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Kentucky appears to be slowly letting go of its tobacco heritage that has kept the state at the bottom of national lists on the number of people who light up or use smokeless products.
For years, Kentucky has been the number one state in the nation for percentage of residents who smoke. But this year’s numbers show the Bluegrass state has dropped to number three behind West Virginia as first and Indiana as second, according to the Center for Disease Control.
But a recent conference held for the media in Danville on Sorting Through the Smoke shows that the state and its counties continue to experience high health and financial costs caused by smoking to the Commonwealth. Organizers indicated they planned this statewide program to disseminate information into rural communities with the hope of changing the pro-tobacco norm in Kentucky and to reduce tobacco use long term.
Information provided at the conference from the Kentucky Institute of Medicine shows Carroll County with one of the highest adult smoking rates in the state, well above average. While smokers make up 29 percent of the state’s population, that number is 35 percent in Carroll County. The youth rate in Carroll County is also above the state’s average at 31 percent.
Three Kentucky counties have higher adult rates at 36 percent of their population and eight counties are at the same levels as Carroll County.
Trimble County is lower with 29 percent of smoking adults and 25 percent of youth, according to the institute. Owen County is the lowest in the three-country area with 25 percent for adult and 22 percent youth smokers.
The number of pregnant women who smoke is even higher with Carroll having 38 percent of women who are smoking while pregnant and Trimble has 47.6 percent. Owen has the lowest rate with 33.6 percent of women who are pregnant and smoking.
The Kentucky Center for Smoke-Free Policy has collected data that tracks smoking habits in general, as well as the workplace and schools.
Smoking is allowed in many of Carroll County’s larger industries, the group’s information shows.
In 2008, 40 percent of manufacturers with 50 or more employees in Carroll County permitted indoor smoking. The center for smoke-free policy indicated that 60 percent of manufacturers in the county offer and reimburse for cessation programs. The percentage of manufacturing workers covered by an indoor smoking policy was 79.6 percent with the state coming in at 73.2.
Neither Trimble nor Owen Counties had any employers that fit into the categories tracked with manufacturers having 50 or more employees.
In Carroll County, smoking is allowed in the old courthouse and the Carrollton and Ghent city buildings. The William Wheeler Hall of Justice prohibits smoking under a state statute and the Carroll County Detention Center went smoke free this year with a mandate from the department of corrections.
To consider a change in the smoking policy at the city offices in Carrollton, Mayor Dwight Louden said the council would need to pass a resolution to prohibit the use of tobacco in the city building to make the building smoke free.
Presenters at the Sorting Through the Smoke conference stressed that these numbers and practices take their toll on Kentucky’s population.
“Smoking is the single greatest cause of preventable death worldwide with one person dieing every six seconds,” according to Audrey Darville a certified tobacco treatment specialist at the Sorting through the Smoke conference.
Kentucky has 22 people every single day die from smoking related illnesses, according to Darville.
“Starting smoking is a choice, but quitting smoking isn’t necessarily a choice,” Darville said.
Becky Wilson, the health educator in Carroll County who teaches the Cooper Clayton Method to Stop Smoking, has found that it’s difficult for those who want to quit. She has had no one finish the program and only two people actually make it to the second week of the 13 -week program, which is the same as the one taught in counties throughout Kentucky.
The program is free, but participants must purchase their own nicotine replacement products such as patches or nicotine gum, Wilson said. The cost of the replacement medications can be as high as $40 for two weeks and Wilson sees that as the main reason the program has not been successful here.
“We did have a grant to pay for the nicotine replacement products in Gallatin County and that increased participants dramatically,” Wilson said.
Kentucky lags behind even in cessation programs, according to those at the conference, being one of only six states that does not pay for cessation medications.
Darville also explained that snuff or dipping is also a serious problem among our youth and adults.
Second-hand smoking related deaths nationwide is equal to three jumbo jets crashing every day, according to Ellen J. Hahn a professor at UK college of nursing and prolific researcher and author on smoking related topics and seminar presenter.
