its comprehensive law and Colorado eliminated the exemption for casinos in its smokefree law.

There also has been encouraging progress on smokefree legislation in other traditional tobacco-growing states. Virginia made a valiant effort to pass a law prohibiting smoking in restaurants, but was stymied by the state House of Delegates. Eleven cities and counties in Kentucky have passed strong local smokefree laws. In North Carolina, legislation prohibiting smoking in state government buildings will take effect in January 2008.

Comprehensive legislation prohibiting smoking in workplaces and public places was also considered in Michigan, Pennsylvania and Wisconsin, but as of December 1, none of them have been passed into law.

In 2007, a record 32 states, the District of Columbia and Puerto Rico received passing grades for smokefree air. However, 18 states still received an F in smokefree air, which means millions of people are still exposed to secondhand smoke in restaurants, workplaces and other public places.

In 2006, the American Llung Association issued its Smokefree Air 2010 Challenge, calling on all states and communities to enact smokefree air laws that protect everyone. Since that time, 11 states, the District of Columbia and Puerto Rico have passed comprehensive laws that include restaurants and bars.

Alaska, Colorado, Delaware, Hawaii, Maine and Montana are the only states to fund tobacco control and prevention programs at or above the levels recommended by the Centers for Disease Control and Prevention in FY2008.

Tobacco Prevention and Control Funding
Despite the overwhelming evidence that well-funded, sustained and comprehensive tobacco prevention and cessation programs work, only six states fund their prevention and cessation programs at or above the levels recommended by the Centers for Disease Control and Prevention (CDC). Studies indicate that thousands of illnesses and deaths from tobacco use could be prevented and billions of dollars in medical expenses could be saved if all states made long-term investments in sustained campaigns to prevent tobacco-related disease and death.

2007 Highlights
Nine states—Alaska, Arkansas, Colorado, Delaware, Hawaii, Maine, Montana, New York and Wyoming—allocated at least 90 percent of the CDC’s minimum recommended funding level for tobacco control programs, earning them A’s in the Tobacco Prevention and Control Funding category. These states have recognized the wisdom in investing in tobacco control programs, which will ultimately lead to declines in healthcare costs and reduce the prevalence of smoking and tobacco-related disease. Regrettably, 32 states, the District of Columbia and Puerto Rico received an F for tobacco prevention and control funding.

In October 2007, the CDC released an updated version of its Best Practices for Comprehensive Tobacco Control Programs. This revision includes new recommended spending levels for comprehensive tobacco control and prevention programs for each state. These new recommendations will be used to evaluate states’ spending in the State of Tobacco Control 2008 report (to be released in January 2009), which will allow states to consider and implement the new recommendations before being graded in 2008.

Cigarette Taxes
States continue to find that increasing their cigarette excise taxes is a win-win for public health. Higher taxes make cigarettes more expensive, which deters kids from starting to smoke and motivates adults to quit. Studies have shown that a 10 percent increase in the price of cigarettes reduces consumption by about 7 percent for youth and about 4 percent for adults.¹⁹ In addition to funding tobacco control and prevention programs, the increased revenues can be used for other critical health programs.

Revenue from cigarette taxes should always be used to fund comprehensive tobacco prevention programs. States that take positive action now to curb smoking will see their health-related costs gradually decline as prevention and cessation programs reduce tobacco use and tobacco-related disease.

2007 Highlights

A survey of 504 current smokers and smokers that quit this year in Iowa found that over half of those that quit this year said the $1.00 increase in Iowa’s cigarette tax was a factor in their decision.

Connecticut, Delaware, Indiana, Iowa, Maryland, New Hampshire, Tennessee and Wisconsin raised their cigarette taxes in 2007, increasing the average state cigarette tax by about $0.11 to $1.112 per pack. New Jersey leads the nation with the highest cigarette tax per pack at $2.575 and South Carolina continues to have the lowest cigarette tax in the country at $0.07 per pack, although its House of Representatives voted to increase it in 2007.

Half the states, the District of Columbia, and Puerto Rrico have cigarette tax rates of a $1.00 or higher. Nine states—Alaska, Arizona, Connecticut, Maine, Maryland, Michigan, New Jersey, Rhode Island and Washington, will be at or above $2.00 per pack.²⁰

Unfortunately, many states have increased their cigarette tax but have failed to dedicate any of the revenue to tobacco prevention programs. This year, Connecticut, Maryland and New Hampshire increased their taxes but failed to devote even a portion of the increased funding to tobacco control and prevention programs.

This report finds that 12 states received an F in cigarette taxes in 2007, down from last year when 13 states received F grades.

Youth Access
Enactment and enforcement of policies to restrict the sale and distribution of tobacco products to minors are effective components of a comprehensive tobacco control program. The tobacco industry aggressively and consistently fights meaningful efforts to curb youth access to tobacco at the federal, state and local levels, while at the same time continuing its ruthless pursuit of the nation’s youth. Because close to one-fourth of our children are current smokers by the time they leave high school,²¹ enforcement of access laws plays a role in reducing the nation’s tobacco epidemic.

2007 Highlights

According to the Federal Trade Commission, the tobacco industry spends almost $36 million a day marketing its deadly products.22

In 2007, Maine became the first state in the country to pass legislation prohibiting the sale of certain types of flavored cigarettes and cigars although the law will not take effect until July 1, 2009. Eight other states considered similar legislation in 2007.

Wyoming approved a law prohibiting the sale of tobacco products by self-service display except in stores that do not allow persons under 18 to enter. Arkansas, Indiana and Nevada passed similar laws that apply to cigarettes only. Twenty-three states now restrict customer access to cigarettes and/or tobacco products.

Nevada also enacted legislation requiring a warning sign about selling tobacco products to minors be posted near where tobacco products are sold. Iowa enacted a law prohibiting the sale of cigarettes in packs of less than 20. North Dakota passed a law restricting the placement of tobacco product vending machines becoming the 48th state to do so.

Eighteen states received an F in youth access. Because reducing youth access to tobacco products is a component of a comprehensive tobacco policy, these states are missing out on important strategies to keep tobacco products out of the hands of children. States must do more than enact strong youth access laws; they must diligently enforce those laws. Strong enforcement is critical for keeping tobacco products away from kids.