Are We Doing Enough to Prevent Death and Disease from Tobacco Use?
We know how to reduce and prevent tobacco use - we can do more to save lives

Thanks to the success of tobacco prevention and quit smoking policies, adult and youth cigarette smoking rates are at historically low levels. Despite this promising trend, tobacco still remains the leading cause of preventable death and disease in the United States, taking 480,000 lives every year. And with more than one in four high school students still using at least one tobacco product, our nation's youth may also be set up for a lifetime of addiction and tobacco-caused disease, unless more is done to prevent and reduce tobacco use and protect against the harms of secondhand smoke.

1. Reduce rates of smoking and other tobacco use to less than 10 percent for all communities by 2024;
2. Protect all Americans from secondhand smoke by 2019; and
3. Ultimately, eliminate the death and disease caused by tobacco use.

These goals are ambitious but we know that together, we can accomplish them.

The American Lung Association's 15th annual "State of Tobacco Control " highlights our progress toward these goals, as well as a call to action for state and federal governments.

Positive actions taken in 2016 include the final rule that will make all U.S. Department of Housing and Urban Development public housing smokefree, and the release of the long-awaited final rule that gives the U.S. Food and Drug Administration oversight over cigars, e-cigarettes, hookah and other tobacco products in addition to cigarettes and smokeless tobacco. These actions lay an important foundation for new leaders in Washington, D.C., and in state capitols across the country to meet these bold goals.

However, if we want to save lives, more must be done.

As of 2015, 36.5 million adults, or 15.1 percent, were current smokers. In order to reduce rates of smoking and other tobacco use to less than 10 percent for all communities by 2024, we need states to dramatically increase their efforts to prevent and reduce tobacco use.

• Tobacco products are extremely addictive, and if you want to stop that addiction, the best way to do that is to prevent tobacco use before it starts. Only two states are funding tobacco prevention programs at or above the Centers for Disease Control and Prevention's recommended level. In addition, tobacco taxes are highly effective in preventing youth tobacco use, but only three states increased their cigarette taxes by significant amounts in 2016.

• According to a 2015 report from the National Academy of Medicine, if the minimum sales age for tobacco products were increased to 21, tobacco use would decrease by 12 percent by the time today's teenagers are adults, and nationwide it could prevent 223,000 deaths among those born between 2000 and 2019. These numbers are significant, and yet only two states and the District of Columbia have passed laws increasing their minimum age for tobacco products to 21.

• When it comes to helping smokers quit, only eight state Medicaid programs--California, Connecticut, Indiana, Maine, Massachusetts, Missouri, North Dakota and Ohio--cover a comprehensive tobacco cessation benefit to help smokers quit, including all seven FDA-approved medications and three forms of counseling for Medicaid enrollees. In 2016, Missouri became the first state Medicaid program to have no barriers to accessing quit smoking coverage - which should serve as an example to the others.

The harms of tobacco use also extend to those exposed to secondhand smoke. There is no safe level of secondhand smoke according to a 2006 report from the U.S. Surgeon General, yet 22 states have not passed comprehensive smokefree laws. With its partners, the American Lung Association has committed to protect all Americans from secondhand smoke by 2019. Unfortunately, progress in states has stalled when it comes to the passage of smokefree protections. Although there are 22 states that have yet to pass smokefree workplace laws, since 2012 zero states have done so.

In recent years, we have seen the emergence of e-cigarettes as a popular tobacco product, especially among youth. Being new tobacco products, e-cigarettes are not often included in previously passed smokefree laws, and the safety of e-cigarette aerosol (the secondhand emissions) is also widely mischaracterized. A recent report from the U.S. Surgeon Genera l on e-cigarette use among youth found that e-cigarette aerosol is not "water vapor," and exposure to it is not safe. That's why the American Lung Association supports including e-cigarettes in smokefree laws, and this year's "State of Tobacco Control" report commends California, Vermont and Washington, D.C., for joining the seven other states that have included e-cigarettes in smokefree laws in 2016.

Finally, the Lung Association committed to ultimately, eliminating the death and disease caused by tobacco use. The American Lung Association actively pushes for strong laws to protect Americans from the harms of secondhand smoke and to prevent and reduce tobacco use. As the nation's first voluntary health association, the Lung Association has a long history of helping smokers quit and supporting patients and their caregivers. We will continue to offer proven methods to quit tobacco through Freedom From Smoking and the toll-free Lung HelpLine - 1-800-LUNGUSA.

We know how to prevent and reduce tobacco use and save lives, and "State of Tobacco Control" serves as a road map for state and federal policymakers to do so. We call on lawmakers to consider the lives lost, and the lives that could be saved by taking action to put in place the tobacco control policies called for in "State of Tobacco Control 2017."