This year marks the 50th anniversary of the 1964 Surgeon General’s Report on the harmful effects of cigarette smoking. This landmark report was the first of its kind to present a clear causal relationship between smoking and lung cancer. This set the foundation for what would be one of the major public health successes in our country. It sparked a ban on cigarette advertising the next year, and over the next five decades, smoking was banned in many public buildings and on campuses. Citywide and statewide smoking bans are now common throughout the country. These regulations and laws have worked. U.S. smoking rates have dropped from 42% in 1965 to 19% in 2011. Smoking has shifted from the norm to something highly stigmatized.
Despite these successes, we have a long way to go. Smoking is still the leading cause of death and disability today. According to the CDC, “More than 45 million American adults still smoke, more than 8 million are living with a serious illness caused by smoking, and about 438,000 Americans die prematurely each year as a result of tobacco use.”
In honor of the 50th anniversary, here is a look at some of the success as well as areas for improvement in the tobacco world.
• Minnesota Tobacco Tax: MN has long been a leader in anti-tobacco campaigns. Most recently, on July 1, 2013, the state raised the tobacco tax by $1.60 per pack. This increase was sparked by the fact that the MN tax was lower than many other states. Legislators and public health advocates pushed for an increase, because tobacco taxes are proven to be one of the most effective ways of reducing smoking rates. Now Minnesota rates seventh of all states in tobacco tax with a total of $2.83 per pack. Clear Way Minnesota estimates that this tax will save $1.65 billion in long-term healthcare costs, prevent over 47,000 youth from starting to smoke and prevent more than 25,000 smoking-related deaths in the state.
• CVS’s big decision: CVS Caremark will stop selling all tobacco products at its 7,600 pharmacies in October 2014. This is huge news as CVS is the second largest drugstore chain in the country. This decision came as CVS’s role as a healthcare provider is growing. The chain now offers walk-in medical clinics and registered nurses in many stores. CVS’s chief executive officer, Larry J. Merlo, explained, “We came to the decision that cigarettes and providing health care just don’t go together in the same setting.” The company acknowledged that it expects to lose about $2 billion in sales, but company decision-makers still believe they made the right choice. This is a big step toward filling the holes in the anti-tobacco campaign and hopefully more stores will follow suit. Way to go CVS!
• FDA’s New Campaign: Teenagers are the biggest market for tobacco sales, because this is when most people start smoking. According to the FDA, 9 out of 10 adult smokers started before the age of 18. In January 2014, the FDA started an anti-tobacco website for teens called “The Real Cost” in an effort to hinder teen smoking. The FDA makes no effort to hide its intentions. According to its website, “Our goal is to reduce the number of teens who experiment with smoking and become lifelong tobacco users.” The website’s focus is using evidence-based research and attention-grabbing stats to emphasize the myriad negative effects of tobacco. There are quizzes to help teens identify if they’re addicted and resources to help them quit.
I like the site because it’s straightforward, non-judgmental and doesn’t belittle teens’ intelligence. Teenagers are capable of making their own decisions and this website gives them the information they need to make educated ones.
Room for Improvement
• E-Cigarettes: E-cigarettes are one of the hottest topics in the news recently. E-cigs are battery powered devices that use a heating element to vaporize a solution that creates smoke. People use them just as they would cigarettes, but they are tobacco free. Most e-cigs contain nicotine and they all contain a long list of various chemicals. Supporters of e-cigs claim they are a great alternative to tobacco and a good way to quit smoking.
Using an e-cigarette is called “vaping” and it seems to be acceptable to do it almost anywhere these days. The medical community and public health advocates are fighting for regulation of the devices, claiming that there are not yet proper studies that demonstrate their health effects and potential harms. Several states, including Minnesota, have attempted to pass laws to ban the cigarettes from public places. This is met with a lot of hesitation from some lawmakers and industry.
While safety is being tested in labs and fought in courts, e-cigs bring up the issue of public perception. The public health community has worked hard to create a world where smoking is not the norm. E-cigarettes present the potential to make smoking in public acceptable again, even if they are not “real” cigarettes.
• Major Disparities: Smoking rates have been significantly lowered, but there are still major disparities between populations in the U.S. The most recent stats show that Kentucky has the highest rate of any state at 28% and Utah is the lowest in the country at 10.6%. There are gender differences too: 20.5% of men smoke compared to 15.8% of women. Another huge disparity is income: 27.9% of people under the poverty level smoke while 17.0% of people at or over the poverty level smoke. Cigarette smoking causes serious and often fatal health effects for everyone; it doesn’t discriminate by gender or income. This means we need to do a better job of lowering rates everywhere and getting the message across to all populations.
The last 50 years have seen lowered smoking rates coupled with fewer deaths and smoking-related diseases. As you can see, there is still a long way to go, but luckily there are people fighting hard to fill the gaps. The outlook is looking good for the future of anti-tobacco. If you want to quit smoking, visit https://www.quitplan.com/ for resources and support.
Raina Goldstein Bunnag has a bachelor’s degree from Boston University and is currently a master’s candidate in nutrition and public health at the University of North Carolina. She keeps abreast of the latest health news and addresses relevant wellness topics each month. If you have any questions or topics you would like to see covered in the column, please send her an email at email@example.com.