Every year since 2002, the American Lung Assn. has issued a report on the state of tobacco control in the U.S. and its member states. The report looks at what the federal government, states and cities are doing to prevent tobacco use, help people quit and protect the public from secondhand smoke.
The 2013 report just came out -- so how are we doing?
Not well, said Thomas Carr, director of national policy for the American Lung Assn. and chief author and editor of the report. “The state report cards were littered with Ds and Fs this year -- by and large the states are not doing enough to prevent and reduce tobacco use.”
Notable this year was a slip in performance by the federal government, Carr said. “In the past three years, they’ve been real leaders … probably the best administration in history. By 2012, all that progress really came to an abrupt halt.”
Carr said that 2009 was the watershed year -- that’s when the Food and Drug Administration got authority to regulate tobacco and federal tobacco taxes increased to 60 cents a pack. In 2010, the agency said it would move to assert its authority over all tobacco products instead of just cigarettes and smokeless tobacco, expanding its oversight to cigars, hookahs and electronic cigarettes. “But they have been dragging their feet,” Carr said.
And though the agency requires tobacco companies to inform them of changes to their products so that the agency can decide whether to approve them or not, “there is a backlog of applications the FDA really hasn’t taken action on,” Carr said. Among those new products are cigarettes containing crushable menthol capsules. An FDA scientific advisory committee recommended in 2010 that menthol cigarettes be removed from the marketplace, but the FDA has not yet released a promised report on this issue -- another area in which the government fell short, Carr said.
Not factored into the poor grade was the FDA’s plan to require graphic health warnings on cigarette packs, because this is now out of the agency’s hands. In 2011, the FDA unveiled the planned images, as we described in this article by staff writer Melissa Healy. But tobacco companies sued the government, and to date one federal appeals court has ruled that the requirement violates free-speech rights of the companies and another upheld the warnings. The Supreme Court is likely to take up the issue at some point.
“Our biggest recommendation is that the FDA use the authority it has to better regulate tobacco products,” Carr said.
How’s California doing? (That’s page 62 of the report.) We spoke with Kimberly Amazeen, vice president of programs and advocacy for the American Lung Assn. of California. She said this state was once way ahead on the tobacco prevention issue with the passage of Proposition 99 back in 1988, which increased the state’s cigarette tax by 25 cents and used the money to fund statewide anti-smoking programs including tobacco research, prevention campaigns and quit lines.
But today California’s tax on tobacco ranks 33rd in the nation, at 87 cents a pack, well below the national average of $1.48, Amazeen said. For that, the state gets a D. “States like Texas, Oklahoma and Montana have higher tobacco taxes than California, which might surprise people,” she said.
Our tobacco prevention efforts get “a big fat F,” she added. “We only fund a meager 15% of what the [Centers for Disease Control and Prevention] recommends for a robust and comprehensive prevention program….at the same time, the tobacco industry here in California is spending 10 times as much marketing their tobacco as the state is spending on prevention.”
California gets an A in its measures to protect its residents from smoke, through widespread smoking restrictions in such places as bars, restaurants and private work sites and its blanket ban in public schools and government work sites.