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CDC urges 50-state anti-smoking effort

By Ann J. Curley, CNN
  • CDC: Smoking causes approximately 443,000 deaths each year.
  • In 2004, smoking cost more than $96 billion in direct medical costs
  • West Virginia's 26.5 percent is highest in U.S.; lowest is Utah, with 9.3 percent

(CNN) -- A coordinated national anti-smoking effort could reduce the more than 400,000 annual tobacco-related deaths in the United States, federal health officials said Thursday.

A new report from the U.S. Centers for Disease Control and Prevention offers a snapshot of each state's tobacco control progress, including wider adoption of measures to control, prevent and stop smoking. The key, the report says, is having all the states adopt uniform tobacco control plans.

"From the numbers it's the leading preventable cause of death," said Dr. Thomas Frieden, director of the CDC. "As a doctor I have cared for people with cancer, with chronic lung disease, people who have to gasp for every breath, and I know that behind those numbers are people and lives. ...

"If states make the right decisions, if policymakers and families make the right decisions, we can save lives."

The CDC estimates that 46 million American adults smoke cigarettes, and smoking causes approximately 443,000 deaths each year. The CDC estimates that in 2004 smoking cost more than $96 billion in direct medical costs, $193 billion in annual health-related economic losses and more than $97 billion in annual lost productivity.

Overall, the report finds that smoking rates for American adults vary. States with the highest smoking rates include West Virginia with 26.5 percent, Indiana with 26 percent, Kentucky with 25.2 percent, Missouri with 25 percent and Oklahoma with 24.7 percent.

The lowest smoking states include Utah with 9.3 percent, California with 14 percent, New Jersey with 14.8 percent and Maryland with 14.9 percent.

In previous reports issued in 1999 and 2007, the CDC outlined strategies that are known to stop and prevent smoking, including raising the price of tobacco products, enacting smoke-free laws, cutting tobacco advertising and promotion while enacting anti-smoking media campaigns, limiting access to tobacco products and encouraging and offering assistance to smokers to quit.

If states make the right decisions, if policymakers and families make the right decisions, we can save lives.
--Dr. Thomas Frieden, CDC director

In 2007, the Institute of Medicine, the medical branch of the National Academy of Sciences, released "Ending the Tobacco Problem: A Blueprint for the Nation," stating a goal of eliminating smoking as a public health problem in the United States. The strategies included strengthening and fully activating tobacco control methods similar to the CDC's plans, as well as tobacco regulation.

In 2008, the World Health Organization's MPOWER program outlined additional steps that complemented and reinforced the other agencies' recommendations.

As an example of the success of these strategies, the CDC cites the state of California, which has one of the oldest comprehensive tobacco control programs. California cut adult smoking rates from 22.7 percent in 1988 to 13.3 percent in 2006. That reduction in smoking accelerated the decline of heart disease deaths and lung cancer incidence in California, compared with the rest of the country.

In 2009, 14 states and the District of Columbia implemented an excise tax on cigarettes. Those state tax hikes followed a 62-cent federal cigarette tax hike instituted by Congress in April 2009.

Twenty-four states and D.C. have comprehensive smoke-free laws. Seven states do not have statewide smoke-free laws of any type: Indiana, Kentucky, Mississippi, South Carolina, Texas, West Virginia and Wyoming.

While some progress has been made in getting more states to implement tobacco control measures, the report stresses that much more is still needed.

The CDC's Best Practices for Comprehensive Tobacco Control Programs 2007 noted that states could plan and enact tobacco control programs with a small percentage of tobacco excise tax revenues and funds from a 1998 agreement between states' attorneys general and the four largest tobacco companies.

The report concludes that putting uniform tobacco control policies in place would dramatically reduce the health and economic burden on states.

"The first step is knowledge, knowing what the issues are," Frieden said. "We need to act."