(GETTY IMAGES / ADAM GAULT)
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IN 2008, SMOKING in the United States actually increased to 20.6% of U. S. adults. This is the first rise in smoking since
1994.
MHE EXECUTIVE VIEW
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Ten years ago, the Department of Health & Human Services' Healthy People 2010 objective for smoking projected that through
increased awareness and policy change as well as the support of government, healthcare and employers, the nation would decrease
tobacco use among adults to below 12%.
For a time, we seemed to be making progress. According to Morbidity and Mortality Weekly Report (Nov. 13, 2009), the proportion
of U.S. adults who were cigarette smokers in 1998 declined from 24.1% to 19.8% in 2007.
Is such a setback in the face of overall progress a cause for alarm? Yes. Tobacco use remains the number-one cause of preventable
death and disease in the United States and is still responsible for more than 440,000 premature deaths annually. Due to burgeoning public efforts to reduce tobacco prevalence, including the rise in smoking bans, increases in tobacco taxes,
and the recent decision of Congress to allow the Food and Drug Administration to regulate tobacco, there is a general perception
that smoking is a fading public health danger, according to the Associated Press.
In some states, however, there have been serious cuts to tobacco control programs. Between 2002 and 2005, there was a 28%
decrease in funding for state tobacco programs. There have been even more dramatic cutbacks in 2009 in response to the economic
crisis, with some states such as Washington, Wisconsin and Colorado at the forefront, cutting their programs by 40% to 80%.
Less than 3% of tobacco tax revenues and monies from the 1998 Master Settlement Agreement with tobacco companies go to prevention
and quitting. In 2009, not a single state was funding tobacco control programs at the recommended CDC levels. In addition,
coverage for tobacco treatment by healthcare insurers remains spotty at best around the country. Thus, there is a critical
role for healthcare insurers, providers, and purchasers to play.
One might think that the recent 62-cent federal excise tax increase would have offered some relief; however, not a penny of
the revenue generated from this increase has helped to fund tobacco prevention, control or treatment efforts. Medical professionals
agree that people make quit attempts in response to large price increases—an observation backed up by the research of health
economists.
However, the tax is a financial disincentive in the face of an addiction. Government, employers and health plans are in a
position to offer treatment and financial support. This is particularly true as the government is becoming a direct benefactor
of ongoing tobacco use from the revenue stream of increased taxation.