Hahn said that nearly 75 percent of Kentuckians don’t smoke, but 70 percent are exposed to second-hand smoke.
But one person attending the Sorting Through the Smoke meeting brought a different point of view. Jim Waters of the Bluegrass Institute said he believes businesses should not be forced by the government to restrict smoking. He stated that the government had no business telling a private property owner whether anyone could smoke on their property.
However, he did concede that all government buildings, where someone had to go to conduct business such as get a drivers license or pay taxes, should be 100 percent tobacco free.
With more than 250 chemicals, many of which are carcinogens, the FDA does not regulate cigarettes, according to Paul Kiser, director of Kentucky ACTION, the statewide tobacco-control coalition. “The FDA regulates what goes into lipstick, but not cigarettes,” Kiser said.
Smoking in the schools
Of the three categories tracked by the Kentucky Center for Smoke-Free Policy Carroll County schools did not fare well when compared with neighboring school districts.
Carroll and Owen counties had no schools that banned smoking on school grounds for employees. The policy at Carroll County states that no tobacco is to be used inside the buildings, but certified and classified adult employees may smoke in designated areas outside the building. Carroll County students may not use or possess any tobacco product on board property, vehicles or on school sponsored trips. Trimble County banned smoking on school grounds for employees in half of their schools.
Information provided by KSCP at the conference showed that 50 percent of schools in Carroll and Trimble Counties offered cessation programs in 2007, while Owen County offered this at all schools.
A final category tracked by the group looked at schools that posted no tobacco signs inside the schools. Carroll and Owen County had no signage, while Trimble County had this at all of its schools.
Becky Wilson said she believes that students are getting a good picture of the dangers of smoking and teaching them earlier does help in curbing smoking as they get older but cessation for those who do start is still a problem.
Wilson recently gave a short seminar in Charla Froman’s eighth grade class and asked class members to write letters to someone they loved asking them to quit using tobacco.
One son wrote to his father asking him to quit dipping because of the possibility he would get oral cancer and die.
One daughter said to her mother, “If you smoke then that means I smoke,” referring to second-hand smoke.
Another daughter pleaded with her mother to stop smoking and her father to stop dipping. “When you smoke you increase your risk of heart disease, cancer and stroke. Cigarette smoking is the most important preventable cause of deaths in the U.S. Dad, when you dip eight to 10 chews you’re really smoking 30 to 40 cigarettes a day,” she wrote.
One student wrote to her grandmother about an illness she has that was brought on by her smoking. The girl gives her grandma some facts about how bad smoking is for her and then gives her tips to help her stay off cigarettes. “The rest of your life depends on your decision. Make it good.”
The cost of smoking
Smoking is an expensive habit anyway you look at it according to Jeff Talbert, an associate professor in the college of pharmacy at UK. Talbert asserted at the conference that the estimated price of smoking in medical costs is approximately $40 per pack.
He said a person smoking one pack of cigarettes a day will spend $1,380 per year.
Insurance premiums are higher for smokers and health care costs are 40 percent higher for smokers, according to Talbert.
Scott Brown of Phil Brown Insurance Agency in Louisville, and carrier for the insurance for Carroll County employees, said in a recent phone interview that smoking is a negative factor in determining insurance rates. If the county could reduce claims by increasing employee health, it would drive down rates, he said.
D’anne Smith of Mark Smith State Farm Insurance in Carrollton agreed saying that being a non-smoker is huge in determining individual health or life insurance rates.
Smith showed that a non-smoker pays about 43 percent less in premiums per year than a smoker.
Kentucky spends $4.5 billion on Medicaid annually and 38 percent of adults receiving Medicaid smoke according to Talbert whose focus is with Medicaid recipients. “If we could reduce that to 20 percent Kentucky could save $650 million a year,” Talbert said.
Kentucky does receive money from taxes on tobacco products, officials noted saying the state still has the 38th lowest cigarette tax in the nation.