Georgia once again gets a failing grade in tobacco control from the American Lung Association for everything from a very low tobacco tax to restricting what help Medicaid patients can get to quit smoking.
In a separate report, a comprehensive review of electronic cigarettes found they do emit some toxic substances but are not as bad as regular cigarettes and could provide some benefit if they convince smokers to completely quit. However, their popularity among kids is likely to lead them to become future smokers, which could offset any public health benefit they provide, according to that report.
In the lung association’s annual State of Tobacco Control report card, Georgia would likely be held back after getting a failing grade in four out of five categories. The state got a C grade for its Smoke-Free Air laws that includes a state ban on smoking in restaurants and most public areas but allowing it in some designated smoking areas and in places that serve only adults, such as some bars.
“We continue to fall behind other states in the work that we do in reducing tobacco use,” said June Deen, senior vice president of public policy and health promotions for the Southeast.
For instance, the state’s Medicaid program will not pay for certain smoking cessation therapies, such as the drug Chantix, while neighboring South Carolina’s Medicaid program covers all smoking cessation therapies approved by the Food and Drug Administration, Deen said.
“And they did away with barriers to treatment, like co-pays or waiting periods or only funding certain parts for a certain period of time,” she said. “We’re hoping for good things out of South Carolina. That was a great step forward.”
Helping people on Medicaid quit smoking would be a cost-saving move for states in the long run, Deen said.
“It might save them from diseases down the road like emphysema or lung cancer,” she said. “It won’t aggravate a child’s asthma or make them more likely to get flu or pneumonia. All of those things reduce health costs.”
Georgia is also missing the boat by not putting more money into preventing kids from taking up tobacco and by not providing enough at times to promote its Quit Line, Deen said.
“We know smokers try to quit several times before they quit for good,” she said. “This is an option that is available to anybody. It makes it very helpful in quitting smoking.”
Georgia has the third lowest tobacco tax in the country at 37 cents a pack and raising it significantly would not only help discourage smoking but provide useful funding, Deen said.
“This state is growing and its health care needs are growing also and we need to look at that,” she said.
In a separate report, the National Academies of Sciences, Engineering and Medicine released its comprehensive review of electronic cigarettes and their public health implications. While there was strong evidence that the devices can emit toxic substances such as particulates and metals, and that some chemicals such as formaldehyde can cause DNA damage and mutations, the report concluded that those emissions for the most part are far less than conventional smoking and switching completely to e-cigarettes could have some public health benefit if enough people did that.
However, there was also “substantial evidence” that kids who use these devices are more likely to try cigarettes later and any public health benefit could be offset by those kids becoming future smokers. The number of kids using the devices declined from 3 million in 2015 to 2.2 million in 2016 but 20.2 percent of high school kids and 7.2 percent of middle school kids use the devices, according to the Centers for Disease Control and Prevention.
The National Academies report also noted that because the devices have only been on the market since 2006, the long-term health effects of using them is unclear. There is also such a wide variability among the devices and the liquids used with them that the health effects, such as the level of nicotine delivered, might also be highly variable.
But last July, the FDA decided to put off for five years a requirement that e-cigarette manufacturers submit their products for review and that earned the agency an “F” from the lung association in its report card, said Erika Sward, assistant vice president of national advocacy for the lung association.
“Unfortunately, FDA made the decision in July of last year to punt that down the road by five years and as a result we are going to have the same kind of Wild West that we’ve had” in terms of lack of regulation, she said.
The new report highlights the risks of use, such as the hazards from the liquids themselves and the high variability of potential harm and “all of that points a big red arrow at the Food and Drug Administration for carefully reviewing each product on the market to determine, on a case-by-case basis, including flavorings, as to whether they are appropriate for the protection of public health,” Sward said.
Reach Tom Corwin at (706) 823-3213 or firstname.lastname@example.org.