Cheryl G. Healton, DrPH
CEO and President
American Legacy Foundation®
Washington, DC
Lately, it seems almost impossible to pick up a newspaper or turn on the news without hearing how dangerous extra weight is to good health. While obesity is a serious health threat, tobacco use remains the number one cause of preventable death in the US. It kills about 440,000 Americans each year - more than AIDS, alcohol abuse, drugs, fires, car accidents, murders, and suicides combined.
The good news is that each and every one of these deaths is preventable. Researchers have learned quite a lot over the years about how to prevent people from smoking and how to help addicted smokers quit. The 1998 Master Settlement Agreement reached between attorneys general from 46 states and the tobacco industry led to the creation of the American Legacy Foundation (ALF) and gave these states an expected $206 billion over 25 years to combat smoking--ample resources to put this knowledge into practice. But, the national record on reducing tobacco use is mixed.
There's been great success in reducing youth smoking nationally--today, youth smoking is at its lowest rate in 27 years. The foundation's truth® campaign, and other state efforts that undercut the tobacco industry's attempts to make smoking seem glamorous and cool, have played a big part in that success. The truth® campaign, launched in 2000, uses the Internet, grassroots outreach, and edgy, in-your-face television ads to educate teens about the deceptive marketing practices of the tobacco industry. In fact, of teens surveyed in the 2001 Legacy Media Tracking Survey (LMTS), 79% reported that they would like to see cigarette companies go out of business. According to a study in the June 2002
American Journal of Public Health, teens who see truth ads are less likely to smoke and their attitudes toward the tobacco industry have changed as well. The University of Michigan's "Monitoring the Future" survey and the Centers for Disease Control and Prevention (CDC) also credited the truth® campaign for helping reduce teen smoking rates nationally.
Raising cigarette excise taxes has also been an important strategy in preventing and reducing smoking among young people and adults. Teens are especially sensitive to price increases. Studies show that for every 10% increase in the price of cigarettes, cigarette consumption is cut by 3%--5%, and youth smoking is reduced by about 7%.
For those who are already addicted to nicotine, powerful new ways exist to help them quit. In 2000, the US Public Health Service issued new tobacco dependence treatment guidelines for physicians that concluded that treatments like nicotine replacement therapies, strong social support, telephone quitlines, and proactive counseling are all clinically effective
and cost-effective strategies.
For women, getting tobacco dependence treatment counseling is one of the most important things they can do to quit. Research shows that telephone, group, or individual counseling can double the chances that a quit attempt will be successful. This is especially true when counseling is combined with using the nicotine patch or other drugs, or seeking support from family and friends. To capitalize on these insights, the foundation's
Circle of Friends initiative links women to smoking cessation services and highlights the importance of having friends and loved ones support women who are trying to break their addiction to nicotine. But, despite the attention given to the epidemic of women and smoking, the foundation's own research demonstrates that the majority of women still strongly underestimate the role of lung cancer as the leading cause of death among women.
With everything now known about smoking prevention and cessation, public health professionals deserve the resources to put this knowledge into practice. The 1998 tobacco settlement provided more than enough money to the states to fund comprehensive tobacco control measures in each state - measures that met the CDC's minimum recommended levels. Unfortunately, most states have squandered this opportunity. According to a report by the Campaign for Tobacco-Free Kids, only four states - Maine, Maryland, Minnesota, and Mississippi - are funding tobacco prevention and cessation programs at the CDC minimum levels, while only 15 others have committed even half of the minimum funding levels recommended by the CDC. This is tragic. The evidence is overwhelming that tobacco prevention and cessation programs save lives. In addition, these programs save the states money. For every $1 spent to reduce and prevent smoking, about $3 is saved in smoking-related health care costs.
While the states are spending their tobacco prevention and cessation money for other budget needs, the tobacco industry continues to spare no expense in its efforts to attract new customers. A recent Federal Trade Commission report found that major cigarette companies increased their marketing and promotional spending to a record $11.22 billion - $30.7 million a day - in 2001. This represents a one-year increase of 17% from the $9.59 billion spent in 2000.
So while there's been great progress, there's still a long way to go. The tobacco industry is well-armed, well-funded, and 100% committed to its continued existence and profitability. Both health care professionals and consumers need to match its resolve with a strong national commitment of their own - to spend the already allocated monies to prevent the needless suffering and death caused by tobacco. The foundation invites other foundations, corporations, government, and individuals to join it in this fight because it cannot be done alone. And we certainly can't breathe easy just yet.
The American Legacy Foundation is dedicated to building a world where
young people reject tobacco and anyone can quit. Located in Washington, DC,
the foundation develops programs that address the health effects of tobacco
use through grants, technical assistance and training, youth activism,
strategic partnerships, counter-marketing and grass roots marketing campaigns,
public relations, and outreach to populations disproportionately affected by
the toll of tobacco. The foundation's national programs include Circle of
Friends, Great Start, a Priority Populations Initiative, streetheory.org and
truth®. The American Legacy Foundation was created as a result of the
November 1998 Master Settlement Agreement (MSA) reached between attorneys
general from 46 states and the tobacco industry. For more information on the foundation's life-saving programs, visit www.americanlegacy.org.
