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West Virginia scores four failing grades in annual Lung Association State of Tobacco Control report

By David Beard

The report grades the 50 states on policies and laws aimed at curbing tobacco use.

“Overall, a lot of great work has been done in West Virginia,” said Molly Pisciottano, the ALA’s advocacy director for West Virginia and Pennsylvania. “We could do more and be able to help more people if we could reach these goals on this report card and raise these grades.”
Leading up to the 50 states’ grades, the ALA makes some overall observations about tobacco use.

In the midst of COVID-19, ALA notes that the U.S. Surgeon general’s office has linked smoking to immune system suppression and that the CDC says smoking increases the risk of COVID infection.

ALA added a new category this year: flavored tobacco policies. It says flavored tobacco products have a disproportionate effect on certain communities. For example, more than 80% of Black Americans who smoke use menthol cigarettes; menthol cigarettes are also favored among LGBTQ smokers, pregnant women and low-income smokers.

And while overall smoking rates have declined by 26%, ALA says, 91% of that decline was among non-menthol smokers.

Flavored vapes are also an issue for ALA. Vaping among high school and middle school students has declined in the past two years — largely related to Juul pulling most of its flavors in 2019 — but more than 3.6 million are still vaping.

Before looking at the five categories, we note that West Virginia’ four neighbors scored either worse or only somewhat better: Kentucky received four F’s and a C; Maryland, three F’s, an A and a B; Ohio, three F’s and A and a C; Pennsylvania, three F’s and two D’s; Virginia, five Fs.

The grades

  • West Virginia received an F in Tobacco Prevention and Control Program Funding. The CDC recommendation is $27.4 million. West Virginia budgets $445,000 and receives $1.2 million in federal funds, so total spending is 6% of the CDC target. The report says the state’s total tobacco-related revenue is $234.4 million.

Asked how the state could spend more, Pisciottano suggested using money from the Revenue Shortfall Fund Part B – part of the Rainy Day Fund, created in 2006 from Tobacco Settlement money.

“Our hope is that some of that funding should and could go to tobacco prevention and control program funding,” she said.

  • The state also received an F for its tobacco taxes. West Virginia’s taxes are $1.20 per pack of cigarettes, 12% of the wholesale price for “other” tobacco products such as chew, and 7.5 cents per milliliter for vape liquids.

Raising the tax could provide more prevention and control money, Pisciottano said, especially if the increase is earmarked for those programs.

The national average for cigarettes is $1,80 per pack, and ALA recommends hiking the tax at least $1, she said.

Among West Virginia’s neighbors, Kentucky’s cigarette tax is $1.10 per pack; Maryland, $2; Ohio, $1.60; Pennsylvania, $2.60; Virginia, 60 cents.

The Dominion Post told Pisciottano that counties bordering Virginia regularly oppose tax hikes over fears of losing convenience store business, while some fear losing the business from states with higher taxes.

She said ALA would like to see all states raise their taxes. “Every state can do better.” The ultimate goal is to raise revenue and decrease tobacco use. “In the end, that would save lives and would save funding that goes to health care-related costs for tobacco-related death and disease.”
West Virginia scored a D for Smokefree Air policies.

On the positive side, Pisciottano said, local authorities have the ability to pass their own comprehensive smoke-free laws. Now, 31 counties ban smoking in all enclosed workplaces; 38 include e-cigarettes. ALA would like to see all counties have comprehensive bans, including inside casinos and including e-cigarettes.

She cautioned ALA doesn’t want a preemptive statewide ban by the Legislature, but that all 55 counties enact full bans.

West Virginia also scored an F in Access to Cessation Services. The state Medicaid program covers all seven smoking cessation medications but not all three forms of counseling: phone, individual and group. It’s the same for those covered by PEIA.

West Virginia has no private insurance mandate for cessation coverage and no tobacco surcharge: a higher Medicaid cost for smokers.

And finally, West Virginia scored an F in Flavored Tobacco Products laws.

Banning flavors is crucial to ending the youth aping epidemic, Pisciottano said. Nationally, about 20% of all high school teens vape, but the figure is closer to 40% in West Virginia. And more than 80% of kids who start on tobacco start with flavors.

“It’s primarily what hooks kids,” she said.

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