We find ourselves in the middle of one of the greatest wealth transfer periods of all time. Those with wealth must decide whether they want to make transfers, and if they do, they must decide how much, to whom, when and in what structure?
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The Attitudes and Behaviors Survey on Health, released last month, shows that smoking rates dropped from 19.1 percent in 2008 to 17.2 percent in 2012 for the overall Colorado population. The data show both a decrease in the percentage of daily smokers and the number of cigarettes smoked.
In addition, Coloradans are opting to keep their cars and homes smoke-free as well, according to the survey, although low-income populations are less likely to fit into this trend.
Low-income populations, young adults, Latinos, African-Americans and the lesbian, gay, bi-sexual and transgender community all saw a higher prevalence of smoking than the general population, although no one is sure why, said Dave Brendsel, spokesperson for the Prevention Services Division at CDPHE.
“If we knew that, we’d have it solved by now,” Brendsel said.
Smoking cessation campaigns have not worked as well on lower-income populations, said Arnold Levinson, an associate professor at the Colorado School of Public Health. Smoking prevalence in low-income populations in the state was 27 percent in 2012, according to the survey.
One explanation, Levinson said, is that people who live at lower incomes often are coping with more stress than are those who make more money and are less confident about their futures, causing them to use tobacco more frequently than others.
For the purposes of the CDPHE study, “low income” was defined as uninsured, with an income at or below 200 percent of Federal Poverty Level, or about $47,700 for a family of four, with no high school diploma.
The overall decline in smoking rates can be partially attributed to the Colorado tobacco tax implemented in 2005, said Brendsel. An amendment to the Colorado Constitution raised the tax on a pack of cigarettes from 20 cents to 84 cents, with the proceeds from the tax going to public health programs and prevention and treatment of smoking-related diseases, as well as funding the Attitudes and Behaviors Survey, conducted every few years.
The decrease also reflects a smoking cessation trend that began in 1965 after the U.S. surgeon general declared smoking a health hazard, Levinson said. At the time, about 42.4 percent of people nationwide smoked, well above the roughly 19 percent who now smoke.
The impacts on the overall health-care system are difficult to quantify, Levinson said, but a recent study performed in Massachusetts showed that every dollar spent on cessation programs, resulted in $3 in health-care savings 15 months later.
In addition, fewer smokers means fewer instances of costly diseases, Levinson said. Cancer, heart disease, emphysema and other conditions related to smoking are expensive to treat, and smokers are 50 percent more likely to die 10 to 15 years earlier than they would have if they did not smoke, often because of one of these conditions.
In Colorado, smoking leads to about $2 billion in health-care spending every year, according to CDPHE, and kills 4,400 Colorado residents annually. The state also estimates that $1 billion is lost in productivity statewide every year as a result of smoking.
Use of cigarettes is likely to continue declining, helped along by a provision in the Affordable Care Act that requires insurance companies to include cessation programs in their coverage, Levinson said.
These programs often offer cheaper coverage to those who don’t smoke, or offer to help people quit in order to obtain a cheaper rate.
Molly Armbrister can be reached at 970-232-3129 or firstname.lastname@example.org. Follow her on Twitter at @marmbristerBW.