The lost promise of an antismoking vaccine is an opinion editorial by Howard Koh that was published on July 11, 2007 in the Boston Globe.
It reflects on the Massachusetts Tobacco Control Program that was gutted in 2002.
IMAGINE first creating, and then essentially abandoning, an innovative life-saving vaccine. Sadly, that is what has happened in Massachusetts.
In 1992, voters approved a statewide program designed to counter the devastating health effects of tobacco. By supporting a 25-cent-per-pack increase in the state cigarette excise tax to fund this initiative, voters put their trust in a solemn investment to lift our collective health.
Over the next decade, the Massachusetts Tobacco Control Program proceeded to stifle tobacco addiction, educate youths, and help prevent cancer and heart disease for adults. The program helped cut statewide cigarette consumption nearly in half. After studying pioneers like Massachusetts and California, the Centers for Disease Control and Prevention recommended that states devote minimum funding levels to build such vital programs nationwide that act like a vaccine to pervent harm.
But in 2002, budget cuts of 95 percent eviscerated the program. The award-winning media campaigns promoting a healthy smoke-free norm were terminated, freeing up the tobacco industry to extend their false advertising messages of glamour. Without funding to support oversight from local officials, illegal tobacco sales to minors rose. Furthermore, defunding cessation services stranded and abandoned smokers, the majority of whom want to quit. Not surprisingly, cigarette consumption, previously dropping, has now risen for the first time in years. In short, the vaccine effect has worn off.
Now a groundbreaking report, "Ending the Tobacco Problem: A Blueprint for the Nation," by the Institute of Medicine underscores the urgency of fully maximizing tobacco control measures. In its recommendations, the report chose as its first instruction to fund statewide tobacco control programs at the level recommended by the CDC.
As the former Massachusetts commissioner of public health who oversaw the Massachusetts Tobacco Control Program and as a member of the Institute of Medicine who served as a peer reviewer for this report, I believe society cannot reach its full potential for health unless we immediately restore the program.
We certainly have the funds to do it. Annually, the state collects more than $600 million from both state cigarette excise taxes and revenues from the 1998 Master Settlement Agreement with tobacco companies. Just under 6 percent of that sum would permit Massachusetts to meet its CDC minimum funding level of $35 million. Instead, the budgets of the tobacco control program have languished as low as $2 million to $8 million in recent years. Meanwhile, annual direct smoking-related health costs for the state are estimated to be at $3.5 billion.
While the tobacco pandemic inflicts enormous human suffering, the tobacco industry remains alive and well. Since the tobacoo program's budget cuts of 2002, an estimated 45,000 Massachusetts residents have died from smoking-related diseases. Lung cancer, which should be rare, solidly ranks as the number one cancer killer among Massachusetts men and women. Meanwhile, over the past five years, the industry has reaped profits from over a billion packs of cigarettes sold in the state. And despite recent reports documenting that smoke nicotine yields from American cigarettes rose significantly from 1997 to 2005, these products remain free from regulation.
Among other things, reaffirming tobacco control programs allows us to capitalize on the opportunity presented by landmark Massachusetts Health Care Reform. The law includes an innovative Medicaid Wellness Benefit and other support systems for people who smoke. Smoking rates for the uninsured and Medicaid recipients approach 40 percent, double that of the general population. By improving access to care, we can uphold the promise of reducing health inequities and reaching the highest attainable standard of health for all.
It's senseless and tragic to tolerate human suffering and premature death when proven treatments are forfeited and ignored. We created the antismoking vaccine; now we need the long-term commitment to sustain it.
Dr. Howard Koh, former Massachusetts Commissioner of Public Health, is professor and associate dean for public health practice at the Harvard School of Public Health.
Source:
Ending the Tobacco Problem: A Blueprint for the Nation - Institute of Medicine
http://www.nap.edu/...
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