January 2009

The Proposed Stimulus Bill and Implications for Tobacco Cessation

One of the biggest challenges facing the country and the world today is the current economic crisis. Credit is frozen, consumer purchasing power is in decline, and in the last four months alone the United States has lost 2 million jobs and we are expected to lose another 3 to 5 million in the next year.

This challenge is being met by Congress and the new administration through proposed broad policy changes. Over the past few weeks, Congress has been considering the American Recovery and Reinvestment Bill of 2009 as effort to create and save jobs and jumpstart the economy. In addition to targeted efforts in many areas including energy, education, and transportation, this stimulus package includes needed investments to improve public health and prevention.

Both House and Senate versions of the economic stimulus package contain several provisions to support and strengthen the nation's healthcare infrastructure, clearly showing that Congress and the new administration view public health and prevention as critical components in the nation's overall economic recovery plan. This investment by Congress could make a major difference in improving the health of Americans and preventing disease, which is one of the most effective and overlooked ways to reduce healthcare costs.

On Jan. 28, the U.S. House of Representatives passed an $819 billion stimulus package that includes $3 billion for a prevention and wellness fund to better manage and treat chronic and infectious diseases. These funds would focus on reducing healthcare costs by augmenting funding for state and local public health departments, immunization programs, and evidence-based disease prevention. The measure also provides $20 billion to help physicians adopt health information technology and $600 million to train primary care health professionals.

The Senate version of the bill to stimulate the economy includes $16 billion in funding to improve the health of Americans, of which $5.8 billion is for prevention and wellness to fight preventable diseases and conditions. This includes more than $600 million to bolster the health workforce, $400 million for community prevention (healthy communities) programs, and $75 million for smoking and other tobacco use prevention programs.

Tobacco control can play a critical role in this stimulus plan by helping prevent diseases and reduce healthcare spending. Both the House and Senate packages provide a significant opportunity for tobacco prevention and cessation efforts. Tobacco programs would be eligible not only for these funds specifically allocated for tobacco, but also for some of the funds to prevent chronic diseases and for evidence-based clinical and community prevention strategy funds.

If the pending bill is approved and includes these anticipated healthcare provisions, NTCC will work hard to ensure that tobacco cessation has a role in the overall recovery plan. Increasing demand for and use of evidence-based tobacco cessation products and services could lead to a significant increase in the nation's overall quit rate, thereby preventing diseases and reducing healthcare costs. Collaborative members will convene at the annual meeting in late March or early April to explore any new opportunities and develop initiatives and activities for 2009.

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Does Smokeless Tobacco Help Smokers Quit Cigarettes?: UC San Diego Researchers Find No Such Association in the U.S.

According to a study from the University of California, San Diego and Sweden's Karolinska Institutet, there are important differences between the United States and Sweden with respect to how people use-and quit-tobacco. The study, in the online issue of Tobacco Control, examined data from more than 15,000 individuals in the U.S. who were surveyed twice, a year apart, to get a picture of tobacco use and cessation in the U.S.

"In Sweden, many smokers have quit smoking by switching to snus," said Shu-Hong Zhu, Ph.D., Professor of Family and Preventive Medicine in the UCSD School of Medicine. (Snus-pronounced snoos-is a form of moist, powdered tobacco that comes in a small sachet and is placed under the lip.) "This has piqued a lot of interest, because anything that helps people quit cigarettes could have huge benefits due to the great harm caused by smoking."

"Historically, there has been no campaign to promote snus to Swedes as a safer alternative to cigarettes," said Hans Gilljam, M.D. a Professor at the Karolinska Institutet and a study author. "But snus has been popular among male smokers, and has helped them quit cigarettes. In fact, Swedish men have a higher smoking cessation rate than Swedish women, few of whom use snus."

The researchers looked for a similar effect among U.S. smokers, but didn't find one. Like their counterparts in Sweden, U.S. men are much more likely than women to use smokeless tobacco. But it does not boost their rate of quitting smoking.

Zhu explained, "With an ongoing tobacco control effort, men in the U.S. seem to be quitting smoking at higher rates than men in Sweden. And U.S. women are quitting at the same rate, unlike their counterparts in Sweden."

