美国肺脏协会+2022年烟草控制状况报告-136正式版

“State of Tobacco Control”2022:20 Years of“State of Tobacco Control”Celebrating the Progress Made and Recognizing the Work that Remains to be Done Executive SummaryThe American Lung Associations annual“State of Tobacco Control”report evaluates states and the federal government on actions taken to eliminate the nations leading cause of preventable deathtobacco useand save lives with proven-effective and urgently needed tobacco control laws and policies.The Lung Association proudly marks the 20th anniversary of releasing its“State of Tobacco Control”report in 2022 by reflecting on the progress made over the past 20 years and looking ahead to the significant amount of work that remains to be done to end tobacco-caused death and disease in this country.A new generation of tobacco products,including e-cigarettes,threatens the progress made,as more than two million middle and high school students reported using e-cigarettes in 2021.1 In response to the youth vaping epidemic,new public policies,including ending the sale of all flavored tobacco products,have risen in importance as well.Key themes in“State of Tobacco Control”this year include:FDA Opportunities in 2021 to Reduce Tobacco Use:The U.S.Food and Drug Administration(FDA)took several actions in 2021 that could signal a beginning to meaningful action in its oversight of tobacco products.On April 29,2021,FDA made an important announcement indicating its intention to issue proposed rules no later than April 2022 to remove menthol cigarettes and most flavored cigars from the marketplace.If FDA follows through on its commitment,it will be an historic achievement for public health in the U.S.given the disproportionate impact menthol cigarettes and flavored cigars have on many different communities and populations,especially Black Americans.FDA had an opportunity to remove e-cigarettes and other tobacco products from the market that did not meet its public health standard through its pre-market tobacco authorization(PMTA)authority under the Family Smoking Prevention and Tobacco Control Act.FDA was under a court-ordered deadline of September 9,2021,to review millions of PMTAs submitted by e-cigarettes and other tobacco product companies in 2020.Unfortunately,as of the end of 2021,FDA had not acted on the products most responsible for the youth e-cigarette epidemic such as JUUL,leaving them on the market.Health Disparities Related to Tobacco Use:An unfortunate constant over the past 20 years is the unequal burden of tobacco use and exposure to secondhand smoke on some communities and populations.The overall adult smoking rate has declined significantly from 21.6%in 2003 to 14.0%in 2019,a 35%decline.2 However,this overall rate masks significant disparities among races/ethnicities and due to socio-economic factors.Smoking remains particularly high among Native Americans and Alaskan Natives at 20.9%and Lesbian,Gay and Bisexual adults at 19.2%.3 Smoking among persons with lower incomes and lower levels of education also 2022American Lung Association“State of Tobacco Control”20222 Lung.orgremains high.4 Certain populations are also disproportionately exposed to secondhand smoke,including:children ages 3-11,Black Americans,persons living in poverty and people with a high school education or less.5 Parts of the country,especially many Southern and Appalachian states remain unprotected from secondhand smoke in public places and workplaces as well.State Progress to Reduce Tobacco Use:The country has made substantial progress on several of the state public policies measured in“State of Tobacco Control”over the past 20 years.These include:Progressing from 2 to 28 smokefree states;Increasing the average state cigarette tax from$0.62 in January 2003 to$1.91 in January 2022;and Improving state Medicaid program coverage of quit smoking treatments since“State of Tobacco Control”first began tracking these data in 2008.In 2021,the tobacco industry brought back to the forefront an old roadblock it has used for more than 30 years:preemption,or lobbying state legislatures to pass laws that prevent local communities from passing tobacco control policies stronger than state law.This severely hampers the ability of local communities to prevent and reduce tobacco use.Unfortunately,the tobacco industry was successful in instituting new preemptive state laws on sales of tobacco products in Florida and Montana in 2021.The COVID-19 pandemics impact on tobacco use is still being assessed.According to a Federal Trade Commission report in 2020,cigarette sales increased for the first time in 20 years.6 It is unclear if this signals higher adult smoking rates,or existing smokers smoking more cigarettes.In addition,the rate of youth vaping in the Centers for Disease Control and Preventions 2021 National Youth Tobacco Survey varied significantly if a student took the survey at home or in a school building.7 Therefore,it is unclear if the level of youth vaping seen in 2021 will be a one-year blip or a