According to the Tobacco Free Coalition of Oregon, every day 18 Oregonians die from tobacco use while 20 kids start smoking. In addition, 35,000 Oregonians are exposed to secondhand smoke at work. Yet Oregon spends only one penny of a $1.18 cigarette tax on tobacco use prevention.
In Lane County, 54,356 people smoke, and more than 12,600 suffer from a serious illness caused by tobacco use. Nearly 100 percent of this suffering is preventable.
This past year, Oregon traveled a little bit farther down the road in the anti-tobacco movement. On Jan. 1, Oregon restaurants and bars went smoke-free. And in June, the Legislature passed a landmark bill requiring Oregon’s commercial health insurers to provide coverage for tobacco and smoking cessation.
This new coverage entitles people enrolled in private and commercial health insurance plans to at least $500 worth of coverage for tobacco cessation treatments approved by the U.S. Food and Drug Administration. All private plan members aged 15 years and older will now be able to receive at least one tobacco cessation benefit during their enrollment. This new benefit begins on Jan. 1, 2010. Oregon Medicaid recipients have had these benefits since 1998.
As pulmonary specialists, we care for patients with smoking-related lung diseases every day. We are keenly aware of the ravages of tobacco use, including second-hand smoke. We’ve learned over the years that the key is in prevention. We can now tell our patients who want to quit tobacco that help is here.
This new law places Oregon at the forefront of preventive health care; only six other states have similar laws in place. Our patients who have insurance — private or public assistance — can now get help and resources to quit smoking and chewing.
Those who are uninsured or underinsured have resources as well. Several tobacco cessation products — nicotine patches, lozenges and nicotine gum — are sold over the counter and don’t require a prescription.
Our patients can be sure that we, like many of our physician colleagues, will ask them about quitting. The new law covers prescriptions, nasal sprays, oral inhalers, over-the-counter remedies, counseling, support and education. Medical research and personal experience have taught each of us that patients need an integrated approach, using a combination of these available therapies along with careful planning to increase their chances of successfully quitting tobacco for good.
Many health care providers, advocates and individuals, however, might say Oregon hasn’t traveled far enough yet in its tobacco control policy. Three other important potential policies failed to move through the Legislature. One bill would have increased the tax on cigarettes and other tobacco products. A second failed proposal would have allocated cigarette tax revenues to rural health safety net programs and services. The third would have made it illegal to smoke in a motor vehicle if anyone under the age of 17 was a passenger.
Tobacco is extremely addictive. Even though most smokers know they should quit, they find it very difficult to go without the daily dose of nicotine that tobacco products provide. According to a recent report by the Centers for Disease Control and Prevention, 61 percent of young high school students who smoke will try to quit, yet only 12 percent are successful — and it doesn’t get any easier as they grow older.
As a community, we need to do everything we can to encourage smoking cessation and to provide the tools for people to be successful. We can’t afford not to try.
In Oregon, we have had early success with such programs as the Oregon Quit Line and funding of smoking cessation for Oregon Health Plan recipients since 1998.
Since we began dedicating more resources to tobacco prevention and education, the rate of cigarette consumption has dropped by almost half.
This is a battle we can win — yet we have much work to do.
Matthew Walter, M.D., a pulmonary and respiratory medical specialist practicing with Oregon Lung Specialists, serves as the medical director of respiratory care for Sacred Heart Medical Center at RiverBend. He is the 2009 president of the Oregon Thoracic Society and is active with the American Lung Association’s Oregon chapter. John Gotchall, M.D., a pulmonary medicine physician, practices with the Corvallis Clinic and is the medical director of the Intensive Care Unit at Good Samaritan Regional Medical Center in Corvallis. He is active with the American Lung Association’s Oregon Chapter and the Oregon Thoracic Society.