"A Thousand Lives" Miller Unveils Tobacco Health Plan"Tobacco is a killer, but we certainly can reduce the death toll in Iowa," Miller says. "This is a once-in-a-lifetime opportunity."
DES MOINES-- Attorney General Tom Miller today unveiled a comprehensive program to reduce tobacco addiction and save thousands of lives in Iowa.
"Since the tobacco settlement was finalized last year, more than 3900 Iowans have died from tobacco-related disease and over 9500 Iowa kids have taken up smoking," he said. "Thirteen people die every day and 33 kids take up smoking -- it's time for action."
"Iowa is receiving millions of dollars because of the harm caused by tobacco. Now we need to finish the job and reduce the terrible death toll. This is a once-in-a-lifetime opportunity," Miller said.
Miller asked the Legislature to fund a $20.5 million comprehensive plan including school programs, community projects, smoking cessation programs, a "counter-marketing" media campaign, and efforts to reduce sales of tobacco to minors.
Miller said Iowa's first tobacco industry payment of $76.6 million will be received no later than June 30 next year. His plan would dedicate under one-third of the funds to a comprehensive effort to solve tobacco-related health problems. The remaining payments from the tobacco industry could be used for other purposes determined by the Legislature.
"We focus most sharply on Iowa young people because we know that about nine out of ten smokers began using tobacco as children -- and that about one-third of those who take up smoking will die from tobacco-related disease," Miller said.
Miller called the plan "A Thousand Lives" -- Protecting Iowa Kids from Tobacco Addiction, Disease and Death.
"Tobacco kills 5,000 Iowans a year, but tobacco use is the leading preventable cause of death in America. We can reduce the death toll," Miller said.
"We can reduce Iowa's smoking rate and save a thousand lives a year. When someone stops smoking, there are immediate health benefits, such as reduced chance of stroke and heart attack. And twelve thousand Iowa kids start smoking every year -- we can reduce that."
Miller emphasized that several states already have succeeded in reducing kids' smoking and overall tobacco usage. "Part of my message to lawmakers is that Iowa doesn't have to start from scratch," he said. "Blueprints for success are available. In Iowa we certainly will use the best practices that are working elsewhere. Lawmakers cannot say, 'We don't know if this will work.'"
Miller said California and Massachusetts achieved significant reductions in cigarette consumption correlated with comprehensive efforts they mounted in the 1990s, and that Florida achieved the largest annual decline in youth smoking anywhere in the nation as a result of a comprehensive program that featured a youth-oriented media campaign.
Miller said Iowa's overall smoking rate is 23.1% -- up from 19.4% in 1991. Centers for Disease Control data indicated that 30.4% of Iowa 18- to 24-year-olds smoke, far over the national rate of 24.8%. Tobacco usage by high school students is even higher.
Miller also pointed out that Iowa retailers sold cigarettes illegally to teenagers 36% of the time when a random sample of 362 tobacco outlets was conducted last year by the Iowa Department of Public Health. Iowa could lose $4 million of its Federal substance abuse block grant funds if the noncompliance rate is not reduced to 20% by next year. Efforts to reduce noncompliance are a major element of the plan proposed by Miller.
"This is a life-and-death issue for lawmakers," Miller said. "We can save a thousand lives a year and many thousands of lives if we commit a good share of our tobacco money to solving our tobacco problems."
"A Thousand Lives" -- Comprehensive Plan
Miller proposed a plan totaling $20.5 million for the next fiscal year. "All experience elsewhere shows that successful efforts must be comprehensive and work on many fronts," he said. "We aim at several objectives at once -- increasing youth and public awareness of the specific dangers of tobacco, making children more resistant to starting use of tobacco, countering the misleading tobacco advertising that surrounds us all, and enforcing laws designed to restrict youth access to tobacco and reduce exposure to second-hand smoke."
Elements of the plan:
Youth, Community, and Statewide Partnerships: $4.5 million.
