Stung by criticism from anti-smoking advocates who fear he’ll diminish efforts to combat tobacco use, Indiana Health Commissioner Dr. Gregory Larkin is working to calm those worries.
In an editorial sent to Indiana newspapers on Memorial Day, Larkin announced plans to increase funding for local projects that target current smokers and teenagers who are tempted to light up for the first time.
And in an interview with the Tribune-Star Statehouse Bureau, Larkin endorsed a comprehensive smoking ban, modeled on the one in Monroe County, Ind., that prohibits smoking in bars, restaurants, retail shops, and vehicles with children as passengers.
In addition, Larkin said he plans to be “engaged” in any future efforts to pass a statewide smoking ban, following a legislative session that saw a watered-down version killed after anti-smoking advocates came out against it.
Citing evidence that comprehensive smoking bans in other states have been shown to reduce tobacco use, Larkin said Indiana legislators should follow suit. “The more communities that are protected, the better,” Larkin said.
Prompting his actions: Sharp criticism from anti-smoking advocates, including the American Cancer Society, about the legislature’s decision to abolish the executive board of the independent Indiana Tobacco Prevention and Cessation agency, known as ITPC, and shift its money and duties to the Indiana State Department of Health, which Larkin heads.
The change becomes effective July 1.
Dr. Stephen Jay, an Indiana University public health expert and member of ITPC’s executive board that was dissolved, told the Associated Press that tobacco industry now has a significantly greater ability “to meddle and fiddle and dilute out tobacco control in Indiana.”
The move to de-fund ITPC provoked protests from those who feared efforts to combat tobacco use would be snuffed out. The independent agency was created by the Indiana General Assembly in 2001 using money from Indiana’s share of the multi-billion settlement from the multi-state lawsuit against the tobacco industry. ITPC saw a drop in state funding in subsequent years, from $32.8 million in 2003 to $8.1 million for 2012.
Larkin said by shifting the ITPC’s assets and duties to the state health department, there’ll be more money going into tobacco prevention and cessation efforts. That’s because the ITPC had been sitting on approximately $10 million in unspent money that the state had allocated to the ITPC, but that had been banked by the ITPC in a trust fund rather than distributed to tobacco cessation and prevention efforts in local communities. Larkin said that money will now be spent on anti-smoking efforts.
Larkin has also worked to calm critics by hiring the current ITPC executive director, Karla Sneegas, as the state health department’s first assistant commissioner of the newly formed Tobacco Prevention and Cessation Division. He also announced plans to establish a voluntary advisory board comprised of experts “who are passionate about combatting tobacco use” to advise the state health department on strategy and policy issues.
He said many of the current ITPC-funded programs, including the Indiana Tobacco Quitline – a phone-based counseling service that helps smokers quit – will be maintained, and the message of tobacco reduction and protection from secondhand smoke exposure will be integrated into other state health department programs.
Larkin praised the work done by the ITPC and also noted that Indiana had a long way to go in reducing tobacco use. Citing statistics from the Centers for Disease Control and Prevention, he said about 23 percent of Indiana adults smoke cigarettes, making Indiana one of the heaviest users of tobacco in the nation. That translates to about $500 million a year in tobacco-related Medicaid costs.
Amanda Estridge, manager of Indiana government relations for the American Cancer Society, said it’s up to the legislature to decide how serious the state will be about curbing tobacco use. She said the two key indicators of that will be a comprehensive, statewide smoking ban – something that’s failed repeatedly in recent sessions – and an increase in funding for anti-smoking efforts from the current $8.1 million to the CDC recommended level of at least $54 million a year.
Success of tobacco control
Public health experts around the nation say tobacco control has been one of the 10 best public health achievements over the last decade. In a report issued by the Centers for Disease Control and Prevention, those experts noted that evidence-based public policies, such as smoking bans and higher cigarette taxes, combined with stop-smoking programs have had significant success.
According to the CDC:
• By 2009, 20.6 percent of adults and 19.5 percent of youths were current smokers, compared with 23.5 percent of adults and 34.8 percent of youths a decade earlier.
• In 2000, no state had a comprehensive smoke-free law prohibiting smoking in restaurants, bars, and work sites. By 2010, 25 states had adopted such bans. Indiana is not among them.
• Progress in reducing smoking rates among youths appears to have stalled in recent years.
• Smoking rates among high school students remained relatively unchanged from 2003 (21.9 percent) to 2009 (19.5 percent).
• In 2009, the combined federal and average state excise tax for cigarettes was $2.21 per pack, an increase from 76 cents in 2000.
Maureen Hayden is statehouse bureau chief for CNHI indiana newspapers. She can be reached at firstname.lastname@example.org