Tuesday, April 18, 2017

Anti-smoking expert: Cigarettes kill 8,900 Kentuckians a year, so it's time to raise cigarette tax and pass statewide smoking ban

By Melissa Patrick
Kentucky Health News

"Smoking is the single most preventable cause of death that we know of," Ellen Hahn, director of the Kentucky Center for Smoke-free Policy, said Sunday on KET's "Kentucky Health."

Hahn told Dr. Wayne Tuckson, host of the "Smoking & Health" series, that 480,000 Americans die each year from smoking; that one in five deaths are caused by cigarette smoking; that one-third of cancer deaths are caused by it; and that smoking is the leading cause of heart disease, which kills more people than any other disease.

"We talk about heroin and opioid addiction; they are awful, but cigarette smoking is the drug of choice," Hahn said. "When you talk about Kentucky, we are talking about 8,900 a year who are dying from cigarette smoking." (In 2015, 1,297 Kentuckians died from an overdose.)

Hahn, a University of Kentucky nursing professor and the director of the Bridging Research Efforts and Advocacy Toward Healthy Environments (BREATHE) initiative, said there are many reasons Kentucky has the nation's highest smoking rate, 26 percent.

Those include the influence of peers and family members who smoke, as well as "insidious" advertisements that encourage smoking.

Hahn called the tobacco industry the "vector" of smoking, referring to the way they advertise their products such as placing them at the "point of purchase," placing them at the eye level of children, targeting specific populations and strategically placing them in movies.

"There is no product that we know is going to kill you that people can just sell pretty freely with very little regulation," she said.

Hahn explained that first-hand smoke is what the smoker is exposed to; second-hand smoke is what a bystander is exposed to, both from the product and the exhalation; and third-hand smoke is what is left behind on all of the surfaces.

And while she said most people worry about the 69 chemicals in smoke that are known to cause cancer, it is the tiny, toxic particles that we breathe in from the smoke that put us at risk of heart and lung disease, such as chronic obstructive pulmonary disease (COPD).

"But I think that now that we know so much about first- and second-hand and third-hand smoke, there is really no reason that anybody should be smoking inside a vehicle or inside their home for that matter, or inside a public place," Hahn said. "There is really no reason to do that because we know how much harm it causes."

Hahn said the "most effective, high impact policy" to decrease smoking rates would be to increase the state's cigarette tax, now one of the nation's lowest at 60 cents per pack. Hahn recommended that it should be raised by $1, which would still be below the national average of $1.69 per pack.

"The more expensive something is, the less people will buy, and particularly people who don't have a lot of money," she said.

Hahn also called for a statewide law that would ban smoking in public spaces and the workplace. The latest Kentucky Health Issues Poll found that 71 percent of Kentuckians support such a measure and 25 percent oppose it.  Right now only one-third of Kentucky is covered by comprehensive smoke-free policies.

"We are not saying people can't smoke," Hahn said. "those laws are only saying that you can't smoke and harm others with your smoke."

However, a statewide ban isn't likely any time soon, since Republican Gov. Matt Bevin has said this is an issue for local governments.

Hahn said smoking is a powerful addiction. She encouraged people who want to quit to call 1-800-QUIT-NOW, to visit smokefree.gov or to contact their health-care provider, because both medications and behavioral support are often needed to quit.

A new state law will make it easier for Kentuckians to gain access to smoking cessation medications by removing the barriers that insurance companies often place on them, like co-payments and prior authorizations.

As for electronic cigarettes as a means to quit smoking, Hahn said that studies have found that smokers who use e-cigarettes to help them quit smoking are less likely to do so, and that they often become "dual users."

She added: "Electronic smoking devices are considered by the FDA as a tobacco product. They are not considered as a quit-aid and we do not recommend them as a quit-aid."

Click here for the schedule of future airings of this program.

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