Miller said community coalitions have won some of the best successes on the tobacco-health front. One hallmark would be youth action -- a statewide youth tobacco corps to educate others and help design effective media and other programs, and teen tobacco summits to galvanize youth participation. Local and statewide organizations of all types would be involved -- youth, parents, trade, professional, civic, religious, health, and law enforcement, for example.
Cessation Programs: $3 million.
Miller noted: "The CDC tells us that helping youth and adult smokers quit produces some of the quickest and largest short-term public health benefits of all. Smokers who quit before age 50 cut in half their risk of dying in the next 15 years, for example."
The cessation project would help create and support cessation programs, support 24-hour help-lines for around-the-clock support and information for people trying to quit, and work to make cessation programs available to all, including low-income Iowans.
Research: $1 million.
"We will need solid research to be sure we have a program that is carefully tailored to Iowa and effective," Miller said. Key subjects include finding the best ways to reduce illegal sales to youth, and determining the most effective media strategies, cessation programs, and community and school projects.
Media Campaign: $6.2 million.
"The tobacco industry bombards us with $5 billion in advertising and promotions each year -- including about $50 million in Iowa," Miller said. "We need to fight back to depict the danger of tobacco and de-glamorize smoking. This has proven to be crucial -- and effective."
The media campaign would include TV, radio, print, billboards, and other media. Young Iowans would be the primary target audience. Special messages also will be directed to parents, pregnant mothers, and smokers wishing to quit.
"We will not demonize smokers," Miller said, "but we will tell the truth about tobacco. We will fight back against the image portrayed by the industry -- that smoking is glamorous, social, and normal."
Local Enforcement of Tobacco Control Laws: $2.5 million.
"Our 36% non-compliance rate is unacceptable, and it could be extremely costly to Iowa," Miller said. (Federal substance-abuse grants to Iowa are slated to be cut by $4 million if the noncompliance rate doesn't fall to 20% by 2000.) Miller's plan would provide grants to communities to dedicate officers to enforcing tobacco laws pertaining to retailers, retail clerks, and under-age smokers -- an arrangement proven to be effective in numerous communities. The program would provide more training for local officials and for retailers.
School Programs to Reduce Tobacco Use: $2 million.
The state funds would assist local schools in numerous efforts -- providing proven, age- appropriate curricula for students, training teens to reach teens, supporting in-school cessation programs, strengthening school/community coalitions, training teachers, and involving parents. The greatest at-risk period for starting smoking is ages 10 through 17, Miller noted.
Statewide Tobacco Law Unit: $300,000.
The unit in the Dept. of Justice would advise and train local and state officials on laws relating to tobacco control, track legal developments in other states and at the federal level, act as a resource for lawmakers and local officials, and enforce provisions of the Master Settlement Agreement with the tobacco industry (advertising restrictions and other measures.)
Monitoring and Evaluation: $700,000.
Miller recommended that one of Iowa's state universities should be charged with monitoring and evaluating the State's overall program. "We need to be accountable, with specific goals and specific measures of performance," he said. "We are completely dedicated to making this an effective program both to protect taxpayers and improve the health of Iowans."
Administration and Management: $300,000.
The Iowa Department of Public Health would be charged with administering the program -- coordinating state agencies with significant roles (Public Health, Education, Revenue, Justice, and Human Services), and awarding and monitoring contracts and grants to local communities and programs. A state-level tobacco advisory committee would be created to guide the overall tobacco control effort.
Miller displayed figures telling how many Iowans had died of tobacco-related disease since the tobacco settlement was reached 291 days ago on Nov. 23, 1998 -- 3,950, more than 13 per day.
The chart also showed how many Iowa youth had started smoking since the settlement -- 9,570, about 33 per day.
"I call on the Legislature to cut this terrible death toll," Miller said. "We have the funds from the tobacco industry to tackle the tobacco problem, and we have programs we know can work. It's time we get it right for our kids and for our future."