Great American Smokeout a time to boost efforts to end smoking

As a lung cancer specialist at The Cancer Institute of New Jersey Hamilton, I have seen suffering and death without regard to age, sex, ethnicity or class. The time has come to take steps that will ease the suffering.

“Will there be suffering at the end of my life? Will I die in pain?”

I have been asked these and similar questions too many times. As a lung cancer specialist at The Cancer Institute of New Jersey Hamilton, I have seen suffering and death without regard to age, sex, ethnicity or class.

The time has come to take steps that will ease the suffering. It is the appropriate time for several reasons.

First, today is the Great American Smokeout. On this day, the American Cancer Society encourages smokers to make a plan to quit, or to plan in advance and quit smoking that day. According to the ACS, tobacco use remains the single largest preventable cause of disease and premature death in the United States, yet more than 46 million Americans still smoke.

Second, November is Lung Cancer Awareness Month. According to the Lung Cancer Alliance, lung cancer is the leading cause of cancer death in every ethnic group.

Finally, November is a time for elections. With that in mind, we must urge our newly elected representatives in Trenton to fund smoking cessation programs at the Centers for Disease Control and Prevention-recommended figure of $120 million a year.

With our children and family members’ lives at stake, we cannot afford to wait any longer.

According to the ACS’s projections, 6,210 new cases of lung cancer will be diagnosed this year, and an estimated 4,160 New Jerseyans will die this year from lung cancer. More than 80 percent of these cancers are smoking-related and thus preventable.

The consequences of smoking are not limited to the smokers.

Second-hand smoke

According to the American Lung Association, more than 187,000 children and 512,000 adults suffer from asthma. For those not impressed with preventable death and suffering of children from asthma, $193 billion may catch their attention. That is the cost of smoking-related health care and productivity loss per year for the United States, according to the CDC.

In New Jersey, 15 percent of our citizens currently smoke, and more than 40 percent have smoked at some point in their lives. Most of these parents, children, spouses and family members are caring people who are addicted. Many realize the risk and burdens of smoking and its effects and want to quit. What they require is support and help.

CDC data suggests that we have made strides over the past two decades in both adult and teen smoking when we were funding smoking-cessation programs.

Unfortunately, the funding has dwindled to almost nothing.

Where’s the money?

New Jersey had been funding its comprehensive tobacco control program at a level of $30 million per year in 2001. Those funds came from the Master Settlement Agreement with the tobacco companies. With securitization of those funds to balance the budget, that money is gone.

According to “Up in Smoke,” a study released in September by the ACS, New Jersey in the current fiscal year will spend almost nothing on tobacco control. The state provided only 1 percent of the amount recommended by the CDC, with most of that paid for with federal grants. In fact, the report chillingly states, “this year the state of New Jersey actually turned away people wanting help to quit smoking because of a lack of funding.”

This is unacceptable.

At the time “Up in Smoke” was released, The Star-Ledger of Newark quoted Jennifer Sullivan, a co-author of the report, as pointing out that New Jersey imposes the sixth-highest cigarette tax in the nation, at $2.70 a pack. “We believe the money is there,” Sullivan said.

I agree, but if we have to, we must increase that tax—only if all of the money goes to smoking cessation efforts.

The report states clearly that raising the tax can do more than pay for cessation programs: It can also prompt people to stop buying. For every 10 percent increase in price, there is a 4 percent decrease in overall consumption.

The report provides a path for reaching the CDC-recommended $120 million, saying $30 million should be budgeted in 2012-13, with that number increasing incrementally.

It would be money well spent.

Success with funding

When adequately funded, the Massachusetts tobacco prevention program was reducing smoking-caused health care costs in the state by two dollars for every dollar spent on the program, according to the report. A longer-running California program was saving more than $3.50 for every dollar the state spent on the program.

In bad economic times, when every dollar must be watched closely, spending money on these programs just makes sense. But if the economic reasons are not enough to make you reach out to your representatives in government, think of those questions again, the ones I’ve heard again and again. They will make clear the human toll when smoking cessation programs are unfunded.

“Will there be suffering at the end of my life? Will I die in pain?”

Dr. Biren Saraiya is Medical Director at The Cancer Institute of New Jersey Hamilton, RWJ Hamilton’s oncology program. It is an affiliate of the Cancer Institute of New Jersey in New Brunswick, the only National Cancer Institute-designated cancer center in New Jersey.