When it comes to Tobacco Control 101, Montana earns a barely passing grade.
Last week, the American Lung Society released its State of Tobacco Control 2012 report that gave letter grades to every state, evaluating performance in four categories: smoke-free air, cigarette tax, cessation and tobacco prevention. The group has released a similar report each of the past 10 years.
Overall, the nation is losing ground in the fight against tobacco. States are doing less to keep kids from smoking, and the tobacco industry is taking advantage of state apathy to fight back, according to the study.
Montana is one of the apathetic culprits, according to the report, and the state Legislature didn’t help matters during the 2011 session.
The one “A” on Montana’s report card was for smoke-free air, thanks to the 2005 Clean Indoor Air Act — which required that all enclosed public places and workplaces be smoke-free.
Montana lagged behind almost half the nation in passing such a law, and it ran into stiff resistance from state bar owners. However, the 2005 Adult Tobacco Survey conducted by the Centers for Disease Control indicated the bill had the support of 80 percent of Montanans.
Paula Wood, director of Tobacco Free Ravalli, said the Clean Indoor Air Act has been positive for businesses, and now she’s moving on to apartment complexes.
“The act applies only to businesses, so we’re looking more at secondhand smoke in private living complexes,” Wood said. “Discover Care has banned smoking and Cardinal Properties, rather than grandfathering long-term renters who smoke, is going completely over to nonsmoking.”
Wood said it makes economic sense because insurance premiums decrease due to less concern about fires or cleaning up smoke residue.
But that’s where the good news stops. Montana received a “C” for cigarette taxes, a “D” for assistance available to those who want to stop smoking and an “F” for tobacco prevention and control. In the last two categories, only a handful of states scored a “C” or better.
Wood said she’d like her organization to be able to help people stop smoking, but, under the Montana Tobacco Use Prevention Program funding, Tobacco Free Ravalli is not allowed to do intervention.
The main state cessation project is the Montana Tobacco Quit Line, which provides anonymous help from counselors and nurses. Along with free coaching sessions, callers can receive four weeks worth of nicotine replacement therapy, such as gum, and medicine, such as Chantix, at reduced cost. But the CDC claims the Quit Line could do more if it was funded at more than $10 per smoker rather than the current $6.37.
“People can call as many times as they need,” Wood said. “But it’s hard to get the information into the hands of some people who need it: those who are low-income and stressed, having to work more than one job or unable to find work. It would be nice to have local counselors, but people can’t afford the hundreds of dollars it costs for cessation counseling.”
The low grades for cigarette taxes and prevention and cessation programs almost go hand-in-hand because taxes help pay for such programs.
Montana voters have regularly approved cigarette tax increases, which pay for health initiatives and contribute to the state’s general fund. In 2004, voters passed a cigarette tax increase from $1 to $1.70 per pack. In 2010, that meant that, out of the more than $77 million collected, the general fund received more than $32 million from the cigarette tax.
A 2009 Montana Department of Public Health and Human Services survey found that two-thirds of Montanans favored additional cigarette taxes, and more than half of smokers said they’d try to quit if the tax increased by more than $1.
But, during the 2011 legislative session, when a bill was proposed to increase the tax by another $1.50 to augment programs to help people stop smoking, tobacco lobbyists argued against it, and the Republican majority voted it down.
The Legislature cemented the state’s failing grade when the Joint Appropriations Subcommittee on Health and Human Services voted to withhold national funding from the MTUPP, directing it instead into the general fund, which now holds $340 million.
In so doing, they bypassed a voter mandate. In 2002, 65 percent of Montana voters passed the initiative that required a third of the yearly tobacco Master Settlement Agreement income that Montana receives to be set aside for tobacco-use prevention.
Representatives from several advocacy groups, including the American Lung Association and the American Cancer Society, testified before the subcommittee that MTUPP was worth the investment. Since its inception, it’s helped cut adult smoking by 23 percent and youth smoking by 46 percent in Montana.
The committee’s action cut MTUPP’s funding almost in half, so Wood’s program, one of the few remaining anti-tobacco programs, hangs by a thread. But she and others like her across the state continue to do what they can to keep Montana from flunking out.
“We fought that very hard. We took some of the kids with us to Helena to show them what we do,” Wood said. “If we can start out teaching the dangers of tobacco in schools, it’s more effective. We didn’t understand why they would do that.”