Kentucky 's spending of tobacco settlement on tobacco-prevention programs fall far short of what CDC recommends

Kentucky ranks 39th in the country in funding programs that prevent kids from smoking and help smokers quit, according to a national report from a coalition of public-health organizations.

Kentucky ranks sixth in high-school smoking in the 2013 Centers for Disease Control and Prevention Youth Risk Behavior Surveillance System report, with 17.9 percent of high schoolers reporting they smoke cigarettes. Nationwide, the rate is 15.7 percent. The report challenges states to get their rates as low as Florida's 7.5 percent.

"If Kentucky reduced its high school smoking rate from 17.9 percent to 7.5 percent, it would prevent 148,150 kids from becoming adult smokers, saving 52,290 lives and $2.6 billion in future health care costs," the Campaign for Tobacco-Free Kids says in a press release.

The campaign says it's not that the state lacks the money to spend on such programs.

"Kentucky will collect $347.3 million in revenue this year from the 1998 tobacco settlement and tobacco taxes but will spend only 0.7 percent of the money on tobacco-prevention programs," says the release. "Kentucky spends $2.5 million per year on tobacco prevention and cessation programs, which is 4.4 percent of the $56.4 million recommended by the Centers for Disease Control and Prevention."

Soon after the settlement, the Kentucky General Assembly decided to spend half the settlement on diversifying and improving the state's agricultural economy, with the rest going to health, early-childhood development and other programs. The legislature later began using the fund for water and sewer projects in rural areas.

Kentucky is not alone in scrimping on such programs. Collectively, states have budgeted just 14.8 percent of the $3.3 billion the CDC recommends. States will collect $25.6 billion this year from the tobacco settlement and tobacco taxes but will spend only 1.9 percent of it ($490.4 million) on tobacco prevention programs, the campaign says.

Meanwhile, kids get plenty of tobacco-company marketing enticing them to smoke. "Tobacco companies spend $271.1 million per year to market their products in Kentucky – 109 times what the state spends on tobacco prevention," says the release.

The campaign says tobacco annually claims 8,900 Kentucky lives and costs the state $1.9 billion in health care bills. "Right now, Kentucky is also putting its children at risk and costing taxpayers money by failing to properly fund tobacco prevention efforts that are proven to save lives and health care dollars," says Matthew Myers, president of the campaign for Tobacco-Free Kids. "We need elected leaders in Kentucky to enact a comprehensive smoke-free law and increase funding for proven tobacco-prevention programs,"

The report is titled "Broken Promises to Our Children: A State-by-State Look at the 1998 State Tobacco Settlement 16 Years Later." It was also released by the American Heart Association, the American Cancer Society Cancer Action Network, the American Lung Association, the Robert Wood Johnson Foundation and Americans for Nonsmokers' Rights.

Study finds electronic cigarettes help people stop smoking

A study has found that electronic cigarettes help people cut back on their use of tobacco, Christopher Ingraham reports for The Washington Post.

The finding was part of a study published in the International Journal of Environmental Research and Public Health, which tracked 48 smokers who were unwilling to quit smoking.

Participants were divided into three groups: two e-cigarette groups and a control group that switched from tobacco to e-cigarettes two months into the eight-month study. During the testing period all three groups were only allowed e-cigarettes. The difference between the groups occurred in between the testing periods.

"At the end of the 8-month study, 21 percent of all participants had stopped smoking tobacco entirely," Ingraham writes. "An additional 23 percent reported cutting the number of tobacco cigarettes they smoked per day by half." Across all three groups, total tobacco consumption fell by 60 percent, and 44 percent of the smokers had reduced or eliminated their tobacco use at the end of the eight months, Ingraham reports.

"The nicotine e-cig offers many smokers a successful alternative for smoking less – or even quitting altogether," write authors Frank Baeyens and Dinska Van Gucht. "E-cig users get the experience of smoking a cigarette and inhale nicotine vapor, but do not suffer the damaging effects of a tobacco cigarette.”

Ingraham lists many of the pros and cons of e-cigs and concludes, "From a public health standpoint, if we're interested in promoting smoking cessation it would seem sensible to encourage studies like this one, which point to new avenues for reducing the harms of smoking and helping people quit altogether."

In some wealthy areas, smoking rates have declined, while smoking rates in working class and rural areas have remained stable. Use of electronic cigarettes among rural teens has also risen in recent years, prompting the U.S. Food and Drug Administration to propose rules to give it authority over e-cigarettes, an industry that accounts for about $2.5 billion in annual sales.

Lexington is considering whether to add electronic cigarettes to its anti-smoking ordinance

The Lexington-Fayette Urban County Council will discuss whether to expand its smoking ban to include electronic cigarettes, possibly as early as Oct. 7 at the General Government Committee meeting, Beth Musgrave reports for the Lexington Herald-Leader.

Berea, Bardstown, Danville, Glasgow, Manchester and Richmond have banned included e-cigarettes in smoking bans; on Oct. 6 Versailles may do likewise. (The city is replacing a Woodford County Board of Health regulation that was ruled unconstitutional.)

Amy Barkley, chairwoman of the Smoke-Free Kentucky Coalition, told Musgrave that cities and states updating their anti-smoking ordinances to include e-cigarettes is "part of a trend," and "Lexington has always been the leader in smoke-free policy in this state."

