EAST HARTFORD - The American Lung Association's 2018 "State of Tobacco Control" shows Connecticut, once again, earned less than satisfactory grades on its tobacco policies.

The 16th annual report grades states and the federal government on policies proven to prevent and reduce tobacco use, and finds that while Connecticut deserves some praise for being tied for the highest state cigarette tax in the country, the incremental increase of 45 cents passed by the legislature in 2017 is unlikely to have meaningful implications for tobacco use.

Additionally, elected officials have failed to turn that revenue into impactful public health investments, choosing to forego funding critical prevention and cessation programs.

"Nationwide, cigarette smoking rates have continued to decline to historically low levels, yet tobacco use remains the nation's leading cause of preventable death and disease, killing more than 480,000 Americans each year," said Jeff Seyler, executive vice president, Northeast Region of the American Lung Association.

"Tobacco use is a serious addiction, and the fact that 14 percent of adults and 14 percent of high school students in the state of Connecticut are using tobacco today highlights how much work remains to be done in our communities to prevent and reduce tobacco use," he said.

Ruth Canovi, director of public policy for Connecticut, told The Newtown Bee that when the report was established 16 years ago, it focused on four policy concerns: funding for tobacco control, tobacco taxation, smokefree air, and access to smoking cessation services. She said these are universally the four areas the tobacco control community has identified, where they can really see results in high performing states.

"When states, the federal government, and even municipalities score high on these policies, we see fewer youths using tobacco products, more successful programs helping adults quit smoking, and reducing everyone's overall exposure to second-hand smoke," Ms Canovi said.

"In 2018, we unfortunately see more people thinking that tobacco use is an issue of the past, but it is still the leading cause of preventable death disease in our country - and there's so much more we could be doing, especially here in Connecticut," she said.

How ARE We Doing?

This year's "State of Tobacco Control" finds Connecticut's grades show zero improvement from last year and are evidence that Governor Dannel Malloy and the state legislature have not done enough to reduce tobacco use, exposure to secondhand smoke, and save lives:

*Funding for State Tobacco Prevention Programs - Grade F

*Strength of Smokefree Workplace Laws - Grade C

*Level of State Tobacco Taxes - Grade B

*Coverage and Access to Services to Quit Tobacco - Grade D

*Minimum Age of Sale for Tobacco Products to 21 - Grade F

The American Lung Association in Connecticut calls on Connecticut policymakers to invest in tobacco and prevention programs. Smoking costs the state more than $2 billion in health care costs each year; yet Connecticut is one of only two states in the nation that provides zero dollars for tobacco prevention programs, when the CDC recommends the Connecticut program be funded at $32 million.

Under a master settlement agreement with the tobacco industry, Ms Canovi said the state receives between $120 million and $125 million annually that is supposed to go to offsetting the related costs of smoking.

"A trust fund in Connecticut was set up to use at least some of those funds toward preventing youths from starting to use tobacco and typically going on to a lifetime of tobacco use and related issues," she said. "But we are not seeing that in Connecticut."

Add to that the extremely high taxes the state generates from the sale of tobacco products, and Connecticut ends up with more than $516 million each year - none of which goes to intended programs to educate, prevent youths from starting smoking, or to help people quit.

Ms Canovi said that if Connecticut would increase funding from these sources for tobacco control programs, the state would have a powerful opportunity to focus these programs to communities that still use tobacco at higher rates and who have been targeted by the tobacco industry.

Unfortunately, with the state's substantial tobacco crop being a major income generator, Ms Canovi said cigar tax legislation that was proposed in 2017 was not successful.

Hope For 2018

Fortunately for the residents of Connecticut there is hope for the state to make significant improvements in 2018.

There were more than ten pieces of tobacco-related legislation introduced at the beginning of the 2017 legislative session - including bills proposing to close the many loopholes in smokefree air laws, increase tobacco taxes with the caveat that this revenue be used to pay for tobacco prevention and cessation, and raising the tobacco sales age to 21, among others.

The Tobacco 21 legislation made the most progress, passing both the Public Health and Finance Committees.

The American Lung Association is advocating for its timely passage, citing the National Academy of Medicine (formerly the Institute of Medicine) finding that increasing the minimum age of sale for all tobacco products to 21 could prevent 223,000 deaths among people born between 2000 and 2019, including 50,000 fewer dying from lung cancer - the nation's leading cancer killer.

"While across the country, and here in Connecticut, we are seeing a decline in the number of youths smoking cigarettes, but when we look at actual tobacco use, we aren't seeing a corresponding decline," Ms Canovi said.

"We're actually looking at a huge increase in the use of electronic smoking [vaping], also the use of other products like those sweetened grape-flavored cigars," she added. "We know those are a good way to get youths hooked because they are cheaper and they're flavored. This leads them into continued use of tobacco and addiction because they still have all the cancer-causing chemicals you find in cigarettes."

Prioritizing Advocacy

Moving forward, the American Lung Association will also be prioritizing its advocacy efforts on closing loopholes in Connecticut's indoor smokefree air laws with a focus on eliminating smoking in all public places and workplaces, which would benefit workers across the state.

This is especially critical for those who work in the service and manufacturing sectors who are often exposed to secondhand smoke daily.

"There are a number of exemptions in our law, so we can do better in protecting people from second-hand smoke," Ms Canovi said. "Workplaces with fewer than five employees can still have smoking in their building. And in behavioral health communities where we actually are seeing increases in use of tobacco products, we see smoking is still allowed."

One area where Connecticut has typically stood out and - continues to lead - is in its comprehensive coverage for all tobacco cessation medications and types of counseling to Medicaid enrollees with minimal barriers (such as co-pays and prior authorization).

Medicaid enrollees smoke at a rate almost three times as high as those with private insurance and evidence suggests that the number of people quitting smoking increased when tobacco treatments are covered. Connecticut is one of only nine states that provide this inclusive coverage to help smokers quit and reduce disparities in tobacco use.

For more information or to review the report, visit LungNE.org