Tobacco Facts

Students and Tobacco

• New York kids (under 18) who become new regular daily smokers each year: 24,900
• In New York State, 16.2% of all high school students smoke.
• If current patterns of smoking behaviors continue, New York kids alive today will ultimately die from smoking: 389,000. 
• Each year 34.8 million packs of cigarettes are smoked by kids in New York.
• 90% of adult smokers became addicted at or before the age of 18. With these numbers, no wonder the tobacco companies spend 15 billion each year marketing its product.
• 82.8 percent of youth (12-17) smokers prefer Marlboro, Camel and Newport – three heavily advertised brands. The tobacco industry spends $515.8 million yearly on marketing to NYS.
• Since 1970, chew or spit tobacco has gone from a product used primarily by older men to one used predominantly by young men and boys. 6.9% of NYS High School males use chew/spit tobacco.
• Among youths who have used both cigarettes and marijuana by the 12th grade, 65 percent smoked cigarettes before marijuana; and 98 percent of those who had used both cocaine and cigarettes smoked cigarettes first.
• The prevalence of daily smoking in schools with 100% tobacco-free policies was 9.5%. In schools with an intermediate level smoking policy, daily smoking prevalence was 21%, and in schools with no smoking policy, 30% of students reported smoking daily.
• In 2001, when 14 of North Carolina’s 117 school districts adopted a tobacco free policy, despite the fear, enforcement problems were more manageable than anticipated, a finding demonstrated in other states.
• Annual health care costs and productivity losses in New York directly caused by tobacco use is $8.17 billion.

Childhood is not only a formative period; it also presents an opportunity to teach children healthy lifestyle habits in school. There are more than 50 million students currently enrolled in the nation’s public and private elementary and high schools (grades K-12). The 129,000 schools in the US provide an organizational structure through which health information and prevention programs can be delivered.

Furthermore, children are greatly influenced by their social environment, which in turn is strongly influenced by public policies.

Health Effects on Tobacco Use On Young People

Many people think that the serious harm from smoking doesn’t appear until at least middle age.

But smoking by young people is associated with significant health problems including: ⁵

• Shortness of breath, difficulty breathing, and lower tolerance for exercise;
• More frequent sinus infections, colds, and pneumonias;
• Wheezing, persistent coughs, asthma attacks, and increased phlegm production;
• Bad breath, tooth decay, and gum disease;
• Increased stress;

Also they are more likely to report their health as poor compared to non-smoking youth.

Nicotine Addiction in Youth
The younger people start smoking, the more likely they are to become addicted.⁵

Symptoms of addiction can occur before becoming a daily smoker.^6,7

In New York, 1/3 of middle school smokers and almost 1/2 of high school smokers say they
cannot go more than a day before feeling the need for a cigarette.³

Teens who smoke are 3 times more likely than nonsmokers to use alcohol; 8 times more
likely to use marijuana; and 22 times more likely to use cocaine.⁵

Smoking is also associated with other risky behaviors such as fighting and engaging in unprotected sex.⁵

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1 - RTI International. (2005). Independent Evaluation of New York’s Tobacco Control Program Final Report 2005. Research Triangle Park, NC: RTI International.

2 - Campaign for Tobacco-Free Kids. (2005). The toll of tobacco in New York. Retrieved on March 1, 2006 from http://www.tobaccofreekids.org/.

3 - New York State Department of Health. (2004). New York State Youth Tobacco Survey 2004. Albany, NY: Tobacco Control Program, New York State Department of Health. Unpublished data.

4 - Johnston, L. D., O'Malley, P. M., Bachman, J. G. & Schulenberg, J. E. (December 19, 2005). Decline in teen smoking appears to be nearing its end. University of Michigan News and Information Services: Ann Arbor, MI.[On-line]. Retrieved March 1, 2006 from www.monitoringthefuture.org.

5 - Centers for Disease Control and Prevention. (1994). Preventing tobacco use among young people—a report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services.

6 - Centers for Disease Control and Prevention. (1995). Symptoms of substance dependence associated with use of cigarettes, alcohol, and illicit drugs – United States 1991-1992," Morbidity and Mortality Weekly Report, 44(44),830-831,837-839.

