Wednesday, October 25, 2000

The burden of tobacco use in Georgia

When we think of the end result of tobacco use, what normally comes to mind is the anguish of addiction, and the enormous physical and emotional toll of catastrophic disease.

A recently released report compiled jointly by the Georgia Department of Human Resources (DHR) and the Coalition for a Healthy And Responsible Georgia (CHARGe) gives a more in-depth view of tobacco's true costs to Georgians. The following is a synopsis of that report.

According to the 1996 Georgia Vital Statistics Report, tobacco use caused more than twice the number of preventable deaths due to motor vehicle injuries, suicides, homicides, alcohol, and drug-induced deaths combined. Ten thousand or more Georgians are killed and $1.2 billion is drained from our economy in health care costs by tobacco use each year. Approximately 80 percent of this dollar cost is born by taxpayers.

An additional $38-108 million in healthcare costs per year are directly related to the health problems incurred by infants whose mothers smoked during pregnancy (accounting for 17-26 percent of low birth-weight babies, up to 14 percent of premature deliveries), and/or who are exposed to secondhand smoke. Maternal smoking accounts for 10 percent of all infant deaths.

These costs continue to increase as healthcare becomes more technologically advanced, and expensive. As we experience the "graying of America," the aging population of tobacco users ensures that these costs will continue well into the future.

And what of the future? It has recently been estimated that 30,000 children in Georgia start smoking every year, and another 10,000 begin using spit tobacco products. Even more frightening is the projected 131,000 premature deaths that will occur as these children grow to nicotine addicted adulthood, shearing an average of 15 years from their life span.

Among children and adolescents tobacco use generally progresses in four stages: forming accepting attitudes and beliefs about tobacco; experimenting; regular tobacco use; and finally, nicotine addiction. Tobacco use is usually the first experimental drug youth come in contact with, and it can have immediate as well as long term negative physical effects on health. Spit tobacco can contain four times the amount of nicotine in one chew as there is in one cigarette.

There is also a fairly new fad, that encourages teens to smoke cigars and foreign made flavored cigarettes called "Bidis." Bidis are particularly hazardous in that they are foreign made with little quality control.

Therefore, in addition to containing possibly four times the amount of nicotine of an American made cigarette: they are just as liable to contain any number of contaminants. But youth are enticed by their exotic look and taste.

There are several other facets of the burden of tobacco on our children.

In Georgia, the average age of initiation for tobacco use is between 10 and 13. The 1999 Georgia Youth Tobacco Survey (GYTS) revealed that 27 percent of eighth-grade students are current tobacco users. More than half of all middle school students have experimented with some form of tobacco (1999 GYTS).

In 1999, 39 percent of Georgia's eighth-grade students reported having tried cigars. During the 1999 compliance checks for sales to minors, more than 40 percent of underage youth were able to purchase their own cigarettes through vending machines in Georgia.

A 1997 national survey indicated that among students under 18 years old who were current smokers, almost 67 percent reported never being asked to show proof of age when buying cigarettes in a store.

An estimated $146 million is spent on tobacco advertising in Georgia each year. A 1998 national survey showed that, of adolescents who are current smoker, more than 92 percent report using the three most heavily advertised brands of cigarettes.

Though we may sometimes wonder what all the fuss is about, secondhand smoke is also a danger that bares a cost in lives and health. Over 53,000 deaths and illness in over 300,000 children every year are attributable to secondhand smoke. The damaging effects on infants and children include: Sudden Infant Death Syndrome (SIDS), asthma induction and exacerbation (bringing on attacks), bronchitis and pneumonia, middle ear infection, chronic respiratory symptoms, and low birth weight.

We can better understand why mere exposure to tobacco smoke results in such severe consequences when we recognize that secondhand smoke contains over 4,000 chemicals 43 of which are classified as Group A Carcinogens (cancer causing agents).

Secondhand smoke is the third leading preventable cause of death in the United States. The burden of tobacco use in terms of the loss of human life and productivity due to debilitating disease is great. It is a major cause of heart disease, bronchitis, emphysema, and stroke, cancers of the lung, larynx, pharynx, and esophagus, and a contributing factor to cancers of the bladder, pancreas, cervix and kidney.

Spit or chew tobacco is a major cause of cancers of the mouth. In 1998, 24 percent of Georgia adults were current smokers.

In the final analysis, the burden of tobacco use falls on us all economically, socially, and/or physically. It has been estimated that building a comprehensive, sustained, multi-year tobacco prevention program would save the taxpayers billions of dollars, and more importantly save thousands of lives.

While the CDC recommends a minimum of $42.5 million per year (or $5.69 per capita) for such a program in Georgia, the state currently allocates per capita funding of only $2.11 for tobacco prevention. This amounts to only 37.1 percent of the recommended minimum.

Of the $150 million of the states' tobacco settlement payments in the FY 2001 budget signed by Governor Roy Barnes, only $15.8 million was allocated for tobacco prevention and cessation programs.

In his report "Reducing Tobacco Use," Surgeon General Dr. David Satcher states: "It is clear that the major barrier to more rapid reductions in tobacco use is the effort of the tobacco industry to promote the use of tobacco products. Our lack of greater progress in tobacco control is more the result of failure to implement proven strategies than it is the lack of knowledge about what to do."

For more information on this subject contact Mrs. Jill Holmes Long, Tobacco Coordinator, District 4 Public Health in Griffin. Or, you may wish to log on to the following sites: www.chargecoalition.org/information/index.html or www.cdc.go/tobacco/index.htm.

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