The tobacco industry’s toll

OK, maybe you didn’t have to sit down to read that. But for a state that has consistently tallied higher-than-average tobacco-use rates — and a state that has paid a higher-than-average price for the habit — that is a rather stunning development.

There’s more. Last year, again for the first time since such measurements have been taken, Oklahoma’s tobacco-use rate among adults fell below 25 percent. It was a very slight decline, but still a decline. The national rate hovers between 19-20 percent.

With the federal tobacco tax set to rise dramatically on Wednesday — by 62 cents a pack — many Oklahoma tobacco-users are following in the footsteps of other former smokers and making a concerted effort to quit. If their efforts prove successful, there soon could be more good news on this front.

And in a state that consistently ranks near the bottom in health measures and near the top in illness-related consequences, any good news is welcome.

But sadly, there’s as much bad news on the tobacco front. While declines have been noted among adults and teen males, increased usage has been seen among teen females and in the 18-24 age bracket in recent years. Use of smokeless tobacco has not declined.

And in some populations, usage remains horrifyingly high. Tribal authorities have estimated usage in some Indian communities in excess of 40 percent. Data show astonishing 90 percent usage rates among Oklahomans afflicted by substance abuse and mental illness.

Still, the improvements seen recently give cause for hope. Those in the know point to multiple efforts to explain the snail’s-pace progress in combatting tobacco use: changes in policies and laws, public education campaigns, and the rising cost of tobacco products, among others.

Among those who can take some credit for the good news is the Oklahoma Tobacco Settlement Endowment Trust, the outfit that decides how to spend earnings generated by the decade-old Master Settlement Agreement with tobacco manufacturers, the result of a lawsuit brought by many state attorneys general against the industry.

Oklahoma voters wisely approved a constitutional amendment in 2000 that established the trust and allocated the tobacco industry payments to the trust and the state Legislature. A board of investors oversees investing and a board of directors spends endowment earnings on health needs, so far focusing mainly on tobacco use.

To date, tobacco industry payments to the state have exceeded $653 million. More than $264 million has been funneled to the Legislature, according to the formula approved by voters, which has spent all the money on health and human services needs.

More than $300 million remains in the endowment trust, whose earnings are spent mainly on tobacco prevention programs.

This savings-and-spending scenario renders Oklahoma the only state in the country that continues to protect its settlement funds in such a way, and to channel the spending entirely toward health needs.

Some observers have suggested the trust should expand its focus and spend money on other health needs. It’s a legitimate proposition; after all, tobacco use is only one of many major ills plaguing the state.

But it is arguably and demonstrably the worst. Tobacco use causes the premature deaths of about 5,800 Oklahomans a year — about 16 people a day, according to the state Health Department. Oklahoma has among the highest percentages of smoking-related deaths in the country.

About 7,300 new users under the age of 18 adopt the habit each year; a third of them will die an early death as a result.

In addition, tobacco use results in estimated direct and indirect costs of more than $2 billion a year, according to state Health Department data.

“One in three Oklahomans will get cancer,” declares Tracey Strader, executive director of the endowment trust, and one of the habit’s most ardent foes. Heart disease, stroke and chronic lung disease — much of it tobacco-induced — also will fell thousands each year.

People like Strader argue for spending much more money on tobacco prevention — the current total spending is about $19 million a year — especially in view of the fact the tobacco industry spends many times that amount, about $250 million a year, on advertising and promotion in Oklahoma.

But even on a relatively small budget, advocates are seeing improvements and signs for hope. When the upcoming federal tobacco-tax hike was publicized, calls to the trust’s helpline went from about 400 a week to 1,200 a week. Strader estimates at least 30,000 Oklahomans will be helped this year through the helpline, which offers coaching sessions, free patches or gum and other services.

Though the progress is slow and sometimes seemingly imperceptible, giving up on tobacco use is not an option. Otherwise, increases in heart disease and cancer will continue to affect the state and its residents in monumental ways.

“If Oklahoma doesn’t address tobacco use, and usage in the rest of the nation declines, the tobacco-settlement payments will decline, and we’ll have both the burden of high tobacco costs and reduced funding as well,” she noted.

Source: Tulsaworld

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