RI Earns An "F" In Tobacco Prevention Effort: Lung Association

A new report from the American Lung Association finds that both federal and many state governments are not doing enough to prevent and reduce tobacco use. Although cigarette smoking rates among youth and adults are at an all-time low, the ALA's annual “State of Tobacco Control Report” contends there has been a “dramatic and extremely troubling” rise in youth use of e-cigarettes -- 78 percent -- from 2017 to 2018.

Overall, Rhode Island received two F grades, one C grade, a B grade and an A grade in the five categories graded in the report.

Bettering that grade, the ALA said, would require Rhode Island to :

1. Raise the minimum age of sale for tobacco products from 18 to 21
2. Increase funding to the Rhode Island Department of Health's tobacco control program
3. Increase the number of local ordinances that license and/or limit the sale or use of tobacco products

Increasing E-cigarette use, the report says, could set the stage “for not only another generation of Americans addicted to tobacco products, but ultimately more tobacco-caused death and disease.” It goes on to criticize the U.S. Food and Drug Administration for failing to use its full authority over the manufacture, marketing and sale of tobacco products to put meaningful restrictions in place, and gives the agency an “F” grade for regulation of tobacco products.

The report blames the FDA’s inaction for the steep rise in e-cigarette use among youths. It also singles out the popular e-cigarette “JUUL,” which it says has claimed the largest share of the overall e-cigarette market in a very short time period. Sales restrictions implemented by the FDA on flavored products don’t go far enough, as they don’t apply to mint or menthol of e-cigarettes, the report says.

An article cited in the publication says that more than 50 percent of high schoolers use mint or menthol e-cigarettes. Furthermore, the American Lung Association says, the FDA’s decision to delay the review of all e-cigarettes until 2022 also contributed to the rise of e-cigarette use among youths.

However, the Lung Association did praise the FDA for undertaking two measures: a proposed rule that would prohibit the sale of menthol cigarettes and all flavored cigars, as well as a nationwide media campaign focused on reducing e-cigarette use among youths aged 12 to 17.

The Lung Association said that overall, states “continued their unfortunate record of failing to put in place the proven policies” called for in the report to reduce deaths caused by tobacco.

The policies the organization says states should adopt are:

• Increase funding for tobacco control programs and focus these programs on at-risk populations
• Comprehensive smoke-free laws must be passed in the 22 states that do not have them
• Expand comprehensive cessation coverage in all-Medicaid programs
• Increase tobacco taxes and equalize taxes across all tobacco products
• Increase the minimum age of sale to 21

The report also pointed out positive measures adopted by states; Massachusetts became the sixth state to pass a law increasing tobacco sale age to 21; Oklahoma and the District of Columbia approved significant increases to state tobacco taxes; and Kansas and New Jersey expanded Medicaid coverage for smoking cessation treatments.

Each state was given a grade for the five policies recommended in the report and while no state received an “A”in each category, the Lung Association says the states doing the best job are Alaska, California, Hawaii, Maine, Massachusetts and the District of Columbia.

In Rhode Island, the grades for each category were:

• Tobacco Prevention and Cessation Funding: F
• Smokefree Air: A
• Tobacco Taxes: B
• Access to Cessation Services: C
• Tobacco 21: F

"All states and the federal government can do more to reduce tobacco use; the FDA in particular has been asleep at the switch for far too long. Their failure to act for years set the stage for e-cigarette use among youth to finally explode into an epidemic," American Lung Association President and CEO Harold P. Wimmer said in a news release. "We call on the FDA and Commissioner Gottlieb to make 2019 the year it takes decisive action on youth e-cigarette use and removes menthol cigarettes and flavored cigars from the marketplace."

You can read the full report from the American Lung Association here.

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