7 - DiFranza, J.R., Rigotti, N.A., McNeill, A.D., Ockene, J.K., Savageau, J.A., St. Cyr, D, et al. (2000). Initial symptoms of nicotine dependence in adolescents. Tobacco Control 9, 313-19.

Health Effects of Cigarette Smoking

CANCER
The risk of dying from lung cancer is more than 22 times higher among men who smoke, and about 12 times higher among women who smoke compared with never smokers.

Cigarette smoking increases the risk for many types of cancer, including cancers of the lip, oral cavity, and pharynx; esophagus; pancreas; larynx (voice box); lung; uterine cervix; urinary bladder; and kidney.

Rates of cancers related to cigarette smoking vary widely among members of racial/ethnic groups, but are generally highest in African-American men.

CARDIOVASCULAR DISEASE
Cigarette smokers are 2–4 times more likely to develop coronary heart disease than nonsmokers.

Cigarette smoking approximately doubles a person’s risk for stroke.

Cigarette smoking causes reduced circulation by narrowing the blood vessels (arteries). Smokers are more than 10 times as likely as nonsmokers to develop peripheral vascular disease.

RESPIRATORY DISEASE & OTHER EFFECTS
Cigarette smoking is associated with a ten-fold increase in the risk of dying from chronic obstructive lung disease, accounting for about 90% of all chronic obstructive lung diseases deaths.

Cigarette smoking has many adverse reproductive and early childhood effects, including an increased risk for infertility, preterm delivery, stillbirth, low birth weight, and sudden infant death syndrome (SIDS).

Postmenopausal women who smoke have lower bone density than women who never smoked. Women who smoke have an increased risk for hip fracture than never smokers.

Children and adolescents who smoke are less physically fit and have more
respiratory illnesses than their nonsmoking peers.¹

Adapted from Health Effects of Cigarette Smoking, CDC Fact Sheet, February 2004.
1 Centers for Disease Control and Prevention. (1994). Preventing tobacco use among young people—a report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services.

The Burden of Tobacco—New York State
TOBACCO USE IN NEW YORK¹
Smokers Other Tobacco*
Adults (18+) 18.1% 5.4%
High School (grades 9-12) 18.5% 12.5%
Middle School (grades 6-8) 5.4% 5.6%
* Other Tobacco includes chewing tobacco, cigars/cigarillos, pipe tobacco, bidis, and clove cigarettes. The percentage of adult smokers has decreased gradually since the 1980s, comparable to the rest of the U.S. In 2003-2004, the number of NY adults who smoke declined more quickly than in the U.S. as a whole.¹

DEATHS IN NEW YORK FROM TOBACCO USE
Adults who die each year from their own smoking 25,500 (1 in 5 deaths)

Annual deaths from someone else’s smoking (from secondhand smoke and smoking during pregnancy) 2,410 to 4,290

Youth alive today in NYS who will ultimately die from smoking 424,100

Number of adults suffering with a tobacco related illness Over 500,0001

Every year smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, murder, and suicide combined.

TOBACCO-RELATED MONETARY COSTS IN NEW YORK
Annual health care cost in NYS caused by smoking:

• Portion covered by Medicaid program
  $7.52 billion
  $5.00 billion
• Resident’s tax burden from smoking-caused expenditures $842/household
• Smoking-caused productivity losses in NYS $5.73 billion
• Health costs do not include those caused by exposure to secondhand smoke, smoking-caused fires, spit tobacco use, or cigar and pipe smoking.
• Productivity losses include productive work lives shortened by a smoking–caused death. They do not include lost work time due to smoking, smoking breaks, declinein performance, or disability due to smoking.

Adapted from The Toll of Tobacco in New York, Campaign for Tobacco-Free Kids, 2005.
¹ RTI International. (2005). Independent Evaluation of New York’s Tobacco Control Program Final Report 2005. Research Triangle Park, NC: RTI International.

Smoking Harms the Body Quickly
Many people think that the serious physical harm from smoking don't appear until at least middle age. But just a few puffs of a cigarette quickly affect every system of the body. Casual smoking can quickly cause a wide range of significant and sometimes permanent harm to the body:

RAPID ADDICTION
Serious symptoms of addiction, sometimes after smoking only a few cigarettes.

RAPID IMMUNE SYSTEM EFFECTS
More frequent ear and sinus infections, colds, and pneumonias; More sick visits to the doctor due to increased vulnerability to illnesses; Slowed wound healing resulting in longer recovery time from minor and serious injuries.