These findings are important because there has been a vigorous debate in the international public health community about whether tobacco control programs should stop advocating complete tobacco cessation and start promoting smokeless tobacco as a less-harmful alternative to smoking. If Sweden's results were to be replicated in a longitudinal study from another country, it would support promoting smokeless as a harm-reduction strategy.

The current study examined data from the Tobacco Use Supplement to the Current Population Survey, 2002, with one-year follow-up in 2003. Results showed both male and female smokers in the U.S. appear to have higher quit rates for smoking than their Swedish counterparts, despite greater use of smokeless tobacco in Sweden.

Over a one-year period, the study tracked the quit rates, and the rates of switching from one form of tobacco to another, of more than 15,000 adult participants. It showed that:

Among U.S. men, less than one percent of current smokers switched to smokeless tobacco during the 12 month study.

Only 1.7 percent of former smokers turned to smokeless tobacco. Men's quit rate for smokeless tobacco was three times higher than for cigarettes. Even though men were far more likely to use smokeless tobacco products than women, overall, they had no advantage over women in quitting smoking (11.7 percent vs. 12.4 percent).

The Swedish data showed just the opposite: Swedes who use smokeless tobacco are likely to keep using it, rather than switching to other tobacco products. Their habit is relatively stable. By comparison, Swedes who smoke cigarettes are more likely to switch to other tobacco products, such as smokeless tobacco. Their habit is less stable.

"Many public health officials and scientists have cautioned that the Swedish results may be unique to Sweden," explained Zhu. "This research confirms that idea."

For more information, see web link:
UC San Diego Medical Center News Release January 26, 2009

Smokers More Likely to Quit with Group Counseling

Smokers motivated to quit were nearly twice as likely to stop smoking with group support than with one-on-one counseling, researchers found.

More than a third of participants in an intensive group smoking cessation program remained abstinent four weeks after their target quit date, compared with less than 20 percent of those who received less intensive, one-on-one behavioral counseling in a pharmacy setting, Linda Bauld, Ph.D., of the University of Bath, and colleagues reported in the February issue of Addiction.

Although the individual intervention was less expensive ($1,070 versus $2,236), both treatments were cost-effective overall, a separate analysis concluded.

"The findings indicate clearly that healthcare managers and others should not abandon more intensive (in particular, group-based) models of treatment in favor of less intensive support," the researchers said.

"Rather, they should look for ways in which pharmacy-based services can improve success rates to bring them up to the level of specialist-led group-based services and how such services can be made more attractive to a wider range of smokers," they said.

The researchers evaluated the effects of the two smoking cessation interventions in 1,785 smokers in Glasgow, Scotland, which has one of the highest smoking rates in Western Europe.

In the group counseling intervention, 411 participants attended weekly, hour-long sessions for up to seven weeks. In those sessions, they received structured behavioral support, vouchers for nicotine replacement therapy, and information on two smoking cessation drugs, bupropion and varenicline (Chantix).

In the individual intervention, 1,374 participants received weekly one-on-one behavioral support in a pharmacy setting for up to 12 weeks, with each session lasting about five to 15 minutes. Smokers were provided with nicotine replacement therapy.

Both services were provided free of charge under Glasgow's Tobacco Control Strategy.

Four weeks after the targeted quit date, 35 percent of participants in the group intervention remained abstinent from cigarettes compared with 18.6 percent (P<0.0005), as validated by an exhaled carbon monoxide level no greater than 10 parts per million.

"Of course," the researchers said, "we must caution that it is perfectly possible that this residual difference between services is the product of unmeasured differences between the characteristics of users of the two cessation services."

The pharmacy-based intervention was more likely to attract younger participants (ages 16 to 40), those in the lowest socioeconomic groups, the disabled, and those who were eligible for free prescriptions than the group program.

Participants in the lowest socioeconomic group were less likely to quit (P=0.015).

"However, encouragingly, we found that both models of service in Glasgow were reaching and treating smokers from disadvantaged areas in significant numbers," the researchers noted.

