33% of state cancer deaths smoking-linked, study finds

A third of cancer deaths in Arkansas can be attributed to cigarettes, ranking the state second behind Kentucky among states with the highest percentage of smoking-related cancer deaths, a new study shows.

Arkansas topped the U.S. in the percentage of cigarette-related cancer deaths among men -- 40 percent -- and ranked fourth among women, at 26 percent, according to the study, published Monday in the journal JAMA Internal Medicine.

The top-10 ranked states, for both men's and women's smoking-related cancer mortality rates, were mostly located in the South, where cigarette smoking tends to be more common.

Nearly 25 percent of adults smoke cigarettes in Arkansas, for instance, placing the state just behind Kentucky and West Virginia, according to 2015 federal Centers for Disease Control and Prevention figures. About 16 percent of high-schoolers also smoke, putting Arkansas above the national average.

The study's authors said they calculated state-level information of smoking-related cancer deaths, which was not available before, to lend states more information that could guide "initiatives at the forefront of tobacco control."

The cancer deaths due to cigarette smoking were calculated using the risks of 12 smoking-related cancers found in CDC surveys and other large studies, the authors said.

Dr. Gary Wheeler, chief medical officer for the state Health Department, agreed with the report's intent and expressed hope that its "timeliness" would prompt "state legislators to go to the revival tent and re-think" about how to make tobacco prevention policies a priority.

Wheeler also said the findings, because they deal with mortality rates, represent outcomes of legislative action, or inaction, from prior decades.

"What we are seeing now reflects what was happening for 20 or 30 years," he said. "Other states, like California, have been using known effective tools for limiting tobacco use and made stark progress."

Wheeler said he has been advocating for tobacco prevention and cessation programs, "counter-marketing" efforts and certain measures, such as expanding Clean Indoor Air ordinances to include all public establishments or bumping the cigarette purchasing age from 18 to 21.

In June, lawmakers voted against reviewing the $1.8 million contract of Arkansas' smoking "quitline," after Sen. Bart Hester, R-Cave Springs, along with other legislators, questioned the program's cost and effectiveness. Without a review, the contract could not take effect, but in August, the contract was extended until the end of the fiscal year next June.

Wheeler said he believed the Health Department "made peace" with legislators about the hotline after delivering another pitch to keep it open.

"From a public health point of view, not using all these tools, or at a non-effective level, is like taking birth control half the days. You really should do it right," Wheeler added. "We need to focus on this issue and how much it's costing us in terms of dollars and lives."

The cost to Arkansas has been steep. In 2009, more than $1.2 billion covered smoking-related expenditures, according to the Centers for Disease Control and Prevention. At that time, the state's annual average tobacco-related death toll was 16,344.

Health care costs remain substantial as expenditures made by tobacco lobbyists have mostly increased.

In 2014, lobbyists in the industry funneled at least $160,415 in campaign contributions to state and federal politicians in Arkansas, according to the National Institute on Money in State Politics, a nonpartisan campaign finance watchdog group. From 2000 to 2008, spending ranged from about $34,000 to $42,000, but jumped to $78,850 in 2010, and $123,225 in 2012.

Some health groups say that Arkansas as well as most states is not doing enough to end tobacco use.

The American Lung Association gave Arkansas a D or F grade in multiple tobacco-prevention categories, including cessation funding and cigarette taxes. The association leads a campaign petitioning elected officials to pass budgets more aligned to federal "best practices" spending recommendations for tobacco prevention funding.

In fiscal 2016, the association reported that the state spent $16.6 million on tobacco prevention and cessation programs, just half the amount recommended by the Centers for Disease Control and Prevention. The health agency separately calculates an amount recommended for each state.

During the same year, however, state tobacco-related revenue totaled more than $270 million. The $1.15-per-pack state-imposed cigarette tax ranks Arkansas 33rd among all states and falls below the overall average of $1.65.

Arkansas also receives about $50 million each year, its share from the 1998 national settlement with tobacco companies.

A Section on 10/25/2016

Upcoming Events