1. Best Practices for Tobacco Control

2. Background

4. Economic Cost In 1998/1999, Texas Smoking-Attributable Costs = $10.09 billion Direct Medical expenditures - $4.55 billion Lost Productivity costs - $5.54 billion In 1998, about 15% ($1,265,000,000 or $543.87 per recipient) of all Texas Medicaid expenditures were spent on smoking-related illnesses and diseases. (includes state and federal contributions to Medicaid)

5. Tobacco Industry Expenditures In 2005 the tobacco industry spent $13.36 billion on advertising and promotion in the U.S. (more than $36.6 million per day) Approximately $884.7 million was spent in Texas in 2005 (over $2.4 million every single day)

6. Texas Tobacco Settlement 1998 - Texas became the 3rd state to settle with the tobacco industry Settlement represented compensation for the states cost of tobacco-related disease Texas to receive $17.3 billion over 25+ years

7. FY 00 -01 $1.8 billion available from the settlement in FY 00-01 Texas Department of Health appropriated the interest from a $200 million endowment ($9 million) per year to implement programs to reduce the use of tobacco products Special attention to populations targeted by the tobacco industry

8. Texas Tobacco Task Force Report Program Elements and Best Practices Community & School Programs Media Campaigns Cessation Enforcement Efforts Targeted to Diverse/Special Populations Surveillance & Evaluation Research

10. Funding for Comprehensive Tobacco Prevention and Cessation Programs (media, provider reminder systems, telephone quitline…) Tobacco Excise Tax Increases Restrictions on Secondhand Smoke Coverage for Smoking Cessation Healthcare Provider Reminder Systems Recommended Tobacco Interventions

11. Latest Results From 2000 to 2006, current use of any tobacco products in the comprehensive program area showed a 42% reduction among middle school students (from 24.8% to 14.3%) and a 36% reduction among high school students (from 40.7% to 26.2%) The prevalence of adult smoking in the comprehensive program area decreased 26.4% (from 21.6% in 2000 to 15.9% in 2004)

12. Smoking Rates for Harris & Jefferson Counties 2000-2005 Reducing tobacco use requires a comprehensive & sustained approach. Gains in Harris County regressed as resources/efforts were reduced.

13. Heart Attack Deaths Decline 3 Times Faster in County with Anti-Tobacco Campaign

14. ROI Results from the Comprehensive Pilot Initiative (Cont.) In 2003, single year program costs of $11.3 million ($2.71 per capita) implementing comprehensive tobacco programming in Houston and Beaumont/Port Arthur resulted in: over 29,800 fewer adult smokers in 2003 savings of over $252 million in medical care and productivity costs over 5 years.

15. Projected Financial Returns from Statewide Investment in Tobacco Control $3 per capita spending of $68.3 million for statewide program in 1 year would yield: ~164,000 fewer smokers statewide After 5 years, the single year investment of $68.3 million would achieve a cost savings of over $1.4 billion in medical care and productivity costs Center for Health Research, Kaiser Permanente Northwest, June 2006

16. Tobacco Excise Tax Increases

17. Tobacco Price Increase Findings (Community Guide) Results in decreases in both the number of people who use tobacco and the quantity they consume. A 10% increase in the price of tobacco products will result in a 3.7% decrease in the number of adolescents who use tobacco and 4.1% decrease in the amount of tobacco used by the general population. Increases in the price of tobacco products also reduce tobacco use in older adults

18. Restrictions on Secondhand Smoke

19. Second-Hand Smoke (SHS) Public Health Issue Contains over 4,000 chemicals including 43 known carcinogens Group A Carcinogen (like asbestos and benzene) Health Effects: Adults Lung cancer Coronary heart disease Health Effects: Children Lower respiratory tract infections in children < 18 months old each year Middle ear infections Asthma SIDS

20. Smoking Ban Findings (Community Guide) Smoking bans in workplaces observed average of 72% reduction in exposure to components of ETS. Effective in a wide variety of public and private workplaces and healthcare settings. Studies evaluating smoking bans also observed reductions in the amount smoked.

22. Smokefreee Laws = Reduced Profits for Big Tobacco Financial impact of smoking bans will be tremendous – three to five fewer cigarettes per day per smoker will reduce annual manufacturer profits a billion dollars plus per year. Philip Morris internal document. A Smokers Alliance: draft. Bates Nos. 2025771934- 2025771937