For more information, see web link:
Medical News Today January 23, 2009

Menthol Cigarette Cessation Rates Lower for Blacks, Hispanics, Low-Income Whites, Study Finds

People who smoke menthol-flavored cigarettes have more difficulty trying to quit than those who smoke non-mentholated cigarettes, particularly low-income and minority individuals, according to a study published in the February issue of International Journal of Clinical Practice, Reuters Health reports. For the study, lead researcher Kunal Gandhi of the Robert Wood Johnson Medical School at the University of Medicine and Dentistry of New Jersey examined 1,688 people who sought treatment to stop smoking over a four-year period. Eighty-one percent of black participants smoked menthol-flavored cigarettes, compared with two-thirds of Hispanics and one-third of whites.

Black and Hispanic menthol cigarette smokers were one-third as likely to have quit smoking after one month as those who smoked non-menthol cigarettes, according to the study. They also had lower long-term cessation rates. Overall, menthol smokers were less likely to have quit after six months.

Among whites, there were no differences in cessation rates for those who smoked menthol and those who smoked non-menthol cigarettes. However, unemployed whites who smoked menthol cigarettes had lower cessation rates at one month than whites smoking other cigarettes.

Gandhi said, "This study suggests that people who smoke mentholated cigarettes -- particularly those with a low disposable income -- may inhale more nicotine and toxins per cigarette," which in turn might create a stronger addiction to nicotine. Previous research has found that people who smoke menthol-flavored cigarettes tend to have higher levels of nicotine in the blood than other smokers. The menthol flavoring masks the harshness of nicotine and other tobacco toxins, according to Reuters

For more information, see web link:
Kaiser Daily Health Policy Report January 22, 2009

Photos of Smokers Trigger Brain Reaction in Those Trying to Quit

If you're trying to quit smoking, just looking at a picture of someone taking a puff could hurt your attempt to kick the habit, a new study says.

Brain scans of smokers taken before and 24 hours after quitting showed increased activity in certain areas of the brain that cue the person to crave a drag when they view photographs of others smoking, according to research published online in Psychopharmacology.

"We saw activation in the dorsal striatum, an area involved in learning habits or things we do by rote, like riding a bike or brushing our teeth. Our research shows us that when smokers encounter these cues after quitting, it activates the area of the brain responsible for automatic responses. That means quitting smoking may not be a matter of conscious control," researcher Joseph McClernon, an associate professor in the department of psychiatry and behavioral sciences at Duke University Medical Center, said in a news release issued by the school.

"So, if we're really going to help people quit, this emphasizes the need to do more than tell people to resist temptation. We also have to help them break that habitual response," he added.

"Only five percent of unaided quit attempts result in successful abstinence," McClernon said. "Most smokers who try to quit return to smoking again. We are trying to understand how that process works in the brain, and this research brings us one step closer."

Study co-author Jed Rose, director of the Duke Center for Nicotine and Smoking Cessation Research, said previous research he conducted showed that wearing a nicotine patch and smoking a cigarette with no nicotine breaks the learned behavior.

"The smoking behavior is not reinforced, because the act of smoking is not leading them to get the nicotine," Rose said in the news release. "Doing this before people actually quit helps them break the habit so they start smoking less. We're seeing people quit longer this way."

For more information, see web link:
The Washington Post January 5, 2009

Survey Highlights Beliefs about Children's Risks from 'Third-Hand-Smoke'

Parents who smoke often open a window or turn on a fan to clear the air for their children, but experts now have identified a related threat to children's health that isn't as easy to get rid of: third-hand smoke.

That's the term being used to describe the invisible yet toxic brew of gases and particles clinging to smokers' hair and clothing, not to mention cushions and carpeting, that lingers long after second-hand smoke has cleared from a room. The residue includes heavy metals, carcinogens and even radioactive materials that young children can get on their hands and ingest, especially if they're crawling or playing on the floor.

Doctors from MassGeneral Hospital for Children in Boston coined the term "third-hand smoke" to describe these chemicals in a new study that focused on the risks they pose to infants and children. The study was published in this month's issue of the journal Pediatrics.

