It’s an unpleasant truth that smoking still causes a lot of pain and suffering. In human terms, the number of lives lost is a tragedy. In economic terms, the “pound of cure” for treating tobacco-related illness comes at a steep price, measured annually in the billions.
Now, in reports recently released by the Department of Health, there is good news on both fronts. A decade of declining smoking rates is finally translating into substantially fewer deaths caused by tobacco. Ten years ago, 28,000 New Yorkers died annually from smoking; today that number is 21,000. The “pound of cure” costs have gone down too. Between 2011 and 2017, there was a decline of $2.5 billion annually spent on treatment, from $12.2 billion to $9.7 billion.
Another encouraging indicator is a dramatic drop in the smoking rate for young adults age 18-24, from 21.6% in 2011 to a new low of 8.6% in 2018. Because it is rare that anyone starts smoking after age 21, this means the pipeline to tobacco dependence is slowly being shut down. In another 10 years, the impact will be reflected in a new set of numbers showing lives spared and dollars saved. Prevention works!
Still, it’s not all a rosy picture. Over 750,000 New Yorkers live with tobacco-related disease, such as cancer, COPD, and cardiovascular disease, all of which can lead to life-altering disability. These underlying conditions, and smoking itself, also compromise the immune system and make individuals more vulnerable to other serious illness, as the COVID pandemic has so grimly demonstrated. Of the 1.8 million New Yorkers who smoke, disproportionate numbers are people with lower income and education or who have poor mental health. The overall smoking rate in New York is 12.7%, but among disadvantaged groups the figures are much higher: unemployed adults 24.5%; adults receiving Medicaid 23.5%; adults with frequent mental distress 27.7%; disabled adults 20%. These people cannot be forgotten. As a matter of equity and social justice, everyone deserves the chance to live a smoke-free life.
The Goliath in the room, of course, is the tobacco industry, determined as ever to hang on to every customer by whatever means necessary and to find creative ways to attract new users. On one hand, this means bolstering the appeal of traditional products like menthol cigarettes or inexpensive little cigars, cigarillos, and smokeless tobacco, all available in a variety of kid-friendly sweet and fruit flavors. On the other hand, both Altria, maker of Marlboro, and Reynolds, maker of Camel and Newport, have adapted to the times by getting into the vaping business ahead of FDA regulations on e-cigarettes. Altria has now gone one step further, declaring that its new mission is “designing a smoke-free future.” But don’t expect them to stop selling cigarettes any time soon. The real motive: to quickly concentrate nicotine addicts around new non-cigarette, non-combustible products before competition heats up or more people quit smoking altogether.
In the past 20 years New York has invested in a comprehensive approach to reducing tobacco use, and it has paid off. We have a strong Clean Indoor Air Act, high cigarette taxes, and an effective Tobacco Control Program that works to reduce exposure to secondhand smoke; promotes measures that motivate users to quit and prevent youth from becoming smokers (or vapers); and, sparks change in norms around tobacco use. The latter is one of the reasons we now take it for granted that smoking is not allowed in bars, restaurants and other public places. The experience, expertise and infrastructure necessary to sustain the downward trend of tobacco use and to meet current and emerging challenges is well established and nationally recognized.
Over 20 years, the total amount of funds dedicated to tobacco control in New York rounds out to a bit over $800 million. Compare that to the $2.5 billion saved every year or the $9.7 billion still spent annually on treating tobacco-related illness. By any measure, there has been a good return on investment. Maybe an ounce of prevention is worth more than a pound of cure.
The Healthcare Consortium is a local charitable organization with a mission of improving access to healthcare and supporting the health and well-being of the residents in our rural community. The agency is located at 325 Columbia St. in Hudson. For more information, visit www.columbiahealthnet.org or call 518-822-8820.