Anti-Smoking----A Huge Payoff!

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Courant.com
For Anti-Tobacco Investment, A Huge Payoff
By ANDREW L. SALNER

December 19, 2010



Every year, tobacco use is responsible for approximately one of five deaths nationwide from cancer, heart disease, stroke or respiratory disease. As such, it is the single most preventable cause of disease and death.

In Connecticut, approximately 4,800 residents die each year due to a tobacco-related cause, and another 440 nonsmokers die from secondhand exposure to tobacco smoke. Annual health care costs in Connecticut related to tobacco exposure are estimated at $2 billion, with approximately $507 million paid for by the state's Medicaid program. Further, an estimated $1 billion in additional cost is related to lost productivity. As a practicing oncologist, I suggest to my patients and family members that they quit using tobacco as an important way to maintain good health.

Thanks in large part to smoke-free public places, tobacco excise taxes and education for our children and adults, the smoking prevalence rate in Connecticut has decreased to 15.4 percent overall. Smoking rates are higher among people in lower economic and education levels, and those with psychiatric and substance-abuse illnesses. Medicaid recipients have tobacco-use rates more than twice as high as rest of the population, at 36 percent. In Connecticut, pregnant women on Medicaid are twice as likely to smoke as non-Medicaid recipients, placing themselves at higher risk for problems such as premature birth and low-birth-weight babies.

Despite an influx of more than $400 million annually in tobacco taxes and settlement funds, Connecticut spends less than $7 million a year on tobacco prevention and cessation programs, far less than the $45 million recommended by the federal Centers for Disease Control and Prevention. This funding is in jeopardy in the next fiscal year due to the state's budget crisis.

Strategies with proven results such as anti-smoking marketing, prevention and cessation programs have demonstrated over and over in other states that disease and death rates can be lowered, and dollars can actually be saved! There appears to be a leveraging effect, with a $2 to $4 long-term savings for every dollar invested in these programs. This could create a win for people who are smokers, their families and communities, and a win for the taxpayers of Connecticut, who spend a considerable amount of money to pay for medical and other costs of smokers every year.

We should start with our Medicaid population. Our state is one of only three that does not fund cessation programs for these residents. Massachusetts introduced a comprehensive smoking cessation program for Medicaid participants 2 1/2 years ago. Since then, 75,000 people have used the program. The smoking rate dropped by 26 percent in this population and new data reveal a 46 percent drop in heart attacks in this group. An investment in Medicaid cessation will also garner matching federal funds.

How much more evidence do we need as a state to say yes to helping people break their tobacco addiction? Not only will it save lives, but it will also help save money in this time of sky-high budget deficits. The end of 2010 marks another year when Connecticut missed an opportunity to save lives and money by helping people quit smoking. The new administration, under Gov.-elect Dan Malloy, should to do the right thing and fund this program.

Andrew L. Salner is director of the Helen & Harry Gray Cancer Center at Hartford Hospital and co-chairman of the SustiNet Tobacco and Smoking Cessation Task Force.