Reducing funding for tobacco control a bad idea

Since the establishment of the Division for Tobacco Use Prevention and Control in 2000, Iowa has seen a remarkable reduction in tobacco use with a consequential improvement in public health.

Kids in middle school are smoking less than the national average and there has been a marked reduction in high school smoking from levels well above the national average in 2000 to less than 20 percent by 2008, according to Iowa Youth Survey, (iowayouthsurvey.org). Adult smoking has dropped to 14 percent, one of the lowest rates in the nation after Utah and California.

The number of Iowans admitted to hospital with serious tobacco related conditions such as coronary heart disease and myocardial infarcts has dropped more than 8 percent, representing a major savings in health costs (Iowa Department of Public Health).

Reducing tobacco use is complex and involves the implementation of a number of evidence-based approaches developed by the Centers for Disease Control to address youth use - for example, the state's Just Eliminate Lies program), increasing the cost of tobacco (the 2007 tax increase), reducing exposure to secondhand smoke (the 2008 Smokefree Air Act) and assisting those who need to quit through a quitline. Iowa Quitline has one of the highest success rates in the nation, with 29 percent of users still not smoking 12 months after quitting (University of Northern Iowa, 2010).

These statistics represent real progress in terms of lives and health care dollars saved - tobacco-related disease will kill 4,400 Iowans this year and costs Iowans over $1 billion a year, of which $301 million of this has to be covered by Medicaid (Campaign for Tobacco-free Kids).

But the barbarians are at the gates. Without a shred of objective evidence to support their assertions, there is a legislative attempt to disembowel one of the most successful programs in the nation.

Tobacco control programs that work are always edgy and controversial - which is why the tobacco industry and their surrogates hate them.

Tobacco use remains the most preventable cause of death. The tobacco industry spends more than $170 million a year in Iowa marketing its products. If we reduce funding to tobacco control, there will inevitably be more kids smoking in the absence of a meaningful youth tobacco control program, more adults unable to quit without a first class quitline and, ultimately, more Iowans dying an unpleasant death. This must be a moral and human issue, not a political issue.

Those who are intent on demolishing tobacco control owe it to Iowans to explain how they intend to protect our vulnerable youth, assist those who are addicted and, above all, be honest about the disease and fiscal burden that will fall on future generations.

Dr. Christopher Squier, Professor of Oral Pathology, College of Dentistry, University of Iowa, is a member of the state Commission on Tobacco Use, Prevention and Control. Comments: christopher

squier0@mchsi.com