RAPID LUNG EFFECTS
Difficulty breathing due to airway tightening; Wheezing, persistent coughs, asthma attacks, and increased phlegm production; Lower exercise tolerance.

RAPID HEART EFFECTS
Increased bad fat deposition in blood vessels leading to early heart disease; Clot formation and narrowing of blood vessels, increasing risk of heart attack or stroke; Faster heart rate and compromised blood flow to the heart; Increased blood pressure, leading to organ damage.

RAPID MOUTH & STOMACH EFFECTS
Bad breath; Tooth decay and gum disease; Heartburn; Ulcers.

RAPID EFFECTS ON THE BRAIN
Decreased blood flow to the brain, resulting in increased risk of stroke; Increased stress.

OTHER RAPID EFFECTS
Vitamin deficiencies and their associated symptoms.
Adapted from How Smoking Quickly Harms the Body, Campaign for Tobacco-Free Kids, 2004. For more detailed information see the Campaign for Tobacco-Free Kids white paper, Smoking’s Immediate Effects on Your Body, available at http://tobaccofreekids.org/research/factsheets/index.php?CategoryID=13

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The Master Settlement Agreement (MSA) 1
TOBACCO MARKETING & ADVERTISING RESTRICTIONS

• Eliminates tobacco billboards and transit ads.
• Prohibits use of cartoon characters to promote tobacco products.
• Prohibits tobacco brand name merchandise except at tobacco-sponsored events.
  
• Prohibits tobacco brand name sponsorship for concerts, events where contestants are under 18, or for football, baseball, soccer or hockey.
  
• Limits other tobacco brand name sponsorship to one event or series annually by manufacturer.
  
• Permits free tobacco-product distributions only at locations where children are not permitted.
  
• Restricts offers of non-tobacco items or gifts based on proof of purchase to adults.
  
• Prohibits use of non-tobacco brand names on tobacco products (such as Harley Davidson cigarettes).
  
• Reaffirms the previously agreed upon prohibition on tobacco product placement in movies and on TV.

ADVERTISING & MARKETING STILL ALLOWED

• Outdoor advertising with signs of 14 sq. ft. or smaller on buildings or property of places where tobacco is sold and at events sponsored by the tobacco industry.
  
• The use of human images in tobacco advertising, such as the Marlboro cowboy.
  
• No specific restrictions on tobacco advertisements in newspapers and magazines.
  
• No specific restrictions on advertising in places that sell tobacco products.
  
• Single tobacco brand-name sponsorship of auto racing, rodeo, or other event not specifically prohibited, with “single” sponsorships including the sponsorship of an entire series of auto races, rodeos, or other events (e.g., all NASCAR races).
  
• No specific restrictions on the televising of tobacco brand-name sponsored events.
  
• Unlimited tobacco-company sponsorships of events in their corporate (as opposed to brand) names.
  
• No specific restrictions on tobacco Internet advertising.
  
• No specific restrictions on tobacco direct-mail advertising.
  
• The agreement does state that tobacco companies cannot “take any action, directly or indirectly, to target youth in the advertising, promotion, or marketing of tobacco products.” This provision has been used successfully to stop some advertising in magazines with large youth readerships.

Adapted from Summary of the Multistate Settlement Agreement (MSA), Campaign for Tobacco-Free Kids, July, 2003.
For additional information: http://www.tobaccofreekids.org/research/factsheets/index.php

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The Master Settlement Agreement (MSA) 2
PUBLIC EDUCATION PROGRAM TO REDUCE YOUTH TOBACCO USE

• Requires tobacco companies to contribute $300 million/year for five years (ending 2003) to a newly created National Foundation (the Legacy Foundation) for a public education program to reduce underage tobacco use and educate consumers about the causes and prevention of diseases associated with the use of tobacco products.
  
• Prohibits any use of the National Foundation’s public education funds to support ads that vilify the tobacco industry, any of its member companies, or any of its employees (tobacco companies have used this restriction to stop various Legacy Foundation ads).
  
• This funding for public education has now ended; the Legacy Foundation still has funds remaining from the prior-year payments and will continue in operation.

