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Tobacco Control:
A Winnable Battle
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
Tobacco use damages virtually every part of the body
Smoking 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 year
Average 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 smokinghas stalled
Civilian, 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/ethnicity
Note: 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/region
Note: 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, 2000-2004Adults ages 35 Years and Older by County
Source: 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, Centers for 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 NYC
Source: 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
billion
Rates 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 20:1
Sources: Campaign for Tobacco Free Kids; Federal Trade Commission; CDC Office on Smoking and Health.
When tobacco control funding increases,
high school smoking decreases
Source: 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 decrease
Source: ImpacTeen Chartbook: Cigarette Smoking Prevalence and Policies in the 50 States.
Increased tobacco excise taxesincrease 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 lawsLaws in effect as of November 10, 2010
Source: 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 laws
Population 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 work
Media 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
For 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: [email protected] Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Closing Statement
U.S. Department of Health and Human ServicesCenters for Disease Control and Prevention