States With High Lung Ca Rates Spend Less on Control

WASHINGTON—The failure of most states to put the money they
receive from the Master Settlement Agreement with the tobacco industry into
tobacco-control programs will increase their future health care costs for
lung cancer and other tobacco-related illnesses, according to two nonprofit
health groups. An independent analysis of data published in October 2002
found that states with the highest incidence of lung cancer generally spent
the least amount of money for tobacco control.

The finding emerged from an analysis prepared by It’s Time
to Focus on Lung Cancer, a joint advocacy campaign of Cancer Care, Inc.,
and the CHEST Foundation. "We found that the 10 states with the highest rates
of lung cancer among men averaged $1.93 per capita for tobacco control," said
Diane Blum, executive director, Cancer Care. "For women, the average spending
was $2.67."

The Centers for Disease Control and Prevention (CDC) has
published guidelines for how much each state should spend per resident on
tobacco control. The recommended amounts—which were determined using several
criteria that included a state’s smoking incidence, its costs accrued from
smoking-related illnesses, and the prevalence of smoking in various age
groups—range from $5.12 (California) to $15.39 (Wyoming) per capita.
Nationally, the per capita average for the states is $7.47.

Only six states—Arizona, Hawaii, Indiana, Maine,
Massachusetts, and Mississippi—spent more on tobacco control per capita in
2001 than the CDC recommendation. Tobacco control budgets in 2001 ranged from
$0.10 per capita in Pennsylvania to $15.47 in Maine.

Kentucky Falls Below the Mark

Kentucky—which had the highest incidence of lung cancer per
100,000 residents for both men (121.7) and women (58.5)—spent $0.84 per
capita on tobacco control efforts. The CDC guidelines for Kentucky recommend
$6.42. All 10 states with the highest incidences of lung cancer for men and
women are spending less than the CDC recommends.

The analysis used the American Cancer Society’s lung cancer
incidence estimates for 2001, as well as state tobacco-control expenditure
data compiled and published in the October 4, 2002, issue of the New
England Journal of Medicine by Cary Gross, MD, of Yale University and his
colleagues.

The new analysis was released during a national telephone
press conference designed to promote the need for higher spending by the
states to curb tobacco use. "Showing this data to officials of states
hopefully will bring more money to smoking cessation," said CHEST Foundation
president Diane D. Stover, MD, a pulmonologist at Memorial Sloan-Kettering
Cancer Center.

After completion of the Cancer Care/CHEST Foundation report,
but before the press conference, CDC released its cancer incidence figures
for the year 1999. "Our conclusions stood up very well with the CDC data,"
Ms. Blum commented.

Seven states ranked in the top 10 for the highest lung cancer
rates among both men and women: Delaware, Florida, Kentucky, Maryland,
Missouri, Rhode Island, and West Virginia. The women’s top 10 list also
included Alaska, Nevada, and Washington. Louisiana, North Carolina, and Texas
completed the men’s list.

The 10 states with the highest lung cancer rates received an
average per capita payment of $32.23 from the settlement agreement in 2001
and spent an average of $2.10 per male resident for tobacco control. States
with the top 10 lung cancer incidences among women averaged $30.09 in
settlement revenue and spent $2.74 per woman.