Ammonia, arsenic, butane, lead, tar. Many chemicals that most people would avoid having in their homes are present in cigarettes. And the list goes on.
According to the American Lung Association’s website, “There are approximately 600 ingredients in cigarettes. When burned, they create more than 4,000 chemicals. At least 50 of these chemicals are known to cause cancer, and many are poisonous.”
Yesterday was World No Tobacco Day. While many passed through the day unaware of its significance, approximately every six seconds a tobacco-related death serves as a reminder of the globally devastating toll of smoking.
Many countries have higher smoking rates than the United States and the Center for Disease Control and Prevention is optimistic that America is trending toward a future free of secondhand smoke exposure. Yet a lack of consensus among the states has resulted in varying levels of change.
Prevention, awareness education and policies that ban smoking in restaurants, bars and workplaces are all major deterrent methods, but one restraint makes the most significant impact in the fight against tobacco use.
“The increase of tobacco taxes is the single more effective measure to decrease the consumption of tobacco, especially among those with less resources, like the youth and the poor,” said Dr. Adriana Blanco, Advisor of Tobacco Control for the Pan American Health Organization which serves as the Regional Office for the Americas of the World Health Organization.
Many states, like New York, have taken this research seriously and seen decreases in consumption. The state charges a tax of $4.35 per pack of cigarettes and adds $0.61 in prepaid sales tax. Additionally, New York City adds another $1.50 in taxes per pack. High smoking rates and low taxation, though, is still a problem in other states.
By the end of 2009, the CDC found that while some states like New York, Rhode Island and Connecticut taxed more than $3 per pack of cigarettes, 12 states taxed less than $0.60 per pack. One of those states, West Virginia, has a low tobacco tax and recently received the worst adult smoking ranking in the country.
Organizations in West Virginia are taking strides to lessen the number of smokers through prevention and education, but is it enough with taxes so low?
Cynthia Keely-Wilson manages the West Virginia Asthma Education and Prevention Program, an organization that partners with the West Virginia Division of Tobacco Prevention in generating education, statistics and cessation programs. Secondhand smoke’s direct affect on asthma sufferers has she and her colleagues greatly concerned.
“In 2007, 387,000 or 26.9 percent of West Virginia adults were current cigarette smokers- the second highest rate in the fifty states,” Keely-Wilson said. “More people with asthma smoke than those who don’t.”
Keely-Wilson, registered respiratory therapist, said she has treated a large percentage of the smoking population in the capital city and that the prevalence of tobacco use is culturally-based.
“It’s embedded in the Appalachian culture,” she said.
While the state has made strides in establishing smoke-free counties, there is still not a statewide smoking ban in West Virginia. Movements to significantly increase the tobacco tax have not been successful.
“Studies have shown across the board that in states where you raise the tax on tobacco, the numbers of consumers drop,” Keely-Wilson said. “If you raise it out of the reach, cost-wise, of people, they make better choices and the use goes down.”
Socially, those groups that have higher smoking rates tend to be poorer and therefore more impacted by the effects of tobacco use.
“Many surveys in the [Americas] region show that tobacco consumption is disproportionally high in the lower socio-economic groups,” Blanco said. “These groups are usually the ones with less access to health resources, such as cessation services, and are the ones more impacted by the high expenditures caused by tobacco-related diseases.”
In turn, those who cannot afford treatment for the plethora of disease and health issues associated with smoking, continue to rely on government funds.
Last year the CDC published a study called “Tobacco Control State Highlights 2010.” According to the study, in 2004 alone, smoking cost the country more than $96 billion in direct medical expenses and more than $97 billion annually in lost productivity.
Though smoking cessation and prevention programs are affecting change, charging more per pack still remains the most direct way to reduce tobacco use.
“Tobacco related diseases and chronic diseases are a problem for development, since they perpetuate the circles of poverty, since the more affected are those who can less afford it,” Blanco said.
Higher excise taxes and portioning a percentage of tobacco taxes to support prevention and treatment programs is one of the ways the CDC recommends states move forward.
Pressure on policymakers to increase tobacco taxes and enact smoke-free state laws seem to be the most direct route to lessening smoke-related death and disease.
“Non-communicable diseases are the leading cause of death and disability around the world,” Blanco said. “Tobacco is a risk factor for the majority of them…Today it kills six million people around the world, 600,000 of them are non- smokers exposed to secondhand smoke. If action is not taken it will kill one billion people during the 21st century.”
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