Ky. leads U.S. in emphysema (COPD), but study shows fewer COPD hospitalizations in Ky. places with smoke-free laws

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People who live in smoke-free communities are less likely to be hospitalized for emphysema, according to a study by the University of Kentucky's College of Nursing and College of Public Health and recently published in the American Journal of Public Health.

The study found that people who live in communities with comprehensive smoke-free workplace laws are 22 percent less likely to be hospitalized for chronic obstructive pulmonary disease (COPD), or emphysema. Living in a community with an established law also resulted in a 21 percent lower likelihood of experiencing hospitalization due to emphysema.

Kentucky has the nation's highest rate of chronic obstructive pulmonary disease, 9.3 percent of the population, according to the federal Centers for Disease Control and Prevention. Tobacco use is the primary cause of emphysema, but air pollution and genetics can also play a role.

The study matched 2003 and 2001 data on hospital discharges with communities that were part of the Smoke-free Ordinance database from the Kentucky Center for Smoke-free Policy, Ann Blackford reports for UKnow.

Dr. Ellen Hahn (Herald-Leader photo by Matt Goins)

“Smoke-free public policies, particularly when they cover all workplaces with no exceptions and have been in place for at least one year, may provide protection against exacerbation of COPD that lead to hospitalizations, with potential to save lives and decrease health care costs,” said Nursing Professor Ellen J. Hahn, director of the center and lead author of the study. “Given that such a high percentage of Kentuckians live in at-risk rural areas and lack the protective factor of income or smoke-free laws, the state faces a higher risk of COPD."

Lexington was the first Kentucky city to pass a smoking ban. "Lexington's smoking ordinance, which bans smoking in most indoor public spaces, doesn't specify that smokers be caught in the act. But that has become the default standard since the ban went into effect 10 years ago," Mary Meehan reports for the Lexington Herald-Leader. "As the smoking ban in Lexington has aged, the challenges have lessened. In many cases, Hahn said, the ban has been self-enforcing. Patrons at restaurants complain to management about smokers, or bar employees take it upon themselves to keep people from lighting up. Gradually, she said, smoking just isn't accepted or expected anymore. Non-smoking in most places has become the 'new normal.' There are now only a handful of businesses that receive citations. Most are small bars and strip clubs."

Read more here: http://www.kentucky.com/2014/04/26/3214347/10-years-after-it-became-law-fayette.html#storylink=cpy

Read more here: http://www.kentucky.com/2014/04/26/3214347/10-years-after-it-became-law-fayette.html#storylink=cpy

CDC: Kentucky grossly underuses tobacco settlement money when it comes to tobacco prevention and cessation programs

Kentucky is not even remotely up to snuff on state tobacco-prevention programming. According to a new report from the Robert Wood Johnson Foundation and the Centers for Disease Control, the state spends only $2.2 million on such programs. That amount is only 4.5 percent of what the CDC recommends that state, which has the highest incidence of tobacco use in the nation, spend. If the state spent what the nation's most prestigious health institution recommended, state spending to improve Kentucky's collective lungs should be in the $57 million range.

Kentucky ranks 36th in state tobacco control spending nationwide. According to the RWJ Foundation report, states will collect a record $25.7 billion in revenue from the tobacco settlement and from tobacco taxes this year, but will spend just 1.8 percent of that money on programs to prevent kids from smoking and help smokers quit. That's less than two cents of every tobacco dollar sent back to the states. Only Alaska and North Dakota are funding the levels that the CDC has recommended.

Read the report here. To view an interactive national map, with each state's spending outlined at here.

American Lung Association calls state's tobacco-cessation benefit inadequate now that Medicaid is under managed care

Kentucky added a robust tobacco cessation benefit to its Medicaid program, only to lose much of it in 2011 by putting the program under managed care by insurance companies, the American Lung Association notes in its annual report. Not only do their plans offer fewer treatments, explained the report, but information was confusing to patients and healthcare providers alike. The report also notes that the state -- which is not alone in this -- offers its smokers who desire to quit inadequate access to medications and counseling.

Robert Preidt of HealthDay reports that the U.S. Department of Health and Human Services late last month published a proposed rule that requires tobacco cessation as an essential health benefit under the Patient Protection and Affordable Care Act. The lung association report how states could put that rule to maximum use. "Giving all smokers access to a comprehensive cessation benefits is not only the right thing to do, it's the smart thing to do," Billings said. "The bottom line is that quitting smoking saves lives and saves money." One recent study, reports Preidt, showed that providing smokers with help to quit has a three-to-one return on investment, meaning $3 is saved for every for $1 spent. (Read more)

To see more about how Kentucky's tobacco cessation coverage rates, according to the American Lung Association, go here.