Background

Tobacco use is the number one preventable cause of death in Washington State. It has become a childhood disease. Every day 55 kids in Washington State begin smoking.¹ Their average age is 12 years old. About 80% of all smokers begin use before the age of 18.² The earlier a smoker starts, the more intense the addiction.

For years, tobacco companies have altered the chemicals in cigarettes and chewing tobacco to make them more addicting. Once you start smoking it's very difficult to stop. Big Tobacco even adds honey, licorice and chocolate to make a cigarette taste better. The cigarette is the only legally available product in the U.S. that when "used as directed" will kill the user and injure others.³

Smoking is known to cause a number of diseases, including but not limited to: lung cancer, heart disease, emphysema, asthma, and chronic bronchitis. Lung cancer is today's largest cancer killer, claiming more lives on an annual basis than breast cancer, prostate cancer and colorectal cancer combined.

The tobacco industry aggressively markets their products. Reports from tobacco company documents show they target low-income people, women and children as potential customers. In 1999 total tobacco company marketing in Washington State was $174.2 million; in 2002 the industry spent more than $202 million.⁴

Tobacco companies have lobbied successfully to keep this information, along with the ingredients of tobacco products, from the public. Tobacco products are the only retail products not required by the U.S. Food and Drug Administration to list ingredients on its packaging. These ingredients include over 43 distinct cancer-causing chemicals as well as nicotine - the chemical that makes cigarettes and other forms of tobacco as addicting as heroin or cocaine.

How can Washington State win the battle against Big Tobacco? Washington State's tobacco prevention and control program must remain well-funded. Sustained and comprehensive tobacco prevention and cessation programs are proven to be one of the best ways to combat tobacco use. Current program components include edgy ads, school based programs, community grants and the toll free Quit Line. This comprehensive approach is working. We are saving money, lives and our kids!

Tobacco Use in Washington State

Youth:

Washington's tobacco prevention and control program works to keep kids from starting to smoke. According to an October 2002 survey of 137,000 students in 752 Washington schools statewide, 53,000 fewer youth are smoking than in 1999. These youth smoking declines were seen in all types of youth, minority groups and geographic regions of the state during the last two years. Overall, the number of girls who smoke dropped by almost two time that of boys. And, these reductions in smoking exceed the national rate of decline of 22 percent for grades 9-12 from 1997-2001.⁵

But, there is more work to be done. Today, we still have 85,000 youth smoking with an additional 16,400 children starting to smoke this year. In addition to continued cigarette use, our state has seen an increase in the use of other forms of tobacco like smokeless tobacco, cigars, bidi and pipes increased since 2000. In fact, cigar, bidi and pipe use has doubled.

Underage tobacco users get their cigarettes/tobacco products from a number of different sources, including friends and family members. A significant percentage of those smokers under 18, approximately 24%, purchased their cigarettes at a convenience store.⁶ It is illegal in Washington State to sell tobacco products to anyone under 18 years old. Sting operations, conducted by the State of Washington and the American Lung Association® of Washington, shows about 12% of the 7,000 retailers in the state do not comply with state laws. In some counties, that rate is significantly higher. For example, the non-compliance rate in Yakima County has been as high as 56%, but is currently 11% due to compliance check and education efforts.⁷

Adults:

Washington's comprehensive tobacco program is saving lives. According to two Department of Health telephone surveys, reaching more than 25,000 adults in Washington, there has been an 8 percent drop in the number of adults who are smoking in the past two years. In 1999, there were about 981,000 adult smokers in Washington and in June 2002, that number had dropped to 898,000. This means there are now 83,000 fewer tobacco users in our state. 28,000 people have been spared an early death and saved $134 million have been saved in future medical costs.⁸

Tobacco Taxes:

Increasing the price of cigarettes through an increase in tobacco taxes has proven to be an effective method of reducing smoking. A 2000 U.S. Surgeon General.s report concludes that raising tobacco taxes is the most effective way to prevent children and young adults from starting to smoke and is one of the most effective tobacco prevention and control strategies.⁹¹⁰

In 2002, Washington voters implemented a $.60 cent tax increase to cigarettes, raising the tax on a pack of cigarettes from $0.825 to $1.425. We can expect additional reductions in smoking rates over the next few years due to this new tax.

The Impact of Tobacco

Tobacco and secondhand smoke are known to cause a number of diseases as well as aggravating other existing lung diseases such as asthma or emphysema. The number of deaths attributable to tobacco use is greater than the number of deaths from AIDS, car accidents, alcohol, suicides, homicides, fire, and illegal drugs - combined.¹¹ Ironically, tobacco use remains the nation's number one cause of preventable death.

