In total, smoking is linked to an estimated 480,000 deaths per year in the U.S., of which cancer is just one cause. Other fatal conditions include heart disease, stroke, diabetes and lung disease. But because smoking is preventable, and because it makes up a significant portion of the deaths linked to cancer, ACS researchers write in their study that tobacco control should be a major part of the Obama administration’s Cancer Moonshot initiative. 

Why is the South most affected?

The South has historically had higher rates of cigarette smoking than the rest of the country for several complex reasons. For one, the region’s low educational attainment and high levels of poverty, both of which are linked to higher rates of smoking, may play a role.

Another reason is that many states in the region are home to tobacco growers who have a lot of political influence in state government. Indeed, 95 percent of U.S. tobacco is grown in the South, according to the ACS researchers.

But southern states also have a political history that makes it even more difficult for state governments to institute research-proven tobacco control policies like high cigarette taxes and comprehensive clean indoor air laws, or invest in educational programs that help adults quit and prevent kids from smoking in the first place, explained Dave Dobbins, chief operating officer of the Truth Initiative, a youth smoking prevention foundation.

“There is a tradition in these states of being resistant to taxation and government intervention in general,” said Dobbins. “That’s part of the character of these states, and I want to make clear that’s not a bad thing. But tobacco is different.”

In contrast, states that have done the most to curb tobacco use through indoor smoking bans and cigarette taxes have the lowest proportion of smoking-related cancer deaths.

California was the first in the nation to ban smoking in indoor workplaces and restaurants in 1995 ― a policy they followed up with a 1998 ban on smoking in bars. At the time, these rules were criticized as “draconian” and “unenforceable,” but California persevered and other states eventually followed suit. Just this year, the state raised the smoking age from 18 to 21, making it the second state to do so after Hawaii. California is 49th on the ACS’s list of the proportion of cancer deaths caused by cigarette smoking.

At $4.35 per pack, New York has the highest state cigarette taxes in the nation (the nationwide average is $1.65). It ranks 47th in cancer deaths caused by cigarette smoking.

Dobbins called it “no accident” that the states with the highest rates of smoking-related cancer deaths were also the states with the weakest anti-smoking regulations. Eight of the 21 states that spend less than 10 percent of the CDC-recommended amount on tobacco control programs are in the South, as are nine of the 14 states with the most relaxed indoor smoking laws.

“The states that haven’t done those things are the ones whose citizens are suffering,” said Dobbins. “These cancer deaths are ugly ― they cause a lot of pain, they cause a lot of misery, and it’s really bad for the people living there.”

  body and soul, health, healthy living