Officials redouble efforts to prevent tobacco use from reigniting
Written by Misti Crane – The Columbus Dispatch – http://www.dispatch.com/content/stories/local/2014/02/28/back-in-focus.html
Elizabeth Pritchard lit her first cigarette in high school out of boredom, a longing for acceptance, rebellion. The usual. She didn’t give any thought to her health.
Now, the German Village resident is 25, has high blood pressure and wants to quit. She works in nutrition services at OhioHealth Grant Medical Center and said she sees an older version of herself in patients — some in wheelchairs — who make their way outside for a smoke.
Fifty years have passed since the first U.S. surgeon general’s report linking smoking and illness, and there is increasing pressure in Ohio and nationwide to prevent smoking in young people and to better encourage and support smokers such as Pritchard who want to quit.
This week, Gov. John Kasich said he wants to spend $35 million in tobacco-settlement money in the next five years on tobacco control. Some public-health advocates say that’s not enough in a state with particularly bad smoking statistics and little to boast about other than a statewide ban.
“It’s a drop in the bucket, but it’s certainly a lot better than what we have at the moment,” said Dr. Tom Houston, an OhioHealth physician who has worked to lower smoking rates for 35 years.
Since 1964, more than 20 million Americans have died of smoking-related illness, according to a new report that marked the anniversary.
“It’s not like traffic accidents or murders that are on the front page. People die quietly in hospitals or at home and have disabling illnesses,” said Dr. Tim McAfee, director of the Office on Smoking and Health at the U.S. Centers for Disease Control and Prevention.
In the new report, acting Surgeon General Dr. Boris Lushniak urged leaders to sustain and accelerate tactics that work and said he hoped there will be no need for another smoking report in 50 years.
For now, many are focusing on 2020, when the national goal is a smoking rate of 12 percent for adults and 16 percent for adolescents.
They say it’s going to take a lot more money and comprehensive programs that help smokers quit, discourage smoking through policy changes and convince young people that they shouldn’t start.
The CDC recommends that Ohio spend $132 million a year.
“We need to up the ante,” McAfee said. “This is the biggest opportunity that we as a society have hands-down to increase the quality of life of the American people.”
In 1965, more than 4 in 10 adults smoked.
In 2012, 18 percent of American adults and 23 percent of Ohio adults smoked. Among teens, based on those who had smoked at least one cigarette in the past 30 days, the smoking rate was 18 percent nationwide and 21 percent in Ohio in 2011, the most recent year for which high-school data is available from the CDC.
Annual costs related to tobacco illness and death nationwide are more than $289 billion, and an estimated 5.6 million children alive today will die early because of smoking at the current trajectory, according to federal estimates.
The CDC has detailed recommendations on what states should do and stresses that programs with a narrow focus, such as just a quit-line, won’t get good results. States that do well have media campaigns about tobacco’s ills, support those who want to quit in various ways and make it harder to buy cigarettes and other tobacco, McAfee said.
Houston said he’d love to see a couple more dollars added to Ohio’s $1.25 cigarette tax, which is in the middle of the pack nationally, but far below states such as New York, which attaches $4.35 to each pack sold.
He said he also wants the state to pay for counseling for Medicare and Medicaid recipients, who now can get medications to help them quit.
Micah Berman, an assistant professor of public health and law at Ohio State University, said that while Kasich’s proposed $35 million is good, the state needs to get more serious about finding money for the cause.
“This is a one-time pot of money. … If you want to continually drive tobacco rates down, there needs to be sustained investment,” he said.
Boosting the age for buying cigarettes and other tobacco is another option. New York City has made the minimum age 21. Some states, including Utah and Colorado, are considering it as well.
Nine in 10 smokers start before they’re 18. The average age of experimentation is 11 or 12, Houston said.
Efforts to help teens need to focus on social influences, not on death and disease, said Dr. Bethany Brisbin, an internal medicine-pediatrics resident at Nationwide Children’s Hospital. “They don’t see a lot of the delayed consequences down the road,” she said.
The Food and Drug Administration has taken note with a new campaign designed to make children 12 to 17 years old think of tobacco as a powerful bully and to remind them of its short-term damage, such as bad skin.
Young people “don’t believe they will ever get addicted. They believe they can quit at any time,” said Kathy Crosby, director of health communication and education in the FDA’s Center for Tobacco Products.
Pritchard knows that well, she said. When she was 17, she though she was invincible. She was having fun and running with the pack.
Now, she’s an addict who is hopeful she’ll be able to quit and wishes she never let cigarettes draw her in to start.
“I want to be healthy,” she said.
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