"Everyone knows that second-hand smoke is bad, but they don't know about this," said Dr. Jonathan P. Winickoff, the lead author of the study and an assistant professor of pediatrics at Harvard Medical School.

"When their kids are out of the house, they might smoke. Or they smoke in the car. Or they strap the kid in the car seat in the back and crack the window and smoke, and they think it's okay because the second-hand smoke isn't getting to their kids," Dr. Winickoff continued. "We needed a term to describe these tobacco toxins that aren't visible."

Third-hand smoke is what one smells when a smoker gets in an elevator after going outside for a cigarette, he said, or in a hotel room where people were smoking. "Your nose isn't lying," he said. "The stuff is so toxic that your brain is telling you: 'Get away.'"

The study reported on attitudes toward smoking in 1,500 households across the United States. It found that the vast majority of both smokers and nonsmokers were aware that second-hand smoke is harmful to children. Some 95 percent of nonsmokers and 84 percent of smokers agreed with the statement that "inhaling smoke from a parent's cigarette can harm the health of infants and children."

But far fewer of those surveyed were aware of the risks of third-hand smoke. Since the term is so new, the researchers asked people if they agreed with the statement that "breathing air in a room today where people smoked yesterday can harm the health of infants and children." Only 65 percent of nonsmokers and 43 percent of smokers agreed with that statement, which researchers interpreted as acknowledgement of the risks of third-hand smoke.

The belief that second-hand smoke harms children's health was not independently associated with strict smoking bans in homes and cars, the researchers found. On the other hand, the belief that third-hand smoke was harmful greatly increased the likelihood the respondent also would enforce a strict smoking ban at home, Dr. Winickoff said.

"That tells us we're onto an important new health message here," he said. "What we heard in focus group after focus group was, 'I turn on the fan and the smoke disappears.' It made us realize how many people think about second-hand smoke - they're telling us they know it's bad but they've figured out a way to do it."

Dr. Philip Landrigan, a pediatrician who heads the Children's Environmental Health Center at Mount Sinai School of Medicine in New York, said the phrase third-hand smoke is a brand-new term that has implications for behavior.

"The central message here is that simply closing the kitchen door to take a smoke is not protecting the kids from the effects of that smoke," he said. "There are carcinogens in this third-hand smoke, and they are a cancer risk for anybody of any age who comes into contact with them."

For more information, see web link:
New York Times January 2, 2009

Smoking Ban Leads to Major Drop in Heart Attacks

A smoking ban in one Colorado city led to a dramatic drop in heart attack hospitalizations, according to a new study that is considered the best and longest-term research to show such a link.

The rate of hospitalized cases dropped 41 percent three years after the ban of workplace smoking in Pueblo, Colo., took effect. There was no such drop in two neighboring areas, and researchers believe it's a clear sign the ban was responsible.

The study suggests that secondhand smoke may be a terrible and under-recognized cause of heart attack deaths in this country, said one of its authors, Terry Pechacek of the U.S. Centers for Disease Control and Prevention.

At least eight earlier studies have linked smoking bans to decreased heart attacks, but none ran as long as three years. Some critics had questioned whether a ban could have such an immediate impact, and suggested other factors could have driven the declines.

The new study looked at heart attack hospitalizations for three years following the July 1, 2003 enactment of Pueblo's ban, and found declines as great or greater than what was seen in the other research.

Smoking bans are designed not only to cut smoking rates but also to reduce secondhand tobacco smoke. It is a widely recognized cause of lung cancer, but its effect on heart disease can be more immediate. It not only damages the lining of blood vessels, but also increases the kind of blood clotting that leads to heart attacks. Reducing exposure to smoke can quickly cut the risk of clotting, some experts said.

In the new study, researchers reviewed hospital admissions for heart attacks in Pueblo. Patients were classified by ZIP codes. They then looked at the same data for two nearby areas that did not have bans - the area of Pueblo County outside the city and for El Paso County.

In Pueblo, the rate of heart attacks dropped from 257 per 100,000 people before the ban to 152 per 100,000 in the three years afterward. There were no significant changes in the two other areas.