But e-cigarettes have changed the terms of smoking-ban debates. Tony Florence, co-owner of 723 Vapor Store in Lexington, which sells e-cigarettes, told Musgrave, "It's ludicrous to try to ban something that is trying to help people kick a horrible habit," Florence said. "The way that I look at it, if you are anti e-cigarette then you are really pro-lung cancer."

Gorton, who is a registered nurse, told Musgrave that she supported an amendment to the smoking ordinance because the Fayette County Board of Health recommended it. Gorton also noted that the state now bans all tobacco products, including e-cigarettes, on most state properties and that Rupp Arena and the attached Lexington Convention Center do likewise.

Supporters of e-cigarette ordinances say the devices are not effective in helping people stop smoking and "not much is known about the effects of electronic cigarettes," Musgrave reports. Barkley also told Musgrave that because e-cigarettes look like real cigarettes it "undermines the enforceability of smoking ordinances."

The Food and Drug Administration does not regulate e-cigarettes. Smoke-free advocates, including Barkley say that "until the FDA regulates e-cigarettes, it's best to include them in smoking bans," Musgrave writes.

But Florence told Musgrave that "the federal government hasn't acted on e-cigarettes for a reason: The research is not conclusive."

Carroll County schools will make campuses tobacco-free in 2015, even including outdoor sporting events

The schools in Carroll County, once one of Kentucky's tobacco strongholds, have begun preparing students, parents, teachers and football fans for smoke-free school campuses starting July 1, 2015.

"This ban will apply on district property at all times, in all places and to all people, including at sporting events and inside vehicles," schools spokesman Carl Roberts writes for The News-Democrat in Carrollton. "The ban also will apply to electronic cigarettes. . . . The district is making every effort to inform students, staff and community members of the transition."

That includes signs, social media, print publications, district memos, and announcements at sporting events, Roberts writes. "At sporting events throughout this school year, cards will be distributed to spectators that provide information about the tobacco-free policy. The cards also will include information on smoking/tobacco cessation classes."

Only 35 of the state's 173 school districts are tobacco-free, but some others are planning to impose bans next year, and more may after this year's school-board elections are out of the way.

Carrollton, which once had several tobacco warehouses, was visited in 1998 by then-President Bill Clinton to explain what his administration wanted to about smoking and help tobacco farmers.

Study shows tailored advocacy for local smoking bans in rural Kentucky gets results

Local smoking bans are only possible if the community is ready for this change, Ellen Hahn, director of the Kentucky Center for Smoke-free Policy, writes in a report of a five-year study she conducted in rural Kentucky.

Readiness for change can be developed in rural communities that participate in smoke-free policy initiatives tailored to their community, Hahn writes in The Journal of Rural Health. The study evaluated six stages of readiness to determine if a community was ready to support smoke-free policy, and then tailored interventions based on how ready the community was.

The study was conducted in 37 rural Kentucky counties that were randomly selected from those without smoking ordinances or regulations. Nineteen of the communities received policy-intervention strategies, tailored to their readiness, from a trained community adviser. The remaining 18 were used for comparison. Data were collected annually and policy outcomes were tracked over five years.

Nearly one-third of the counties that were the target of interventions adopted smoking bans covering restaurants, bars, and all workplaces, while none of the comparison counties did.

Rural, tobacco-growing areas were chosen because they are "disproportionately affected by tobacco use, secondhand smoke, and weak tobacco control policies," Hahn writes in the study, "A Controlled Community-Based Trial to Promote Smoke-Free Policy in Rural Communities."

Can e-cigarettes help you quit smoking? That's unproven

The notion that electronic cigarettes can help smokers cut back or quit smoking is uproven, says an article in the June issue of Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology. The article contradicts British research suggesting that e-cigarettes could play a positive role in reducing smoking rates for people who try to quit smoking without the aid of prescription medication or professional support.

Photo from U.S. Food and Drug Administration

Manufactures of e-cigarettes say that progressively adding smaller doses of nicotine to the e-cigarette will help smokers quit smoking. But the authors say this theory hasn't been proven and no evidence supports the claims. "Despite the apparent optimism surrounding e-cigarettes and their purported therapeutic role in smoking cessation, there just simply is not enough evidence to suggest that consumers should use e-cigarettes for this purpose," lead author Andrew Nickels says.

Nickels examined the risks of e-cigarettes, including the ongoing dependence on nicotine and dual use of e-cigarettes and regular cigarettes. Dual use is common, with people using e-cigarettes in public and smoking regular cigarettes at home. The researchers found that this behavior continues to expose children and asthma sufferers in the household to secondhand smoke. "It also promotes ongoing nicotine dependence,” says co-author Chitra Dinakar.

Nicotine is an addictive neurotoxin, and the increased use of e-cigarettes has caused an increase in calls to poison centers. The most common adverse health effects from e-cigarettes are nausea and eye irritation, according to the federal Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report. More than half the calls involved children under 5.

Because e-cigarettes are fairly new, the article says there could be other long-term health complications that have yet to be discovered. Results of long-term exposure to such substances are unknown.

The U.S. Food and Drug Administration has proposed a rule that will allow it to regulate e-cigarettes. In April, Gov. Steve Beshear signed into law Senate Bill 109, which prohibits the sale of e-cigarettes to minors in Kentucky.