Sunday, February 3, 2019

Tobacco control report indicates troubling trend

Daily News (West Bend, Wis.)
Published: Feb. 1, 2019


Tobacco control report indicates troubling trend

Wisconsin last passed tobacco-related legislation in 2009

By Nicholas Dettmann

ndettmann@conleynet.com 262-306-5043

WEST BEND — Disappointing. Staggering. Those were two words Dona Wininsky, the American Lung Association’s director for advocacy, grassroots and patient engagement in Wisconsin, used to describe Wisconsin’s work in tobacco prevention efforts.

On Wednesday, the 17th annual State of Tobacco Control report was released by the ALA. The report gave grades to each state and the District of Columbia in five areas — tobacco prevention and control program funding; smoke-free air; tobacco taxes; access to cessation services and; minimum age.

Wisconsin got an “A” in smoke-free fair, but got an “F” in three categories (prevention and funding, cessation services and minimum age) and a “D” in tobacco taxes. And with the tobacco tax grade, that is a drop from a “B” only a few years ago.

“It’s definitely not good that we only have one ‘A’ on the report card, and the cigarette tax grade has dropped from a ‘B’ a few years ago to a ‘D,’” Wininsky said. “That’s because other states in the country have raised theirs, making the national average go up.”

In other words, Wisconsin needs to wake up.

“Wisconsin hasn’t passed any significant tobacco control policy in 10 years while other states are, whether it’s increasing their cigarette tax, raising the legal age to purchase from 18 to 21, adding e-cigarettes to their smoke-free air law or something else,” Wininsky said. “We haven’t done any of that. We’re just stuck.”

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Breaking down the report

States that showed improvement were Alaska, Maine and Massachusetts, as well as District of Columbia. Mississippi, Missouri, Texas and Virginia got failing grades in all five categories.

In tobacco program funding, only three states got a “C” or better. District of Columbia and 43 states got an “F.” Smokefree air is the area that states, as well D.C., did the best, with 37 states and D.C., getting at least a “C,” including 23 states and D.C. getting an “A.” D.C. got the only “A” in tobacco taxes, while 34 states got an “F.” Five states, plus D.C., got an “A” in having the legal age to purchase tobacco be 21 or older. Forty states got an “F” in that category.

In 2009, Wisconsin passed the smokefree air law, which prohibited smoking inside places such as bars and bowling alleys. That is the last piece of legislation passed by Wisconsin related to tobacco prevention efforts.

At the time, Wininsky said “it was huge” for Wisconsin to pass that law and had reason to believe it was headed in the right direction. That was because vaping and e-cigarettes hadn’t been invented yet.

“Passing a statewide smoke-free air law is one of the cornerstones of what the CDC recommends in terms of an effective tobacco-control policy,” Wininsky said.

Now that the tobacco industry has evolved, Wisconsin, as well as many other states quickly fell behind.

“Wisconsin’s grades haven’t changed over the last several years,” Wininsky said.

“In the meantime, the industry and when I say industry I mean that more broadly, not just tobacco industry, but tobacco and vaping industry, have developed and introduced and marketed all kinds of new products, nicotine-based and tobacco-based products that are specifically geared toward hooking the next generation of smokers,” she said.

One statistic revealed in the report appears to support that.

In Wisconsin, e-cigarette use by Wisconsin high schoolers grew 78 percent from 2017 to 2018 (11.7 percent to 20.8 percent).

“That is staggering,” Wininsky said. “These are the kids that have heard the message that smoking is bad for you. They wouldn’t dream of touching a cigarette, but they’ve been convinced by marketing that this isn’t harmful; it’s just plain, old water vapor, which is an outright lie.”

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How to fix the grades

Raising the legal age to purchase tobacco products from 18 to 21 and to raise the tobacco tax are two areas that can help swing the grades in a positive direction, Wininsky said. Other states are trying to do so.

In the last five years, six states have upped the legal age from 18 to 21. Illinois and Minnesota have longdebated the issue. In Illinois, Wininsky said, the legislation moved through that state’s Legislature, but was vetoed by the governor. In Minnesota, it is working on doing it on a community-by-community basis.

About 10 years ago, Wisconsin had a “B” in tobacco taxes. But, because other states have upped their tax rates, the national average has changed and states that did that passed up Wisconsin, bringing the Dairy State closer to the national average, thus leading to a lower grade. Ten years ago, the Wisconsin tobacco tax was $2.52. It’s still that number today. The national average now is $1.78.

Data supplied by Wininsky indicated for each 10 percent price increase of cigarettes leads to a 7 percent reduction of use by youth and 3

to 5 percent reduction of use by adults. The data also emphasized the need to increase taxes on tobacco products such as cigars.

If those areas are addressed, Wininsky and the American Lung Association’s Wisconsin office believes the grades will improve.

“Having high tobacco taxes is another cornerstone because we know that people and in particular who use are very price sensitive,” Wininsky said. “You can see a correlating drop in smoking rates when the tobacco rates go up because cigarettes start to cost more.” The effects of smoking have been well-documented. There is also billions of dollars invested in the industry. Wininsky said tobacco companies spend upward of $10 billion in marketing their products. According to the report, in 2018, more than $2.6 billion is spent by consumers on health care costs because of smoking. But Wininsky also pointed to something else from research. “There are enough studies on nicotine and the developing brain that we know that the adolescent brain, the brain in general is not fully developed until the early 20s,” she said. “So we’ve got kids experimenting with these at 12, 13, 14, 15 (years old) and altering their brain chemistry and their priming their brains for future addictions.” Going forward, the American Lung Association’s Wisconsin office has set three goals aimed to improve the state’s grades:

Protect and increase funding for the Tobacco Prevention and Control Program

Equalize the tax on little cigars (brown cigarettes) with regular cigarettes

Pass legislation that places all tobacco products behind the counter or in a locked cabinet “The bottom line is we’ve got to start taking some action,” Wininsky said. “We’ve been pretty much dormant in terms of tobacco control for 10 years. We have to step up the game or we’re going to see a lot of the progress we’ve already made go by the wayside.”

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