The study assumed declines in the amount of secondhand smoke in Pueblo buildings after the ban, but did not try to measure that. The researchers also did not sort out which heart attack patients were smokers and which were not, so it's unclear how much of the decline can be attributed to reduced secondhand smoke.

For more information, see web link:
The Associated Press December 31, 2008

Online Advertising as a Public Health and Recruitment Tool: Comparison of Different Media Campaigns to Increase Demand for Smoking Cessation Interventions

To improve the overall impact (reach × efficacy) of cessation treatments and to reduce the population prevalence of smoking, innovative strategies are needed that increase consumer demand for and use of cessation treatments. Given that 12 million people search for smoking cessation information each year, online advertising may represent a cost-efficient approach to reach and recruit online smokers to treatment. Online ads can be implemented in many forms, and surveys consistently show that consumers are receptive. Few studies have examined the potential of online advertising to recruit smokers to cessation treatments.

Researchers developed a study to demonstrate the feasibility of online advertising as a strategy to increase consumer demand for cessation treatments, illustrate the tools that can be used to track and evaluate the impact of online advertising on treatment utilization, and highlight some of the methodological challenges and future directions for researchers.

An observational design was used to examine the impact of online advertising compared to traditional recruitment approaches (billboards, television and radio ads, outdoor advertising, direct mail, and physician detailing) on several dependent variables: number of individuals who enrolled in Web- or telephone-based cessation treatment, the demographic, smoking, and treatment utilization characteristics of smokers recruited to treatment, and the cost to enroll smokers. Several creative approaches to online ads (banner ads, paid search) were tested on national and local websites and search engines. The comparison group was comprised of individuals who registered for Web-based cessation treatment in response to traditional advertising during the same time period.

A total of 130,214 individuals responded to advertising during the study period: 23,923 (18.4 percent) responded to traditional recruitment approaches and 106,291 (81.6 percent) to online ads. Of those who clicked on an online ad, 9655 (9.1 percent) registered for cessation treatment: 6.8 percent (n = 7268) for Web only, 1.1 percent (n = 1119) for phone only, and 1.2 percent (n = 1268) for Web and phone. Compared to traditional recruitment approaches, online ads recruited a higher percentage of males, young adults, racial/ethnic minorities, those with a high school education or less, and dependent smokers. Cost-effectiveness analyses compare favorably to traditional recruitment strategies, with costs as low as US $5-$8 per enrolled smoker.

Developing and evaluating new ways to increase consumer demand for evidence-based cessation services is critical to cost-efficiently reduce population smoking prevalence. Results suggest that online advertising is a promising approach to recruit smokers to Web- and telephone-based cessation interventions. The enrollment rate of 9.1 percent exceeds most studies of traditional recruitment approaches. The powerful targeting capabilities of online advertising present new opportunities to reach subgroups of smokers who may not respond to other forms of advertising. Online advertising also provides unique evaluation opportunities and challenges to determine rigorously its impact and value.

For more information, see web link:
Journal of Medical Internet Research, Vol 10, No 5 (2008)

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Walmart Offers $9 Smoking Cessation Starter Pack

To help motivated consumers quit smoking and to further its Operation Main Street efforts to save customers money on prescription medications, Walmart recently announced that it has expanded its affordable pharmacy program to include a smoking cessation prescription starter pack for $9, the lowest price on the market. The $9 starter pack of bupropion ER 150mg, the generic equivalent of Zyban, is now available at Walmart, Neighborhood Market and Sam's Club pharmacies in a 17-tablet, 10-day supply. This announcement is part of the retailer's January Healthy Living initiative, which aims to help Americans maintain their better eating, smoking cessation and exercise pledges in 2009.

"Times are tight right now, and Walmart is committed to helping our customers maintain their healthy lifestyles in both good economic times and bad," said Dr. John Agwunobi, Walmart senior vice president and president, health and wellness. "With our affordable smoking cessation offerings, we're hopeful that smokers who are committed to quitting will be able to get the tools they need to stop smoking and still be able to afford everyday household items so they can live better."

