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August 24, 1999 The Centers for Disease Control and Prevention (CDC) today released two state-specific
reports on tobacco use, one highlighting the severity of the public health problem and the
other presenting a science-based blueprint for solving it. The two reports, State Tobacco
Control Highlights, 1999 and Best Practices for Comprehensive Tobacco Control
Programs was officially released today at the fifth annual National Conference on Tobacco
and Health in Kissimmee, Florida.
According to CDC data, tobacco use is responsible for more than 430,000 deaths each year,
or one in every five deaths, and is the leading preventable cause of death and disease in our
Nation. Studies have shown that an estimated $50 billion to $73 billion is spent nationally
each year on treating smoking-related illnesses such as lung cancer, chronic lung disease,
coronary heart disease, and stroke. Currently, states spend a tiny fraction of this amount on
effective tobacco control programs to reduce and prevent tobacco use. CDC estimates that
states need to spend between $8 billion and $21 billion over the next five years to implement
effective tobacco control programs.
The first report, State Tobacco Control Highlights, 1999, summarizes information
on tobacco use in all 50 states and the District of Columbia. It is an update of a publication
first released in 1996 and presents current state-based information on the prevalence of
tobacco use, tobacco control laws, the health impact and costs associated with tobacco use,
and tobacco agriculture and manufacturing. The report shows, for example, that:
"This report is extremely useful because it allows public health workers and policy
makers at the state level to compare their data with that of other states using comparable
measures," said CDC Director Dr. Jeffrey Koplan. "These data provide the most
current evidence that tobacco use places a tremendous health and economic burden on every
state in the nation."
The second report, Best Practices for Comprehensive Tobacco Control Programs,
provides states with recommended strategies and funding levels for effective programs to
prevent and reduce tobacco use, eliminate the public's exposure to secondhand smoke, and
eliminate disparities related to tobacco use and its effects among different population
groups. CDC provided a draft version of the report to the states in 1998 to help guide their
decisions about the use of funds from last year's master settlement agreement with the tobacco
industry.
The Best Practices guidelines address nine components of comprehensive tobacco control
programs: community programs, chronic disease programs (e.g., heart disease prevention, cancer
registries) to reduce the burden of tobacco-related diseases, school programs, enforcement,
statewide programs, counter-marketing, cessation programs, surveillance and evaluation, and
administration and management. For each component, CDC presents a range of funding levels for
each state to consider based on needs and priorities in that particular state.
CDC estimates that the annual costs to implement all of the recommended program components
range from $7 to $20 per capita in small states to $5 to $16 per capita in large states. For
the average state, total recommended program costs would range between $31 million (lower
estimate) and $83 million (upper estimate) each year.
"Considering that the states will receive a combined amount of nearly $41 billion over
the next five years from their settlements with the tobacco industry, the mid-range of our
funding estimates ($14.5 billion) would account for about a third of the resources that will
be available to states," said Dr. Koplan. "The sad fact remains, however, that most
states have not earmarked significant settlement funds for tobacco control, and no state is
currently implementing all of the recommended program components fully."
Dr. Michael Eriksen, director of CDC's Office on Smoking and Health (OSH), said that State
Highlights and Best Practices present the two sides of the tobacco control
story. "The bad news is that tobacco use continues to be the leading preventable cause of
death in our country. The good news is that we clearly know what effective prevention programs
should look like. So now our challenge is to translate this knowledge into action for the
health of the citizens of every state," Dr. Eriksen said.
Beginning September 30, 1999, the CDC will fund the tobacco control programs in all 50
States, the District of Columbia, and the Territories. "This effort, which we are
referring to as the National Tobacco Control Program, is intended to provide funding
and technical support to States and will serve as a building block for coordinated national
tobacco control efforts to reduce tobacco-related diseases and deaths today and into the next
millennium," Dr. Koplan said.
Copies of State Highlights and Best Practices are available free of
charge from the Office on Smoking and Health, 770-488-5705 (press 2 for publications). Links
to online versions of both documents are located at OSH's Web site, http://www.cdc.gov/tobacco.
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