Thursday, March 16, 2017

Bill passes to decrease smoking; one doesn't; lawmakers set to pass resolution for feds to ditch plan to limit tobacco carcinogen

By Melissa Patrick
Kentucky Health News

FRANKFORT, Ky. – Smoke-free advocates would say that this legislative session's record is 1-2.

That's because Kentucky lawmakers have passed one bill that will increase access to smoking-cessation treatments, but can't find enough support to pass one that would make Kentucky schools 100 percent tobacco-free -- and are poised to pass a resolution that asks federal officials to withdraw a proposal that would reduce the carcinogen levels in smokeless-tobacco products.

Sen. Julie Raque Adams' bill to decrease insurance barriers to smoking-cessation treatments is one of two tobacco-related bills that passed this legislative session and is on its way to the Governor for his signature.

The Patient Protection and Affordable Care Act requires all insurance policies to cover smoking-cessation treatments, but insurance barriers, like co-payments, prior authorization requirements and limits on length of treatment, make them not readily available.

Senate Bill 89 would require barrier-free access to all U.S. Preventive Services Task Force-recommended smoking cessation treatments in all Kentucky health plans, including Medicaid.

The other tobacco bill, sponsored by Sen. Ralph Alvarado, R-Winchester, which would have banned tobacco use on all school properties and at school events, is all but dead in the state House, despite its quick passage in the Senate.

Just over half of Kentucky's public-school students are in school districts with tobacco-free policies: 62 of the state's 173 districts, covering 654 schools.

Kentucky's high school students have a higher smoking rate than the national average, 17 percent compared to 15 percent; and 24 percent of them use electronic cigarettes, according to the 2015 Youth Risk Behavior Survey. The survey also found that 22.5 percent of the state's middle-school students have tried smoking.

Alvarado called Senate Bill 78 "low-hanging fruit" because it involves the health and safety of Kentucky's children and polling shows that 85 percent of Kentuckians support such an effort, but House Speaker Jeff Hoover said, "There was just not enough support in the caucus right now to do it."

Another piece of tobacco-related legislation introduced this session is a resolution that urges the the U.S. Food and Drug Administration to withdraw its proposal to reduce the levels of N-nitrosonornicotine, or NNN, a carcinogen, in all smokeless tobacco products sold in the U.S.

The FDA's proposal states,"NNN is a potent carcinogenic agent found in smokeless tobacco products and is a major contributor to the elevated cancer risks associated with smokeless tobacco. The FDA estimates that, in the 20 years following implementation of its proposed product standard, approximately 12,700 new cases of oral cancer and approximately 2,200 oral cancer deaths would be prevented in the U.S. because of this rule."

The resolution notes that the majority of farmers who raise the dark tobacco that makes up the main ingredient of smokeless tobacco products live in Kentucky and "raise approximately 24,000 acres of the crop with an estimated cash value of approximately $173 million per year."  It also says that the proposed standards in the FDA proposal are "technically unachievable" and that the impact of this rule would be "far-reaching and onerous because of the negative impact on agriculture and on manufacturing jobs in Kentucky."

House Concurrent Resolution 48, sponsored by Walker Thomas, R-Hopkinsville, passed the House 69-3 and is expected to pass the Senate in the final two days of the session, after the veto recess. The FDA is accepting public comment on this proposal until April 10, 2017. Click here for directions. 

1 comment:

  1. The proposed FDA regulation is also based on erroneous calculations of the number of mouth cancers from smokeless tobacco use in the U.S., because the FDA failed to use accurate risk estimates specific to the most commonly used products, i.e. moist snuff (dip) and loose leaf chewing tobacco (chew). Using accurate risks provided by a recent federal study, the number of deaths among men who use dip or chew is ZERO. The proposed regulation is therefore unjustified for dip and chew products.

    Brad Rodu
    Professor of Medicine
    University of Louisville