According to the Centers for Disease Control and Prevention (CDC), nearly 43 million Americans currently smoke, with 70 percent of them saying they want to stop. However - given today's current economic landscape -money previously set aside for smoking cessation products may now be re-allocated toward items American families need most. Smoking cessation medication for $9 at Walmart may help reverse this trend as the bupropion ER starter pack - initiated at the request of both health care professionals and customers - is low-priced and affordable for consumers who want to quit.

"The public health community has long recognized that the cost of either cigarettes or smoking cessation medications has served as a determining factor for smokers to continue smoking or finally to decide to quit," said Cheryl G. Healton, Dr. P.H., President and CEO of the American Legacy Foundation. "This move by Walmart to provide science-based smoking cessation therapies that smokers can more easily afford is a huge step forward in helping millions of smokers finally quit for good. We applaud Walmart and hope other retailers will follow their example. It can only result in longer, healthier lives."

At more than 3,000 stores and supercenters nationwide, customers can now find over-the-counter smoking cessation products permanently featured in the tobacco area. For additional information and resources, consumers can visit http://www.Walmart.com/stopsmoking or the American Legacy Foundation's website at http://www.BecomeAnEx.org.

For more information, see web link:
PRNewsWireJanuary 15, 2009

Anti-Smoking Advocate Is Named to Health Post

President-elect Barack Obama announced earlier this month that he had chosen the head of a leading anti-tobacco organization to be the No. 2 official at the Department of Health and Human Services.

The prospective nominee, William V. Corr, is executive director of the Campaign for Tobacco-Free Kids, a nonprofit group that seeks to reduce tobacco use among children and adults.

As a member of the Obama transition team, Mr. Corr has led efforts to review and evaluate the work of the Department of Health and Human Services.

Mr. Obama has selected Tom Daschle, a former Senate Democratic leader, to be secretary of health and human services. If confirmed by the Senate, Mr. Corr would be the deputy secretary. From 1998 to 2000, Mr. Corr worked as chief counsel and policy director for Mr. Daschle, when Mr. Daschle was minority leader.

The new Congress is expected to move aggressively against the tobacco industry, by increasing federal regulation of cigarettes, raising taxes on tobacco products and approving an international tobacco control treaty.

As a senator, Mr. Obama, an intermittent smoker, was a co-sponsor of a bill that would have given the Food and Drug Administration broad authority to regulate "the manufacture, marketing, and distribution" of tobacco products, including cigarettes.

In the Clinton administration, Mr. Corr was chief of staff at the Department of Health and Human Services.

"Reforming our health care system will be a top priority of my administration and key to putting our economy back on track," Mr. Obama said. "Under the leadership of Tom Daschle and Bill Corr, I am confident that my Department of Health and Human Services will bring people together to reach consensus on how to move forward with health care reform."

For more information, see web link:
New York Times January 14, 2009

U.S. Flunks on Tobacco Control Report Card: Lung Association Report Says Feds and Most States Neglect Preventing Tobacco-Caused Illness

A new report card gives the U.S. government consistently failing grades for not protecting Americans from illnesses caused by tobacco.

According to the American Lung Association's State of Tobacco Control 2008, the federal government as well as most states failed to enact critical policy measures, such as higher taxes on cigarettes and to adequately regulate tobacco products.

This year's report card for the federal government was "abysmal," Paul Billings, the association's vice president for national policy and advocacy, said.

Specifically, the federal government got:

• An "F" for FDA regulation of tobacco products -- the bill authorizing FDA regulation of tobacco products passed overwhelmingly in the U.S. House of Representatives but was not considered by the U.S. Senate before it adjourned for 2008.
• An "F" for a cigarette tax -- the federal government's cigarette tax is 39 cents per pack, well below the "F" standard of anything just less than 60 cents a pack.
• A "D" for failing to ratify the World Health Organization's Framework Convention on Tobacco Control, a treaty designed to limit smoking's health risks worldwide. The Bush Administration again "neglected to submit the treaty to the Senate for ratification," the report card said.

The report card also faulted the federal government for not doing more to increase access to smoking-cessation programs, Billings said.

On the state level, no state earned a straight A. "Hawaii, Maine, Massachusetts and Rhode Island received the best grades," Billings said.

