OHSU Researcher Co-authors National State-by-State Report Card on Women and Smoking; Oregon Flunks
09/30/03 Portland, Ore.Smoking is the leading cause of preventable death among women, yet 38 states, including Oregon, received failing grades for not meeting national goals to reduce and prevent smoking among girls and women. The report shows that our nation is not doing enough to stop this major killer of women and the billions in health care costs it imposes on state and national budgets, according to the Report Card released today by the National Women's Law Center and the Center for Women's Health at Oregon Health & Science University.
Women and Smoking: A National and State-by-State Report Card is the first survey to comprehensively assess women's smoking-related health conditions and the policies that have proved effective in reducing smoking. The study grades and ranks each state based on 11 health status indicators, and evaluates the strength of state tobacco control policies through 10 policy indicators. The nation is evaluated as well. Women and Smoking grades the health indicators against goals drawn primarily from the U.S. Department of Health and Human Services' Healthy People 2010.
"This report delivers deplorable news for women, especially in Oregon. A lot of women are dying and we can and should be doing more to help. These are preventable deaths," said Michelle Berlin, M.D., M.P.H., associate professor of obstetrics and gynecology, and public health and preventive medicine, OHSU Center for Women's Health. She is the primary author of the health status aspects of this report.
Oregon received a failing grade and tied with Virginia for 20th place in the nation.
Almost 2,000 women die of smoking-related deaths each year in Oregon. That is more than four times the number of women who die of breast cancer, which claims the lives of about 485 women each year in the state. Nationally 178,000 women die annually from conditions related to smoking, including lung cancer and cardiovascular disease.
In Oregon almost 20 percent of adult women smoke. Among those, the number of smokers aged 18 to 44 is especially alarming, Berlin said. In the 18-to-24-year-old range, 26 percent smoke; in the 25-to-44-year-old group, 24 percent smoke -- all higher rates than the national numbers.
Oregon also fares worse than the nation for how many pregnant women smoke, especially for teenagers. More than 25 percent of pregnant girls aged 15 to 19 smoke. Overall, 13 percent of pregnant women smoke. The national goal for pregnant women smoking is less than 1 percent.
"The rates of smoking among teenagers and young women whether pregnant or not is extremely discouraging. There is a culture with young girls that smoking is cool, there's peer pressure and there's also the feeling of invincibility among teenagers," said Berlin. "We are not getting through to this group. We have to make it not cool. The best way to stop the effects of smoking is never to start smoking, and we know the best way to keep kids from smoking is to make it expensive with a high excise tax on each pack of cigarettes. Oregon is good at this, but not great."
There are a few encouraging notes in the report. In Oregon, Medicaid insurance, which is for low-income people, does cover smoking cessation programs. However, the state does not mandate private insurers do the same, and 17 percent of women in Oregon have no health insurance. Also, 53 percent of women smokers in Oregon are trying to quit, but that does not meet the national goal of 75 percent. While only 30 percent of the funding for Oregon's tobacco control efforts have been restored, a hopeful sign is that the statewide smoking cessation telephone line is expected to return. The phone line has been one of the more successful ways to help smokers quit in our state, showing quit rates at twice the national average. Nevertheless, stronger measures are needed, Berlin said.
No state received the highest grade of "Satisfactory," and only two states received a grade of "Satisfactory Minus." Utah ranked first overall, although even its grade was only Satisfactory Minus. Utah is followed by Hawaii, Massachusetts, Minnesota, Connecticut, District of Columbia, California, Colorado, Maryland and New Jersey. The 10 states that ranked the lowest were Nevada, Kentucky, West Virginia, Arkansas, Tennessee, Indiana, Oklahoma, Ohio, Missouri and Wyoming. The nation received an overall grade of "Fail."
How do we reach the national goals set for women and smoking?
"The best advice for women is to never start. Then, we need to make it more expensive, which has been shown to prevent young girls from smoking. If you smoke, you need to stop as soon as possible. The state as a whole needs more cessation programs, more insurance coverage, more bans on work-site smoking, more smoke-free homes and more health care providers talking to their patients about how best to quit smoking," Berlin said.
The impetus for the Women and Smoking Report Card came from National Women's Law Center's work on its Making the Grade on Women's Health report card series, which regularly assesses the overall health of women at the state and national levels. It is funded by the American Legacy Foundation, Bristol-Myers Squibb Foundation, CIGNA Foundation, and Open Society Institute.