The American Lung Association released its annual State of Tobacco report for all 50 states Wednesday. Arkansas received an F in four out of five categories, failing in tobacco prevention, tobacco taxes, access to cessation services, and the minimum age of sale for tobacco products. The state did receive a C in the smoke-free air section which American Lung Association spokeswoman, Ashley Lyerly, says is one of the easiest ways for Arkansas to improve its grade.
"Primarily that grade looks at a whole host of components related to various different worksites where people could possibly be exposed to second-hand smoke exposure," says Lyerly. "There are a couple of key areas where there are some protections but workers are still not protected, and that is in restaurants, bars, and casinos and gaming establishments."
Strides have been made in Pulaski County to help make it smoke-free. Last November a coalition of organizations and community members started a campaign called Smoke Free Little Rock. They are "dedicated to passing a comprehensive smoke-free ordinance through the Little Rock Board of Directors" that would protect workers from the harmful effects of second-hand smoke.
In December an executive order was passed in Pulaski County that restricted workers who take smoke breaks to do them in their cars.
"Trying to close some of the loopholes for the statewide smoke-free air law would be something that could really help reduce tobacco use," says Lyerly. "Ultimately we know that if we have workplaces that are smoke-free, public places, bars that then we start to see the social norm change and we start to see more quit attempts associated with that."
The Arkansas Department of Health has reviewed the American Lung Association's report. Dr. Gary Wheeler, the chief medical officer, says the report grades states on their accomplishments of various public policy around tobacco control.
"We have over the years done relatively badly because we have not kept up with the rest of the United States in terms of implementing tobacco policy," says Wheeler. "That said, we're certainly not the only state that fits in that category. There are many states that got equally bad grades, and only really a handful that did well in all the different policy areas that are identified in the lung report."
The health department does take these grades seriously, Wheeler says.
"The grades that are given are pretty straight up and down. Either you have policies or you don't," he explains. "The policies that they recommend are not unreasonable — in fact, they're all very reasonable — and in states where these policies have been implemented there has been tremendous success in reducing the amount of tobacco use."
Policies the American Lung Association is encouraging Arkansas to implement is increasing the legal age at which people can buy tobacco products from 18 to 21 and raising taxes on those products. Doing so, the group says, could help reduce the state's high school tobacco use rate of 36.9 percent, which is currently higher than the adult rate of 29.1 percent. The rate includes the use of cigarettes, electronic cigarettes, and smokeless tobacco.
"We've seen sort of this boom recently in the promotion and marketing of smokeless tobacco products as well as electronic smoking devices and they're sort of the new thing," explains Lyerly. "Unfortunately what we're seeing is that kids and youth are finding ways to have access to those products and using them. They're becoming not only single users of cigarettes but also triple users, smoking cigarettes, using smokeless tobacco, and electronic smoking devices."
According to Dr. Wheeler, overall tobacco rates of youth have climbed because of electronic cigarettes. This is backed up by a report published on Tuesday by the National Academies of Science, Engineering and Medicine. It states that kids are more likely to try cigarettes after using electronic cigarettes and smokeless tobacco among its other forms.
The American Lung Association report commends Helena-West Helena for currently being the only city in Arkansas to raise its minimum age of sale for tobacco products. Increasing taxes on tobacco products would also have a positive effect on underage tobacco users, which the group recommends Arkansas by at least a dollar.
"Raising taxes on tobacco — and it usually takes a minimum of a dollar to two dollars per pack to get the desired effect — has a dramatic impact on the uptake of smoking by youth," says Wheeler. "It's a wonderful prevention tool and also encourages many adults to quit when they have that extra amount of money they have to pay."
Dr. Wheeler also says in the last session of the Arkansas Legislature there were efforts to increase taxes on tobacco products, expand the clean indoor air rule so that all parties are protected from secondhand smoke, and raise the legal age of purchase of tobacco products to 21, but the proposals did not pass.