But even these states fell short in at least one grading categories, including smoke-free air laws, amount of state cigarette tax, funding for tobacco-cessation programs, and covering tobacco-cessation treatments for Medicaid recipients and state employees, Billings said.

The states with the worst grades -- all Fs -- were Alabama, Kentucky, Missouri, North Carolina, South Carolina, Virginia and West Virginia, according to the report.

Twenty-three states plus the District of Columbia and Puerto Rico have enacted comprehensive smoke-free air laws that protect almost all workers from exposure to secondhand smoke, Billings said. Fourteen states got an "F" in this category, he said.

In 2008, only Massachusetts, New Hampshire, New York and the District of Columbia raised cigarette taxes. The average state tax is $1.19 per pack, Billings said. New York state has the highest tax at $2.75 a pack; South Carolina has the lowest at 7 cents a pack.

Billings said that only Alaska and Delaware funded tobacco-cessation programs to the level recommended by the U.S. Centers for Disease Control and Prevention. "Tragically, 42 states received "Fs" in this category," he said.

Utah Governor Wants to Push Cigarette Tax to $3

Gov. Jon Huntsman Jr. endorsed a $2.30 tax increase on a pack of cigarettes, giving Utah the highest state cigarette tax in the country with a goal of wiping out the remaining state sales tax on food.

"I think that's a perfectly fair tradeoff," the governor said after publicly embracing the tax hike for the first time and going further than previous legislative proposals. Huntsman's target would more than quadruple the existing 70-cent tax on a pack of smokes.

Legislative leaders were open to the idea, and said it will be among the topics discussed in the upcoming legislative session. House Speaker Dave Clark, R-Santa Clara, said he would be supportive of the tobacco tax increase as long as there was an equal tax cut.

As of last August, New York had the highest state cigarette tax in the nation at $2.75, according to figures compiled by the Campaign for Tobacco-Free Kids. However, many cities across the country impose their own cigarette tax, making the cost of a pack much higher. The national average was $1.18.

Michael Siler, director of governmental affairs for the Utah Chapter of the American Cancer Society, said he has known for a while the governor supported raising the tobacco tax, but didn't know how high he would set the target.

"As far as we're concerned, it's a good thing," he said, saying it would encourage smokers to kick the habit and could help cover the smoking related costs.

Cigarette tax supporters have said that every 10 percent increase in the cost of a pack of cigarettes, smoking rates would fall by 6.5 percent among youth and 2 percent among adults.

Huntsman said that the $3 per pack tax would bring in $120 million to $150 million in revenue, beyond the $60 million the current tax generates. Huntsman said that would be "more than enough" to eliminate the sales tax on food. That would cost about $75 million.

For more information, see web link:
The Salt Lake Tribune January 7, 2009

Stricter Smoking Ban Set for Federal Offices

Government workers at federal buildings who want a cigarette break will have to take a stroll before they light up, according to a new federal policy.

A regulation published recently in the Federal Register by the General Services Administration prohibits smoking in the courtyards of federal buildings, or within 25 feet of doorways and air intake ducts. It also bans designated smoking rooms in federal buildings. The policy is to be implemented within six months.

The regulation replaces an executive order signed by President Bill Clinton in 1997 that prohibited smoking in federal buildings but allowed smoking in designated rooms or outdoor areas. Anti-smoking advocates viewed the exceptions as significant loopholes that exposed co-workers and passersby to secondhand smoke, and they welcomed the new regulation.

"We see this as a major victory," said Heather Grzelka, director of media relations at the American Lung Association. "This is going to go a long way to protecting workers from exposure to secondhand smoke."

James A. Williams, acting administrator of the GSA, made the decision based on the recommendations of the Federal Management Regulation Evaluation Review Panel, according to an agency spokeswoman.

The GSA regulation cites studies that show that secondhand smoke is harmful to co-workers or anyone else exposed to it. The agency also noted that 26 states have banned smoking in all state government buildings, and that 19 states have banned smoking in all private work places.

"There is no safe exposure to secondhand smoke," Grzelka said. "Even if you don't enter the smoking room, you're still affected, because there's no way to clean that air."

For more information, see web link:
The Washington Post December 31, 2008

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