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TOBACCO PREVENTION AND CONTROL RISK FACTORS AND POLICY SOLUTIONS PRESENTATION TO THE NEVADA CHRONIC DISEASE FORUM JANUARY 10 TH , 2012 Christopher Roller Senior Government Relations Director, American Heart/American Stroke Association Larry Matheis Executive Director, Nevada State Medical Society

TOBACCO PREVENTION AND ONTROL RISK FACTORS AND … · TOBACCO PREVENTION AND CONTROL RISK FACTORS AND POLICY SOLUTIONS PRESENTATION TO THE NEVADA CHRONIC DISEASE FORUM JANUARY 10TH,

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Page 1: TOBACCO PREVENTION AND ONTROL RISK FACTORS AND … · TOBACCO PREVENTION AND CONTROL RISK FACTORS AND POLICY SOLUTIONS PRESENTATION TO THE NEVADA CHRONIC DISEASE FORUM JANUARY 10TH,

TOBACCO PREVENTION AND CONTROL

RISK FACTORS AND POLICY SOLUTIONS

PRESENTATION TO THE NEVADA CHRONIC DISEASE FORUM JANUARY 10TH, 2012

Christopher Roller Senior Government Relations Director, American Heart/American Stroke Association

Larry Matheis Executive Director, Nevada State Medical Society

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OBJECTIVES

History of the problem in Nevada

Tobacco use and exposure as a risk factor

Impact of Tobacco in Nevada

Policy solutions to the problem

The future

Questions and discussion

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HISTORY

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HISTORY

For decades Nevada has been on the front

lines on the war against tobacco

Nevada has historically had higher than average

smoking rates

Nevada has ranked towards the bottom of states

in spending on tobacco programs, tobacco taxes

and higher in workplace exposure to SHS

Indoor/workplace smoking in casinos and bars

with gaming set the tone nationally

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HISTORY

The Nevada Legislature passed an increase to

cigarette taxes from $.35 to $.80 per pack in a

special session in 2003

In 2006 Nevada voters approved the Nevada

Clean Indoor Air Act

The Nevada Legislature has not passed changes

to oral tobacco products advocated for by the

tobacco industry in multiple sessions

In the 2011 session Legislators approved a bill

improving warnings for smoking while pregnant

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HISTORY

In the 2007, 2009 and 2011 sessions the Nevada

Legislature failed to pass multiple bills that

would have increased state tobacco taxes

The Nevada Legislature “swept” all state funding

of tobacco prevention in control programs in the

2010 special legislative session

The Nevada Legislature has weakened the voter

approved NCIAA in two successive sessions

The Nevada Legislature failed to pass a bill that

would have banned smoking on campuses of the

NSHE

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TOBACCO AS A RISK FACTOR

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TOBACCO AS A RISK FACTOR

Tobacco -

Contributes to 1 in 5 deaths in the United States

More than HIV, illegal drug use, alcohol use, vehicle

injuries and suicides combined

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TOBACCO AS A RISK FACTOR

The CDC reports that 46.6

million adults in the US smoke

Each year, about 443,000

people die from smoking or

exposure to secondhand smoke

in the US

8.6 million suffer from

serious illnesses caused

by smoking

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TOBACCO AS A RISK FACTOR

Smoking causes: Decreased oxygen to the heart and to other tissues in the body

Decreased exercise tolerance

Decreased HDL (good) cholesterol

Increased blood pressure and heart rate

Damage to cells that line coronary arteries and other blood vessels

Increased risk of developing coronary artery disease and heart attack

Increased risk of developing peripheral artery disease and stroke

Increased risk of developing lung cancer, throat cancer, chronic asthma, chronic bronchitis and emphysema

Increased risk of developing diabetes

Increased risk of developing a variety of other conditions including gum disease and ulcers

Increase tendency for blood clotting

Increased risk of recurrent coronary artery disease after bypass surgery

Increased risk of becoming sick (especially among children: respiratory infections are more common among children exposed to second-hand smoke)

Source: Cleveland Clinic

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TOBACCO AS A RISK FACTOR

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TOBACCO AS A RISK FACTOR

Smoking and CVD

People who smoke a pack or more a day have

more than twice the risk of a heart attack than

non smokers

Approximately 20% of heart disease cases are

caused by smoking

Smoking is a major cause of atherosclerosis (deterioration of normal artery walls and thickening and

blockage of arteries due to fatty deposits)

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TOBACCO AS A RISK FACTOR

The nicotine present in tobacco smoke

causes heart disease by:

Decreasing oxygen to the heart.

Increasing blood pressure and heart rate.

Increasing blood clotting.

Damaging to cells that line coronary arteries and

other blood vessels.

