Success in California

Photo Credit: Ben Heine
A recent peer-reviewed study shows that California's tobacco control program has saved billions in health care costs just within its first fifteen years. The full article can be viewed at http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050178

The study examined cigarette consumption, tobacco control expenditures, and health care costs in the years between 1980 and 2004. The most telling finding is that 86 billion dollars were saved in the first fifteen years of the program. The health care cost reductions observed were substantial, rapid, and grew over time. The savings in health care costs were fifty times what the program expenditures were!

California's program is unique in the sense that it focuses on media campaigns and policy which specifically target adults instead of teens and youth. Hopefully this report will be the proof that Wisconsin needs to ensure a well funded tobacco prevention and control program. This study shows that tobacco control programs not only reduce smoking and prevent disease, but also quickly and significantly reduce health care costs.

Spotted - warning labels in Europe

Smoke-free air ordinance reduces asthma hospitalizations

A study published this week in the Journal of Allergy and Clinical Immunology concluded that smoke-fee laws reduced asthma emergency room visits by more than a fifth.

University of Kentucky researchers assessed emergency room visits for asthma in the Lexington area before and after the enactment of a county-wide smoke –free law. They found that, after 32 months in effect, the smoke free law dropped asthma emergency room visits by 22%. Those are HUGE numbers for Kentucky!

What does that mean for Wisconsin?

In Wisconsin, there were over 22,000 hospital emergency room visits for asthma last year costing over $17 million, according to the Wisconsin Department of Health Services. While the research can’t be extrapolated directly, a one-fifth drop in asthma visits in this state would save $3.4 million.

About 13 percent of Wisconsin’s population suffers from lifetime asthma, a chronic lung condition triggered by allergies, viral infections and irritants like tobacco smoke.

When Wisconsin goes completely Smoke-free, the citizens of the state could save as much as $3.4 million in asthma visits alone. When you add in the cost of all other health complications caused by second-hand smoke the savings in health care is quite significant.

It’s time for Wisconsin to go smoke-free, it’s time to save hard working Wisconsinites millions of dollars in health care costs.

What would you buy with the money tobacco costs you?

$10,000,000,000

That's 145 million Packers tickets
Or 3.5 million tickets to see the Packers in next year's Super Bowl
Or 250 million gallons of gas to get you there
$10 billion?

According to the American Legacy Foundation’s report, Saving Lives, Saving Money II, that's the savings taxpayers could enjoy with an increased focus on tobacco cessation and prevention.

According to the report, if all current Wisconsin smokers on Medicaid successfully quit long-term, the state could spend almost 7% less - a whopping $245 million. Nationwide, those Medicaid savings translate to billions. Prevention saves dollars as well. If Wisconsin could permanently stop all smoking among current 24-year olds, Medicaid savings over their lifetimes would be $16.8 million. Nationwide, such prevention could save nearly a billion dollars.

Of course, there are far more important numbers than $10 billion. Try 8.6 million. That's the number of Americans living with preventable tobacco-related disease each day. From Medicaid to final expenses, an increase in tobacco cessation and prevention would save both lives and cash.

Guest Post: One Victim in the 100 Years War

Special thanks to Roger for this guest post!

Each of us involved on the various fronts of the 100 Years War on Tobacco probably has an emotional connection to someone who lost their lives because of tobacco use. I suspect that loss in some way fuels the blow torch of change that each of us feels is necessary. I am no different than you.

Before I tell my story, the phrase "100 Years War on Tobacco" may have slowed your reading pace. The director of UW-CTRI, Michael Fiore, has recently begun using that phrase to describe the protracted and sometimes frustrating struggle in which we are engaged. Dr. Fiore identifies the start of the 100 Years War on Tobacco with the first Surgeon General's warning on tobacco use in 1964. We are close to being halfway through the 100 Years War and our victories in drastically reducing adult tobacco-use rates and rapidly increasing the number of states with tobacco-free worksite laws is remarkable.

A small part of our common success is encouraging clinicians who treat tobacco users to use the best evidentiary tobacco cessation treatments at every patient visit. The clipped shorthand reminder is to have the tobacco talk with "every patient at every visit." The every patient at every visit intervention is a consistent and necessary attack to help patients permanently remove the cigarette, cigar, pipe or wad of tobacco from their lives. Ten years ago, a clinical model to treat every patient at every visit was introduced and we know it as the Five A's: Ask, Assess, Advise, Assist and Arrange.

While we are thankful that the Five A's model is here, my family could have used that model in the first decade of the 100 Years War instead of in the fourth.