Tobacco use causes 90% of lung cancer deaths, 90% of deaths from chronic lung disease, 33% of all cancer deaths, 10% of newborn deaths and increases the risk of miscarriage by 80%.¹² A third of smokers will eventually die from smoking, and smoking is responsible for one in five deaths in the U.S.¹³ Every year, more than 8,300 Washingtonians die from tobacco related diseases.¹⁴

Tobacco costs our state over $1.52 billion in health care costs every year, or 12% of total Washington medical expenditures. Every long term smoker costs the state $12,000 more in health care costs than a non-smoker. Roughly 17.8% of smoking-caused healthcare expenditures in Washington are paid by the Medicaid program.¹⁵

Clean Indoor Air/Secondhand Smoke:

Everyone has the right to breathe clean air! But when a smoker lights up in the presence of others, all parties suffer from the effects of the secondhand smoke. Secondhand smoke contains over 4,000 chemicals; 200 of these are poisons; 43 cause cancer.¹⁶

Each year, secondhand smoke causes or exacerbates a wide range of adverse health effects, including lung cancer, respiratory infections, asthma and heart disease. Secondhand smoke causes 3,000 deaths from lung cancer in otherwise healthy nonsmokers; 62,000 deaths from heart disease; 26,000 new asthma cases; up to one million cases of aggravated asthma; and up to 300,000 cases of bronchitis and pneumonia in toddlers, 15,000 of which require hospitalizations.¹⁷

The Environmental Protection Agency (EPA) estimates that secondhand smoke causes approximately 53,800 deaths in nonsmokers each year.¹⁸

The U.S. Environmental Protection Agency classifies secondhand smoke as a "Group A" carcinogen, along with asbestos, benzene, arsenic, and radon. Secondhand smoke kills more people than all other Group A carcinogens combined.

Children with asthma are especially at risk from secondhand smoke. The EPA estimates that for between 200,000 and one million asthmatic children, exposure to secondhand smoke worsens their condition.¹⁹

Children of smokers are more likely to have bronchitis and pneumonia, especially during their first year of life, and are more likely to develop asthma and a variety of respiratory infections including pneumonia. An estimated 150,000 to 300,000 cases of lower respiratory tract infections in children less than 18 months of age, resulting in 7,500 to 15,000 annual hospitalizations, are caused by secondhand smoke.²⁰

Secondhand smoke can cause ear infections, bronchitis, coughing, wheezing and increased mucous production. According to the EPA, secondhand smoke can lead to the buildup of fluid in the middle ear, the most common cause of hospitalization of children for an operation.

Studies show that infants living in households with a parent who smokes have levels of nicotine in their urine that are comparable to levels found in light smokers.²¹ An estimated 244,000 kids in Washington State are exposed to secondhand smoke at home.²²

There is no known safe level of exposure to secondhand smoke. And, Washington voters know it. Seven out of ten Washington voters see smoking, either in public or secondhand smoke as a serious health risk. Over 65% of Washington voters favor smoke free legislation in our state.²³

What you can do!

Use your voice: Join the American Lung Association® of Washington's Lung Action Network (an "e-advocacy" system) to let your state and U.S. elected officials know that you support tough tobacco control measures including increased cigarette excise taxes, tough youth access laws, smoke free air, and well-funding tobacco education programs. Visit www.alaw.org/lungaction to join. It.s a free and simple way to make your voice heard!

Make a donation to the American Lung Association®: Visit www.lungusa.org to make your donation online.

For more information about tobacco or the American Lung Association® of Washington's program to fight big tobacco, bad air, and the asthma epidemic, please call 206-441-5100 or email us at alaw@alaw.org.

Sources:
¹Washington Department of Health "New Youth Smoking Data" March 2003
² Behavioral Risk Factor Survey System, Washington Department of Health, 2000
³ Jeffrey Wigand, PhD, former Tobacco Company Executive
⁴ Campaign for Tobacco Free Kids, 2003
⁵ Washington Department of Health "New Youth Smoking Data" March 2003
⁶ Behavioral Risk Factor Survey System, Washington Department of Health, 2000.
⁷ Washington Department of Health Liquor Control Board Reports, 2001(VERIFY)
⁸ Washington Department of Health "New Adult Smoking Data" January 2003
⁹ Campaign For Tobacco Free Kids "Raising Cigarette Taxes Reduces Smoking, Especially Among Kids" factsheet
¹⁰ Campaign For Tobacco Free Kids "Raising Cigarette Taxes Reduces Smoking, Especially Among Kids" factsheet
¹¹ A Tobacco Prevention and Control Plan, Washington State Department of Health, December 1999
¹² A Tobacco Prevention and Control Plan, Washington State Department of Health, December 1999
¹³ A Tobacco Prevention and Control Plan, Washington State Department of Health, December 1999
¹⁴ A Tobacco Prevention and Control Plan, Washington State Department of Health, December 1999
¹⁵ Campaign for Tobacco Free Kids, 2003
¹⁶ American Lung Association® Secondhand Smoke Fact Sheet 2002
¹⁷ American Lung Association® State of Tobacco Control Fact Sheet 2002
¹⁸ American Lung Association® State of Tobacco Control Fact Sheet 2002
¹⁹ American Lung Association® State of Tobacco Control Fact Sheet 2002
²⁰ American Lung Association® State of Tobacco Control Fact Sheet 2002
²¹ U.S. Centers for Disease Control and Prevention, "State-Specific Prevalance of Cigarette Smoking Among Adults, and Children's and Adolescents' Exposure to Environmental Tobacco Smoke-United States, 1996", Morbidity and Mortality Weekly report (MMWR) 46(44): 1038-1043 (November 7, 1997)
²² Washington Department of Health, 2003
²³ Grove Insight, February 2003, "Report Findings from a Survey of 400 Registered WA Voters", BREATHE Coalition.