Despite the accumulation of scientific evidence and years of public education campaigns around the dangers of tobacco use, it is the number one preventable cause of death in the United States according to the CDC. One in every five deaths is related to cigarette smoking and exposure to secondhand smoke – 443,000 lives a year. The cost is staggering – reaching nearly $100 billion to treat smoking caused diseases.

The percent of adults who reported smoking in 2011 varied from a low of 11.8 percent in Utah to a high of 29 percent in Kentucky. Along with Kentucky, more than one in four  adults smoke in eight other states – Arkansas, Indiana, Louisiana, Missouri, Mississippi, Ohio, Oklahoma, West Virginia. Nationally, 18.1 percent of adults report smoking. Youth smoking rates are lower – 13.1 nationally – with just six states posting rates of 20 percent or higher.

Voters in California turned back an effort to add $1 to the cost of a pack of cigarettes. The rate increase would have been the first one in California since 1998. Without the increase, California’s 87 cent tax remains well below the current national average of $1.46 per pack.

Twenty four states and the District of Columbia were given an A by the American Lung Association last week because they had comprehensive smokefree air laws. On the other hand, twelve states received a failing grade in the "State of Tobacco Control: 2012" report. The remainder of the states scored somewhere between an A and a F.

This week we learned about the President’s success in his struggle to quit smoking. One in five American adults either smoke or use some form of tobacco and although many try to quit, less than 10 percent are successful due to a lack of support. Tomorrow, ActionToQuit’s free webinar describes how hospitals can support smokers who want to quit, by screening all patients for tobacco use and providing treatment. ActiontoQuit urges all sectors – employers, insurers, health care providers, quitlines and policymakers – to work together to help tobacco users get access to all the treatments that can help them quit, and has produced a series of webinars and podcasts. See also: CSG’s Quitting Tobacco: Save Lives, Save Money in Medicaid and State Employee Plans

In the November 2010 elections, voters weighed in on a wide range of ballot proposals — from a plan in Indiana to cap property taxes and a workplace smoking ban in South Dakota to a proposal in Nebraska to abolish the treasurer's office and a new governor-recall law in Illinois.

Quitting tobacco use improves individuals’ health, but state governments also benefit. State Medicaid programs pay an average $607 million per year in tobacco-related health care costs, and employees who quit using tobacco take fewer sick days and have lower health care costs. For every dollar states spend on smoking cessation, returns to the state average $1.26 in avoided productivity losses, direct medical expenditures and premature deaths. The American Lung Association and the Partnership for Prevention analysis of insurance coverage for smoking cessation treatment is summarized, including state by state listing of coverage in state Medicaid and state employee plans for smoking cessation, as well as statewide workplace smoking bans.

A new CSG Capitol Facts and Figures examines state cigarette taxes.

Cigarette taxes are a means to raise state revenue in a down economy as well as to discourage the use of tobacco.  Studies have found that increasing the price of tobacco effectively reduces smoking rates and can potentially save billions of dollars in medical expenses and loss of productivity annually.  However, states have failed to use the increased tax revenues to expand tobacco prevention and control programs.