HJNO Nov/Dec 2019

Q&A 24 NOV / DEC 2019 I  Healthcare Journal of new orleans   Louisiana citizens seeking help to stop smoking/vaping. We at the Trust are deeply concerned that this migration to vaping/e-cigs via Juul and similar e-cig products, will create a whole new generation of cigarette smokers, per- haps re-igniting smoking in former smokers who quit some time ago, but who may still have nicotine-driven cravings. Vaping has the potential to undo the great work that has been accomplished over the past 10–15 years to reduce the smoking prevalence to near or below 15 percent nationally, and fall- ing—a tragedy by anyone’s measure. As we say at the Trust, “Don’t switch; quit!” Many states seem to be moving toward Tobacco 21 legislation. Do you think Louisi- ana will raise its tobacco purchase age to 21? A pretty good effort to make such a change was attempted in the Louisiana legislature this year. A form of Tobacco 21, the movement to pass new laws forbidding the sale or use of cigarettes/tobacco/e-cigs/ vaping (i.e., nicotine) to youths under the age of 21 years of age is now law in 18 states, and counting, and over 500 localities across the United States. It was introduced as House Bill 38 by Representative Frank Hoffmann, District 15, Monroe, in our 2019 session, and was approved by the House Health andWel- fare Committee, but was defeated on the House floor. It was officially supported by the Orleans ParishMedical Society, the Jef- ferson Parish Medical Society, the Smok- ing Cessation Trust, and many of the largest hospital providers across our state. Oddly, it was even supported by the tobacco industry itself, leaving many to wonder how it could have failed on the House floor. The Smoking Cessation Trust strongly encourages the citizens of Louisiana to join us in putting pressure on the state legisla- ture to make the needs of our youth a pri- ority. If this coalition of support continues to grow this year, and into the spring 2020 legislative session, we could possibly see our representatives do the right thing and pass Tobacco 21. How much is smoking costing Louisiana tax- payers and employers? It is time for the Louisiana public to get serious about the impact of smoking and other health-impacting lifestyle issues— what the CDC calls social determinants of health. We love to live large in Louisiana, but there is a price to be paid for some of our overall health behaviors. Let’s try to wrap our collective minds around just one sta- tistic; through state taxes, we pay nearly $4 billion per year in costs associated with just smoking. If we get serious about help- ing our fellow citizens who smoke obtain cessation/nicotine addiction help to quit, we could avoid both the measurable costs ($4 billion) that add to our tax burden, and the unmeasurable costs of life-long health issues that inevitably impact the lives of smokers. To accomplish this will require a few changes: • Health plans who cover the people of Louisiana need to cover cessation treatment and medications, as reflected in the U.S. Public Health Service’s “Treating Tobacco Use and Depen- dence: 2008 Update.” • Government-sponsored health bene- fits need to cover cessation treatment and medications, as reflected in the U.S. Public Health Service’s “Treating Tobacco Use and Dependence: 2008 Update”. • Physicians need to be provided train- ing in evidence-based treatments for nicotine addiction. • Our cigarette tax needs to increase to limit access to tobacco products for those under 21 years of age. • Tobacco should not be a legal product for those under 21 year of age, to deny the tobacco industry access to another generation of consumers. • The Louisiana legislature needs to redi- rect tobacco settlement funds from the general fund (or use new tobacco taxes) to fund a CDC recommended, state-wide cessation program until either the settlement funds are no lon- ger received from the tobacco industry, or until no Louisiana resident smokes tobacco products. What is the biggest challenge the Trust faces? The Smoking Cessation Trust’s court order does not allow us to advertise. Due to this restriction, the number of Louisi- ana residents we have been able to reach with information about the Trust program has been reduced. We know from the work we do with the CDC that when they spend advertising funds for the Tips from Former Smokers campaign each year in Louisiana, the calls to the state Quitline increase by three to five times over the period when they are not advertising. It seems logical that if the Trust could advertise, we could help the entire potential Trust member- ship of more than 400,000 people more efficiently. Therefore, we rely heavily on physicians and hospitals across the state to identify and refer patients who started smoking before 9/1/1988 to the Trust for assistance in order to get them qualified and approved to receive free care and stop smoking cigarettes. While we hope the court that oversees the Trust will see fit to extend the 10 years codi- fied in the trial court orders pertaining to the Trust, those eligible in Louisiana can only count on the Trust’s benefits being available till July 2022. If doctors and hospitals truly care about their patients who smoke, now would be the ideal time to refer them to us. How can eligible people who want to quit contact the Smoking Cessation Trust? Louisiana citizens who started smoking before 9/1/1988 can contact the Smoking Cessation Trust at www.smokefreela.org ; locally at 504-529-5665 or toll-free at 855- 259-6346. n