Lung Association gives Arkansas failing grades on tobacco; wants special session

The American Lung Association gave Arkansas a failing grade in three areas and Cs in two others in a report released Jan. 29.

In its “State of Tobacco Control,” the Lung Association gave the state F’s in the following areas:

– Funding for state tobacco prevention programs
– Level of state tobacco taxes
– Coverage and access to services to quit tobacco

The report said the state is spending $13,206,874 on state tobacco control programs, of which more than $11 million comes from state funding and the rest from federal funding. That’s 36% of the Centers of Disease Control’s recommended $36.7 million. The state generates $279.4 million in tobacco-related revenues, the report said.

Cigarettes in Arkansas are taxed at $1.15 per pack of 20. The Association recommends state tobacco taxes be increased by at least $1 per pack and that taxes be equalized on all tobacco products. It said studies have shown that each 10% increase in cigarette prices reduces adult use by 4% and youth use by 7%.

In 2019, the Legislature passed a law providing Medicaid coverage for all seven tobacco cessation medications approved by the Food and Drug Administration. But the Medicaid program covers only minimal counseling services and barriers exist to accessing coverage, the report said.

Moreover, only minimal medications and counseling are covered in state employee health plans, the report said. Private insurers are not mandated to cover cessation programs.

The state received C’s in these areas:

– Strength of smoke-free workplace laws
– Minimum age of sale for tobacco products

Smoking is prohibited at government worksites, schools, child care facilities, retail stores and other areas. It also is banned at private workplaces other than those with three or fewer employees. But the ban does not extend to e-cigarettes.

In 2019, the Arkansas Legislature raised the minimum age for purchasing cigarette and e-cigarettes to 21. But the Lung Association opposed that bill because it prohibited communities from passing stronger local policies and exempted members of the military.

Dr. Joe Thompson, Arkansas Center for Health Improvement president and CEO, said the age restriction won’t be effective unless the law is enforced regarding sellers and unless age-eligible buyers are prevented from reselling or providing to youths. He also called for prohibiting advertising of e-cigarettes in the same way that tobacco advertising to youths is prohibited.

He said tobacco use is the number one cause of preventable disease and deaths in Arkansas.

The Lung Association recommends the removal of current exemptions in the Clean Indoor Air Act and recommends the inclusion of e-cigarettes. It also recommends repealing the preemption of local authority over tobacco passed by the Legislature last year, and prohibiting the sale of all flavored tobacco products including e-cigarettes.

The report says the adult tobacco use rate in Arkansas is 31.4% and the smoking rate is 22.7%. The high school tobacco use rate is 26.3% and the smoking rate is 13.7%. It estimates the annual health costs due to smoking at more than $1.2 billion.

The report says tobacco control supporters are trying to produce legislation to be considered in a special session that would occur before the start or after the end of this year’s fiscal session. The fiscal session will convene April 8.

Sen. Jim Hendren, R-Gravette, who tried unsuccessfully to pass such legislation in 2019, said he is meeting this week with potential allies about that subject, but the effort is in the beginning stages.

“We’re working on that, but I’m not kidding myself about how difficult it would be to get consensus on something as controversial as taking on big tobacco,” he said.

Hendren last year tried to pass a bill that would have levied what amounted to a 67% tax rate on e-cigarette products while also increasing taxes on cigarettes. The proceeds would have funded an earned income tax credit, a tax refund for lower-income Arkansans. The bill also would have levied a 20% special excise tax at the retail level on cigarettes, or 80 cents a pack.

Introduced late in the session, it narrowly passed the Senate with bipartisan support but died in the House. It then was placed in interim study.

Months later, the House and Senate Public Health, Welfare and Labor Committees voted Sept. 18 to adopt an interim study proposal to determine strategies to combat teen vaping. The proposal was submitted by Hendren and Sen. Missy Irvin, R-Mountain View, the committee chair.

Hendren said challenges remain to holding a special session.

Irvin said via email that she doubted a special session will occur this year.

“I do not see the support in either chamber to call for a special session,” she wrote. “I do anticipate this will be an issue in the 2021 session, but not anytime before.”

In September, Hendren introduced the School Safety Act, which would tax vaping products equivalent to the 67% tax currently levied on other tobacco products and use that money to fund school safety. It also would enact other restrictions.

Hendren said he wants taxes on tobacco and tobacco-related products to cover the health care costs caused by those products. The Arkansas Center for Health Improvement said last year the state’s Medicaid program spends $795 million annually to treat tobacco-related illnesses in adults ages 30-65, but tobacco taxes raised only $230 million.