I'd like to introduce you to my dad, Richard (Dick) Dier. Born in Fort Frances, Ontario in 1935, like a lot of Canadian kids he took up the national sport-ice hockey-and Dick Dier was good at it. When he was 13, his parents moved their family across the Rainy River to the International Falls, Minnesota. Sometime in the late 1940s, he put his first cigarette in his mouth.

As my dad grew into a young adult, he continued to smoke and continued to play hockey. Being an athlete who strove to be in top condition despite smoking a pack or two a day were diametrically opposite behaviors, but tobacco addiction, like many addictions, trashes the rational order of things. In 1958, investors launched a professional hockey team called the Green Bay Bobcats. My dad hopped on a DC-3 and flew south from Northern Minnesota to Green Bay to try out for the Bobcats and he made the team at age 23.

He never stopped smoking as the years in his 30s and 40s sped by. In 1991, he was having problems with one of his knees (most likely some clutter was floating around from his hockey-playing days), so he went to an orthopedist who prescribed minor surgery to clean up his knee. During that visit, when my dad was 56 years old, someone noticed that he had early signs of COPD, or chronic obstructive pulmonary disease. That nurse or doctor advised him to quit smoking. My dad said he would think about it.

A week later my dad called that doctor's office and said he wanted to try to quit. He got a prescription for the patch, and a month later was smoke-free for the first time in 40 years.

The date he quit smoking was something of which he was proud: Each year, he took my mother out for dinner on the anniversary of his quit date. I had quit smoking and using spit tobacco when I was in my late 20s, but my two brothers, their families and my family were very relieved when he quit. By quitting, I thought he and we had caught a break. My dad and my mom were in their mid-50s and healthy; their children were on their own, their work careers were winding down and the warren of grandchildren to spoil was growing.

In the spring of 1995 my dad dropped a little weight. I saw him on his 60th birthday (June 24, 1995) and noticed his weight was down. I didn't say anything and remember feeling happy because he had gotten pudgy since quitting. In late July and early August of that year, his face would sometimes be puffy when he woke up in the morning. One Saturday morning in mid-August I biked over to my parents' house and rapped on the back door. My dad had just gotten up and I was stunned: His face was so swollen that it looked as if it were beaten with two-by-fours.

The following Monday I called his doctor and they told my dad to come in. When he did, they took an X-ray and saw a shadow. That led to a CT scan, which revealed a significant mass that was impeding the flow of blood back to his heart when he was lying down.

He went in for a biopsy on Oct. 17, and I'll always remember him talking to the surgeon before they wheeled his gurney into the operating room. He grabbed the surgeon's hand with both of his and asked the surgeon to please fix his face.

They found a cancer, and it was virulent. As his oldest son, I gathered his entire medical history, from International Falls to Green Bay, and took all of it and him to Mayo Clinic for a second opinion and we hoped, a second chance. Before we left, I noticed that in all of his examinations before 1991 not one clinician talked to him about his smoking. The first time a clinician told him he needed to quit smoking occurred in that pre-surgery consult in 1991.

The journey from life to death for someone suffering from lung cancer is too visually horrible and emotionally painful to recall here. I will share this, however: On our way back from Mayo Clinic, he rued the day he ever started smoking and said, "Those goddamn cigarettes, they just don't let you go."

I often share my dad's story with clinicians, and their crowded lives being what they are, I suspect that it's one of the few things they take away from my presentations. My dad died on Feb. 12, 1996, about 100 days after he was first diagnosed. He was only 60 years old and he wasn't ready to leave his wife, his children, his grandchildren, his friends or his life.

I tell my dad's story to help clinicians understand how much power and responsibility they have when they talk to their patients who use tobacco. I am haunted to know that if a clinician had talked to him about quitting smoking in 1961, 1971 or 1981 instead of waiting until 1991, Dick Dier might be 73 years old today and wondering why the Green Bay Packers ever parted ways with Brett Favre.

This guest post was written by Roger Dier, a UW-CTRI outreach specialist in the Northeast Region of Wisconsin.

Please feel free to share your story below in the comments section or at www.mysmokefreestory.com

Navajo Nation’s Smoke-Free Legislation

In a historic win, the Tribal Council of the Navajo Nation approved legislation that prohibits the non-ceremonial use of tobacco products in all areas of the reservation except personal residential property. This INCLUDES casinos!!

What a giant leap forward for the smoke-free movement. The Navajo Nation is the first among all the Indian tribes to go smoke-free. So many more people will be breathing cleaner air due to this legislation.

For more information visit, www.navajo.org.