HOW MUCH?? Are You Serious?

Four Key Points We’ve come a long way Recommendations in Context Key Messages Next Steps

BP-2007 Reaffirms What We Know Scientific evidence Real-world experience Conclusions from National experts

If every state funded TP at CDC minimum, states would prevent nearly two million kids alive today from becoming smokers, save more than 600,000 of them from premature, smoking-caused deaths, and save $23.4 B in smoking-related HC costs.

States with best funded and most sustained tobacco prevention programs during the 1990s – AZ, CA, MA and OR, reduced cigarette sales more than twice as much as the country as a whole

State-sponsored anti-tobacco media campaigns are working to change youth attitudes about tobacco and to reduce youth smoking.

Reductions in tobacco smoking are major factor in the decrease in cancer mortality rates Sustained progress in tobacco control is essential if we are to continue to make progress against cancer.

Although Washington made progress in implementing tobacco control policies between 1990 and 2000, smoking prevalence did not decline significantly until after substantial investment was made in the state’s comprehensive tobacco control program.

Comprehensive Programs Help Adult Smokers Quit Maine: Cut adult smoking by 12.5% b/t 2001 and 2004 WA: Cut adult smoking by 20% between 1999 and 2005 Massachusetts: Cut adult smoking by 21% between 1993 and 2000 California: Cut adult smoking by 32.5% between 1988 and 2004 New York: cut adult smoking by 15% between 2000 and 2006 Arizona: Cut adult smoking by 21% between ‘96 and ‘99

Comprehensive Programs Reduce Youth Smoking WA: Cut youth smoking by 50% b/w 2000 and 2006 Maine: Cut high school smoking by 59% b/w 1997 and 2005 Ohio: Cut high school smoking by 45% b/w 1999 and 2003 Oregon: Cut smoking by 63% among eighth graders between ‘96 and 2004 Florida: Cut middle school smoking by 47% & high school 30% b/w 1998 and 2001 Mississippi: Cut smoking among public middle school students by 48% in 5 years

Comprehensive Programs Work Saves Lives California: Studies show program prevented tens of thousands of deaths from heart disease and lung cancer due to smoking

Ending the Tobacco Problem: A Blueprint for the Nation Institute of Medicine, May 2007 “To be effective, however, TC programs must be consistent, and budget cuts in TC programs are threatening that consistency …the committee recommends that all states maintain funding for their TC activities at the level suggested by the CDC – about $15-$20 per capita, depending on the state’s population, demography and smoking rate. ”

President’s Cancer Panel Report August 2007 The leadership of this nation must summon the political will to fund comprehensive tobacco prevention and cessation programs at levels recommended by the CDC

Putting the Recommendations in Context

Domestic Cigarette Advertising and Promotional Expenditures 1998 - 2005 (Billions of dollars) $15.15 $14.15 $13.11 $12.47 $11.22 $9.59 $8.24 $6.73 Source: Federal Trade Commission Cigarette Report for 2004 and 2005

Tobacco Use Costs the Nation $ 96.7 Billion $30 Billion in Medicaid Costs $3.7 Billion

Tobacco Money for Tobacco Prevention $ 24.9 Billion $8.1 Billion Tobacco Settlement Revenues $16.8 Billion Tobacco Tax Revenues $3.7 Billion

New Opportunities Bonus payments of $900+ million annually beginning in FY 2008

Cigarette Tax Rates (cents per pack) WASHINGTON 202.5 MONTANA 170 MAINE 200 NORTH DAKOTA 44 VT:179 MINNESOTA 149.3 OREGON 118 VT IDAHO 57 NH NH: 108 WISCONSIN 177 SOUTH DAKOTA 153 NEW YORK 150 MA MA:151 WYOMING 60 MICHIGAN 200 CT RI:246 IOWA 136 CT:200 PENNSYLVANIA 135 NEBRASKA 64 NJ:258 NEVADA 80 OHIO 125 DELAWARE:115 UTAH 69.5 IN 99.5 ILLINOIS 98 WV 55 30 VIRGINIA MARYLAND:200 COLORADO 84 KANSAS 79 MISSOURI 17 87 DC:100 KENTUCKY 30 CALIFORNIA NORTH CAROLINA 35 TENNESSEE 62 OKLAHOMA 103 ARIZONA 200 ARKANSAS 59 NEW MEXICO 91 SOUTH CAROLINA 7 MS 18 ALABAMA 42.5 GEORGIA 37 ALASKA 200 TEXAS 141 36 LOUISIANA HAWAII 180 FLORIDA 33.9 States that have not passed tax increases since 1999 States that have recently passed or implemented a cigarette tax increase (since 1999) November 2007 WI increase to 177¢ per pack and MD increase to 200¢ per pack effective 1/1/2008.

Just 20 cents from each pack sold…

Tobacco’s Devastating Toll Tobacco is the leading preventable cause of death, killing more than 400,000 each year 4,000 kids try their first cigarette every day; another 1,000 kids become regular smokers every day and 1/3 will die prematurely as a result Nearly 90% of lung cancer cases, 1/3 of total cancer deaths, and 1 in 5 deaths from heart disease are tobacco-related Costs the nation almost $100 Billion in health care costs annually

Get Over the Sticker Shock But why so high? Think about where we’ve come in 10 years Think about the elements Media campaign - legislators understand the necessity of being on air Cost of doing business Cessation efforts – very tangible piece of program Think about the TOLL

Pull Team Together Program staff, advocates and vendors accomplish more by working together! Talk about where you are and where you’d like to go Develop a multi-year plan to increase your funding Sustainability is IMPORTANT – ongoing commitment to program makes a difference

Work on Sustainability What would your program look like at higher funding levels – be prepared if asked Make it REAL! Document unmet need – how many smokers not reached through quitline, # kids who don’t receive anti-tobacco messages, where infrastructure is lacking so services are not available Use stories to sell program – kids protected, smokers who’ve quit, jobs/services brought to community, people positively impacted by program

Bread and Butter Activities Media advocacy/Community Education Communication with elected representatives Continuous communication and coordination with partners

Key Messages Develop clear, concise and compelling messages New BP affirms that we know what to do to eliminate tobacco use as a serious public health problem – need political will to do so New BP reflect the fact that we have more experience and evidence than ever before CDC’s funding recommendations pale in comparison to tobacco industry spending on marketing, tobacco revenue states collect each year, and the health care costs caused by tobacco Spending levels are appropriate when you consider magnitude of tobacco problem Failing to invest what CDC recommends means more people will become addicted, more people will get sick and more people will die prematurely Disseminate key messages – local partners talking off the same page

You Are the Key Continue your efforts – they are working – need to do more of them! Do not shy away – this enormous problem demands a response – a response that has been proven to work! You can prevent more kids from starting to smoke, help more smokers quit and accelerate declines in heart attack deaths and chronic lung disease