Washington Fails to Protect Its Residents from Tobacco and Nicotine

Washington state has received a failing grade in its efforts to prevent and reduce tobacco and nicotine use, according to a new report by the American Lung Association. The report, released on January 25, 2023, evaluates state and federal policies on tobacco control and highlights the need for stronger action to protect public health.

The report grades states and the District of Columbia in five areas that have been proven to prevent and reduce tobacco use and save lives:

• Strength of Smokefree Workplace Laws
• Ending the sale of all flavored tobacco products
• Funding for State Tobacco Prevention Programs
• Level of State Tobacco Taxes
• Coverage and Access to Services to Quit Tobacco

Washington received an “F” grade in four out of the five categories, and a “D” grade in the fifth category. The only area where Washington did not receive an “F” grade was in smokefree air, where it received a “D” grade for having a comprehensive law that prohibits smoking in most indoor public places and workplaces.

Washington is one of the 45 states that received an “F” grade for failing to end the sale of all flavored tobacco products, including menthol cigarettes, flavored e-cigarettes, and other products that appeal to youth and young adults. Flavored tobacco products are a major driver of the youth tobacco epidemic, as they mask the harshness of tobacco and make it easier to start and harder to quit.

Washington also received an “F” grade for its inadequate funding of tobacco prevention and cessation programs. According to the report, Washington spent only $1.5 million on these programs in fiscal year 2023, which is less than 1% of the $264.5 million recommended by the Centers for Disease Control and Prevention (CDC). The report notes that investing in tobacco prevention and cessation programs can save lives and money by reducing tobacco-related diseases and health care costs.

Another area where Washington failed to meet the standards was in tobacco taxes. Washington has a cigarette tax of $3.03 per pack, which is higher than the national average of $1.88 per pack, but still far below the $4.50 per pack recommended by the American Lung Association. The report states that increasing tobacco taxes is one of the most effective ways to reduce tobacco use, especially among youth and low-income populations, as it discourages initiation and encourages cessation.

The final category where Washington received an “F” grade was in coverage and access to services to quit tobacco. The report evaluates the extent to which state Medicaid programs, state employee health plans, and private insurance plans cover the seven FDA-approved medications and three forms of counseling to help tobacco users quit. The report found that Washington’s Medicaid program and state employee health plan do not cover all of these treatments, and that there are barriers and limitations that prevent tobacco users from accessing them. The report urges states to remove these barriers and ensure that all tobacco users have access to comprehensive and affordable cessation services.

Washington Needs to Take Action to Protect Its Residents from Tobacco and Nicotine

The report concludes that Washington has a lot of room for improvement in its tobacco control policies, and that it needs to take action to protect its residents from the harms of tobacco and nicotine. The report recommends that Washington should:

• End the sale of all flavored tobacco products, including menthol cigarettes and flavored e-cigarettes
• Increase funding for tobacco prevention and cessation programs to at least the CDC-recommended level
• Increase the cigarette tax by at least $1.50 per pack and apply an equivalent tax to other tobacco products, including e-cigarettes
• Ensure that all tobacco users have access to comprehensive and affordable cessation services, regardless of their insurance status or type

The report also calls on the federal government to take action to support state and local efforts to prevent and reduce tobacco use, such as:

• Finalizing the rule to end the sale of menthol cigarettes and all flavored cigars
• Enforcing the premarket review requirement for all tobacco products, including e-cigarettes
• Implementing graphic health warnings on cigarette packs and advertisements
• Increasing the federal tobacco tax and indexing it to inflation

The report warns that tobacco use remains the leading cause of preventable death and disease in the United States, killing 480,000 people each year and costing the nation $170 billion in health care expenses and $156 billion in lost productivity. The report also highlights the disproportionate impact of tobacco use on certain populations, such as racial and ethnic minorities, LGBTQ+ individuals, low-income communities, and people with mental health and substance use disorders.

The report states that the COVID-19 pandemic has underscored the urgency of addressing tobacco use, as it increases the risk of severe complications and death from the virus. The report also notes that the pandemic has created new challenges and opportunities for tobacco control, such as the increased stress and isolation that may trigger tobacco use, and the increased motivation and availability of telehealth services to help tobacco users quit.

The report urges policymakers, health professionals, advocates, and the public to take action to end the tobacco epidemic and protect the health and well-being of all Americans.