The American Lung Association's "State of Tobacco Control 2015" is a report card that evaluates state and federal tobacco control policies by comparing them against targets based on the most current, recognized criteria for effective tobacco control measures, and translating each state's relative progress into a letter grade of A through F. A grade of "A" is assigned for excellent tobacco control policies while an "F" indicates inadequate policies. The principal reference for all state tobacco control laws is the American Lung Association's State Legislated Actions on Tobacco Issues online database, available at LungUSA2.org/slati. The American Lung Association has published this comprehensive summary of state tobacco control laws since 1988. Data for the state cessation section is taken from the American Lung Association's State Cessation Coverage database, available at LungUSA2.org/cessation2.
In response to new data and information, the American Lung Association periodically reviews the methodology for the State of Tobacco Control report, and makes revisions to the methodology for state grading categories if necessary to update the report to use the most current evidence and best practices. Revisions were made to all four state grading categories in "State of Tobacco Control 2015." Because of the revisions to the state grading methodology, all state grades from "State of Tobacco Control 2015" cannot be directly compared to grades from "State of Tobacco Control 2014" or earlier reports.
Calculation of State Grades
State level tobacco control policies are graded in four key areas: tobacco prevention and control funding, smokefree air laws, state cigarette excise taxes and coverage of tobacco cessation treatments and services. The sources for the targets and the basis of the evaluation criteria are described below.
Did You Know?
2014 was 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 2014 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 1,300 people per day.
Secondhand smoke kills more than 40,000 people in the U.S. each year.
28 states and Washington, D.C. 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 states plus the District of Columbia's cigarette taxes are $1.54 per pack.
Nine states have taxes on other tobacco products equivalent to their state's cigarette taxes.
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 2015).
No states approved cigarette tax increases large enough to impact smoking rates in 2014.
No states approved a comprehensive smokefree workplace law in 2014.
2 states—Indiana and Massachusetts—offer a comprehensive cessation benefit to tobacco users on Medicaid.
The average amount states invest in quitlines is $3.65 per smoker in the state.
Nationwide, the Medicaid program spends more than $40 billion in healthcare costs for smoking-related diseases each year—more than 15 percent of total Medicaid spending.
A recent study found that CDC's Tips from Former Smokers media campaign is highly cost effective in helping smokers quit and reducing smoking-caused deaths.
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.
41 states and Washington, D.C. 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, more than 3,200 kids under 18 try their first cigarette and about 700 kids become new, regular smokers.
Each day, more than 2,300 kids try their first cigar.
Smoking costs the U.S. economy $356 million in direct healthcare costs and $411 million in lost productivity each day.
The five largest cigarette companies spent over $22.9 million dollars a day marketing their products in 2011.
Secondhand smoke causes $5.6 billion in lost productivity in the U.S. each year.
Smoking rates are almost twice as high for Medicaid recipients compared to those with private insurance.
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.
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