Tobacco Control: How Washington Measures Up In Smoking Prevention

Will 2020 be the year that federal, state and local lawmakers prioritize public health over the tobacco industry? This is the question posed in the American Lung Association’s most recent State of Tobacco Control Report released this week. And while the report says some states can answer that question with a resounding yes, others — including the federal government — seem to be a long way from it.

Overall, states still have a lot of work to do to put in place policies called for in the report — policies that researchers say would help significantly reduce the number of lives lost to tobacco usage each year. While states made notable progress by implementing laws requiring tobacco purchasers be 21 years of age or older, states must prioritize additional policies to restrict access to tobacco, the report says.

Policies highlighted in the report include increasing both tobacco taxes across all products and funding for tobacco control programs, as well as expanding comprehensive stop-smoking coverage under Medicaid. In addition, the report calls on 22 remaining states to pass comprehensive smoke-free laws and for all states to ban the sale of all flavored tobacco products.

With these policies in mind, the American Lung Association graded states on several factors: tobacco prevention and control program funding, smoke-free air, tobacco taxes, access to cessation services and minimum age — all of which align with the priorities the agency says states should adopt.

When it comes to preventing tobacco use, Washington received an overall grade of F. The grade was determined by averaging the states’ individual grades in the following categories:

• Tobacco prevention and control program funding: F
• Smoke-free air: A
• Tobacco taxes: C
• Access to cessation services: F
• Minimum age: B

The American Lung Association says:

House Bill 1074 raised the minimum legal sale age for tobacco products, including electronic cigarettes to 21 years of age. The bill also authorizes the governor to seek out government to government consultations with Indian tribes regarding raising the minimum legal age of sale in certain tribal compacts. One-time funding of $1 million was appropriated to the Department of Health to support local health jurisdictions to provide youth tobacco and vapor prevention programs, including the necessary outreach and education for the provisions of HB 1074.

In the last hours of the 2019 legislation session, House Bill 1873 passed. This legislation imposes a tax of 9 cents per milliliter of solution on products in an "accessible container", and a tax on all other vapor products of 27 cents per milliliter of solution. The bill directs revenues to be divided between the Foundational Public Health Services Account and the Andy Hill Cancer Research Endowment Fund. A reduction in tax is provided for products issued with a modified risk tobacco order.

The Lung Association was disappointed to see the volumetric tax structure used to tax these harmful products, as well as the low rate. The Lung Association will work towards a tax structure that creates tax parity with electronic cigarettes and other tobacco products.

Washington residents also racked up a staggering $2,811,911,987 in economic care costs related to smoking, according to the report. Here’s a breakdown other of smoking-related statistics in Washington:

• Adult smoking rate: 12%
• Adult tobacco use rate: 17.9%
• High school smoking rate: 5%
• Middle school smoking rate: 2.7%
• Smoking attributable deaths: 8,290

To determine each state’s report card, the American Lung Association evaluated state and federal tobacco control policies by comparing them with targets based on the most current, recognized criteria for effective tobacco control measures.

Nationally, tobacco control and prevention measures were graded in five areas: U.S. Food and Drug Administration regulation of tobacco products, federal coverage of tobacco cessation treatments, federal excise taxes on tobacco products, federal mass media campaigns, and federal minimum age of sale for tobacco products.

The federal government received the following grades in each area:

• Federal regulation of tobacco products: F
• Tobacco taxes: F
• Cessation coverage: D
• Mass media campaigns: A
• Federal minimum age: A

Overall, the federal government received a grade of F. While raising the federal minimum age of sale to 21 was a good first step, the report calls on the federal government to eliminate all flavored tobacco products from the market, ensure all tobacco users have access to a comprehensive tobacco cessation benefit without barriers, and increase federal funding for the Centers for Disease Control and Prevention’s Office on Smoking and Health to help states combat the youth e-cigarette epidemic.

The full 2020 State of Tobacco Control report is available online.