Indiana’s tobacco control policies are failing to reduce smoking rates among adults and youth, and tobacco use is costing the state more than $2.9 billion in healthcare costs and lost productivity annually, according to the American Lung Association’s 2016 State of Tobacco Control report.
Indiana has one of the highest adult smoking rates in the nation — 22.9 percent — and its youth smoking rate is in the high side as well — 13.7 percent. Locally, Lake County has a higher rate — 23 percent — than the state average smoking rate, according to the Behavioral Risk Factor Surveillance System survey. Porter County’s smoking rate is 21 percent. The report gave Indiana an F for tobacco prevention and control program funding, tobacco taxes and access to cessation services, and a C for smoke-free air policies.
“Indiana is missing a clear opportunity to save lives by not taking action to prevent and reduce tobacco use. We must also face the reality that youth use of other tobacco products nationwide like e-cigarettes and little cigars is at an all-time high,” said Monique French, Director of Tobacco Control & Advocacy of the American Lung Association in Indiana, in a statement.
The report recommends that state lawmakers raise the cigarette excise tax — currently 99.5 cents per pack — by at least $1; pass a comprehensive smoking ban that covers casinos, bars and taverns; and increase funding for Indiana’s tobacco control program.
Indiana’s cigarette tax is one of the lowest nationally — ranks 32nd. Though there have been efforts to raise it by $1 during recent sessions, State Rep. Charlie Brown, D-Gary, said the current proposal seems to shift revenues away from smoking prevention and cessation. House Bill 1001, authored by Rep. Ed Soliday, R-Valparaiso, would steer all gas tax revenue from the general fund to roads, and the gap in the general fund would be made up by increasing the tobacco tax by $1 per pack and specifically steer the money to Medicare health care costs attributed to smoking-related illnesses.
“There is discussion currently about raising it, but it’s for the wrong reasons — for road and bridge repair,” Brown said. “I’m totally for raising it but not for this purpose.”
In testimony for the bill, IU Health Cardiologist, Dr. Julie Clary said the tax hike could result in 40,000 Hoosiers quitting, possibly saving 14,000 lives.
Cynthia Sampson, tobacco prevention coordinator for the Northwest Indiana Health Department Cooperative, said price has been shown to be a considerable influence on quitting smoking.
“That’s one of our main focuses with legislators this year,” Sampson said. “They’re still in session so we’ll see what happens. If a tax increases, it decreases use — especially since most people start smoking when they’re young. Very few people start taking up smoking at age 50.
“When you look at other states, smokers are paying little to nothing in Indiana.”
The state passed a smoking ban, written by Brown, in 2012, but it exempted a variety of businesses, including casinos, bars, taverns and private clubs.
“That’s my pet project, the smoking ban, but casinos and bars are still able to convince my colleagues that they’ll lose money and the state will lose revenues without smoking in place,” Brown said. “Several of us don’t believe that and the local bans haven’t proven that at all.”
Smoking cessation and prevention
Locally, hospitals and health care facilities offer smoking cessation classes and the Indiana Quit Line at (800) 784-8669 offers additional counseling for those wanting to quit smoking.
Community HealthNet holds a class called Baby & Me Tobacco Free to help assist pregnant mothers in quitting smoking. Tobacco use has been linked to premature delivery and health complications for both mother and baby, so the program has been a focus in reducing Indiana’s high infant mortality rate.
Darling Pleasant, senior program manager at Community HealthNet, said more than 30 women have entered the program since last March. If they quit smoking during their pregnancy, they will receive $25 vouchers for diapers as long as they stay smoke-free up to a year after delivery.
“They have different barriers,” Pleasant said. “Just like the everyday smoker, they’ll smoke to relieve stress and smoking is a hand-to-mouth sensation. We’ll help them to find other ways to deal with stress and hand-to-mouth alternatives like suckers or peppermints. We’ll encourage them to journal some things as well.”
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Sampson said her agency has been working with local hospitals and physicians to help steer people interested in quitting smoking to the Indiana QuitLIne.
“In the emergency room, they give you a list of questions,” Sampson said. “We want one of the questions to be ‘Do you smoke?’, if so ‘Are you interested in quitting?’. When the answers go into the system, we want to give them the opportunity to get free counseling.”
Sampson said they’re also working with public housing units about making buildings smoke-free and how to effectively enforce the policy.
“We’re in the process of planning an event to educate residents and staff,” Sampson said. “Not all places are smoke-free and there are enforcement issues. We’re working with them to try to enforce policies as they would any other policy. When it isn’t respected, we want them to know that it’s OK to enforce it.”