TOBACCO RELATED RESEARCH, LOBBYING, AND FUTURE CLAIMS

• Requires tobacco companies to provide the national foundation with $25 million/year through 2008 to support research concerning tobacco use and other substance abuse.
  
• Dissolves the Tobacco Institute, the Council on Tobacco Research, and the Center for Indoor Air Research, which all served as propaganda tools of the tobacco industry.
  Bars any efforts by tobacco companies or their lobbyists to oppose eight specified kinds of new state or local tobacco-control legislation or administrative rules:
  1. restrict youth access to vending machines;
  2. include cigars in definition of tobacco products;
  3. enhance enforcement of laws forbidding sales to youth;
  4. support the use of new technology to enforce age-of-purchase laws;
  5. limit promotions of non-tobacco products that use tobacco products as giveaways;
  6. enforce access restrictions through penalties on youth possession or use;
  7. limit tobacco product advertising or wearing of tobacco logo merchandise in or on school properties; and
  8. limit non-tobacco products designed to look like tobacco products (e.g., candy cigarettes).
  
• Tobacco companies can continue lobbying against any of these measures if they had already begun opposing them prior to the settlement.
  
• Requires that industry documents produced in litigation be placed on the Internet; the industry must maintain the site for ten years; and produce an index to the documents.
  
• The agreement settles all claims the states brought or could have brought against tobacco companies based on tobacco company action taken before the settlement. It also settles all potential claims by states based on the companies’ future acts that pertain to the use of or exposure to tobacco products manufactured by the companies, including claims for related health costs. It does not block potential claims based on future actions not related to the use of or exposure to tobacco products; nor lawsuits by Indian tribes or private citizens.

Adapted from Summary of the Multistate Settlement Agreement (MSA), Campaign for Tobacco-Free Kids, July, 2003.
For additional information: http://www.tobaccofreekids.org/research/factsheets/index.php

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The Master Settlement Agreement (MSA) 3
TOBACCO COMPANY PAYMENTS
Tobacco companies are required to pay approximately $195.9 billion to the states between now and 2025. Payments are increased to account for inflation, but reduced when the top four cigarette companies’ combined U.S. cigarette sales or their combined percentage share
of the total U.S. cigarette market fall below 1997 levels.

There are no restrictions on how the states spend the settlement funds they receive but there is strong language that indicates that they are expected to spend a significant portion to prevent and reduce tobacco use, especially among kids.

NEW YORK: TOBACCO STATE SETTLEMENT AND TOBACCO PREVENTION SPENDING
The state of New York received its first payment, $315 million, from the settlement in 1999.

Since that time the payments to the state have ranged from $715.8 million to $955.8 million. In 2005, New York state received $804.4 million.

The 1998 multi-state agreement stipulated that the state receive 51.2% of the tobacco settlement payments, New York City gets 26.6%, and the 57 counties outside New York City share the remaining 22.2% based on a set formula.

New York state’s share of the funds are folded into the state’s general fund and allocated through the annual budget process. A 1999 law, the Health Care Reform Act (HCRA), set aside most of the settlement payments for several specific programs funded under the Act,
including tobacco prevention.

The HCRA also increased the state’s cigarette tax by 57 cents per pack, to $1.11 per pack.

The additional cigarette tax revenue was also appropriated to the various health programs.

HCRA funded tobacco prevention at $30 million in FY 2001, $40 million in FY 2002 and FY 2003, $37 million in FY2004, 39.5 million in FY2005, and $43.4 million in FY2006.

In 2002, Governor Pataki proposed securitizing, or selling to investors, about half of New York’s future settlement payments for a much smaller, up-front payment. Under a plan organized by the NYS Association of Counties, 29 of 58 counties have securitized future settlement proceeds. Funds received are being used to fund a variety of capital projects.

Programs funded by the remainder of New York’s FY2006 settlement funds include the Children’s Health Insurance Program (CHIP), indigent care, family health programs, mental health programs, pharmaceutical assistance, Medicaid expansion, and small business health insurance.

NEW YORK: CDC RECOMMENDED MINIMUM SPENDING ON TOBACCO PREVENTION $95.83 Million
Adapted from Tobacco State Settlement: New York, Campaign for Tobacco-Free Kids, Nov. 2005.
For additional information: http://www.tobaccofreekids.org/research/factsheets/index.php