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TOBACCO AS A RISK FACTOR

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IMPACT OF TOBACCO IN NEVADA

Tobacco use and exposure remains the leading

cause of preventable illness and death globally,

nationally, and locally

Tobacco use and exposure contributes to the top

four causes of death in Nevada:

Heart Disease, including heart attacks

Cancer

Chronic Obstructive Pulmonary Disease

(COPD)

Stroke

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IMPACT OF TOBACCO IN NEVADA

Nevada ranks 3rd highest in the nation for

smoking-attributable mortality

Estimated annual deaths from smoking in Nevada:

Adults who are smokers: 3,100

Kids now under 18 who will die prematurely

from smoking: 47,000

Adult nonsmokers who will die from exposure

to secondhand smoke: 220 to 620

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IMPACT OF TOBACCO IN NEVADA

Tobacco use and exposure costs Nevada millions every year:

Annual health care costs in Nevada directly caused by smoking: $565 million

Portion covered annually by the state Medicaid program: $123 million

Smoking related productivity loses in Nevada: $832 million

Residents’ annual state & federal tax burden from smoking related government expenditures: $563 per household

Source: Campaign for Tobacco Free Kids

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IMPACT OF TOBACCO IN NEVADA

The Institutes of Medicine and National Institute for Occupational Safety and Health Reports on health impacts of secondhand smoke (SHS), 2009

The evidence is consistent about the relationship between SHS exposure and heart attacks, between smoke-free laws and decreases in acute coronary events

Health of casino and other service employees impacted by exposure to SHS

The 2006 passage of the Nevada Clean Indoor Air Act is an example of a policy action that has been taken in Nevada to reduce the impact of tobacco use and exposure

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POLICY SOLUTIONS

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POLICY SOLUTIONS

Although numerous policy solutions exist,

we will focus on three:

Smoke free/tobacco free laws

Tobacco prevention and control program funding

Tobacco tax increases

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POLICY SOLUTIONS

Smoke Free Laws

Surgeon General:

“No safe level of exposure to second hand

smoke”

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POLICY SOLUTIONS

Smoke Free Laws

Benefits include:

Reduction in exposure to SHS by workforce and the public

Reduced health care costs

Increased productivity and less sick days

Reduced insurance costs

Reduced cleaning and maintenance costs

Reduced death and disability

Prolonged work life

Reduced smoking rates

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POLICY SOLUTIONS

Smoke Free Laws

In Nevada:

NCIAA passed by 54% of voters in 2006

Twice weakened by the Nevada Legislature

Local communities fighting back

A matter of time?

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POLICY SOLUTIONS

Tobacco Program Funding

The Centers for Disease Control and Prevention

(CDC) recommends Nevada spend $32 million

annually on tobacco prevention and control.

Why?

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POLICY SOLUTIONS

Tobacco Program Funding

The Centers for Disease Control and Prevention

(CDC) recommends Nevada spend $32 million

annually on tobacco prevention and control.

Annual tobacco industry marketing

expenditures nationwide - $13.4 billion

Annual tobacco industry marketing

expenditures in Nevada: $115.6 million

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POLICY SOLUTIONS

Tobacco Program Funding

Current state tobacco prevention funding in

Nevada:

Funding Sources Tobacco revenue $ to Tobacco Prevention

MSA $42 million $0

Tobacco Tax $139.97 million $0

General Fund $0 $0

Total $181.97 million $0

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POLICY SOLUTIONS

Tobacco Program Funding

Dead Last

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POLICY SOLUTIONS

Tobacco Program Funding

Since funding began, smoking rates have

decreased significantly:

1999 2007

Youth smoking rate 33% 13.6%

Adult smoking rate 31.5% 21.5%

However, these trends may be changing…

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POLICY SOLUTIONS

Tobacco Program Funding

Research indicates that once tobacco prevention

funding is eliminated or reduced, smoking rates

quickly increase

Other states that have reduced or eliminated

tobacco prevention funding have seen increases

in smoking rates and an alarming increase in

illegal sales of tobacco to minors

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POLICY SOLUTIONS

Tobacco Program Funding

A continued reduction of Nevada’s investment in

tobacco prevention may result in:

Increased smoking rates

Increased complications of smoking

Increased medical costs

Increases in chronic disease, and

An increase in state Medicaid expenditures

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POLICY SOLUTIONS

Tobacco Taxes

*A $1.00 per pack increase in cigarette taxes will produce the following:

Additional revenue in the first year of $75.7 million

Decrease in youth smoking rate estimated at 17.4%

16,400 adults estimated to quit smoking

Long term savings from adult and youth smoking declines of an estimated $600 million

*Campaign for Tobacco Free Kids

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POLICY SOLUTIONS

Tobacco Taxes

Public support exists for an increase in

state tobacco tax rates

Polls conducted during the 2009 and 2011

legislative sessions showed approximately 70%

public support

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POLICY SOLUTIONS

Tobacco Taxes

Political will is needed

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THE FUTURE

Nevada needs a commitment to a

comprehensive strategy towards tobacco

control

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THE FUTURE

This is about investing

Every $1 invested in tobacco prevention and

control programs saves $4 in reduced health care

costs, increased productivity, etc.

$ not spent on tobacco products are used in other

areas of our economy (example: A two pack a day

smoker has approximately $4300 additional to

spend on other consumer products, services, etc)

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THE FUTURE

Combining tobacco tax increases with expanded

state tobacco prevention and control efforts and

increased protection against SHS would result in

larger tobacco use declines in the state and a

reduction in SHS exposure, thereby saving even

more lives and more dollars.

This has been proven to occur both in other

states and in the past in Nevada.

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QUESTIONS AND DISCUSSION