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Smoking, obesity top state health issues

Smoking and obesity are the top health challenges facing Kansans. Dr. Jason Eberhart-Phillips, director of health for the Kansas Department of Health and Environment, said they are costing lives and money.

But, he said, there are proven measures that state and local policymakers could implement to help reduce the diseases.

Up in smoke

Each year, tobacco-related diseases kill at least 3,900 Kansans and cost taxpayers $927 million.

Nationally, about 443,000 deaths are attributable to cigarette smoking. That's about 200 times the death toll caused by 9/11.

"We are spending millions of dollars to keep some guy with a bomb in his underpants off of our plane, and yet we are spending very little on tobacco prevention," Eberhart-Phillips said, shaking his head.

Eberhart-Phillips outlined some effective ways to reduce smoking during a presentation Friday at the Kansas Health Institute in Topeka:

  • Counter marketing. In New York City, he said, "they do very graphic advertising that shows people unequivocally just what they are getting into when they take up smoking."
  • Restricting access to tobacco for youth.
  • http://www2.ljwor...">Raising cigarette taxes. KDHE estimates that the measure would cause about 9,000 adults to quit and keep 16,000 teens from ever starting.
  • Passing smoke-free policies. Eberhart-Phillips said there's no debate that secondhand smoke is bad. It kills 400 Kansans every year and causes 2,100 heart attacks. Data shows that 40 percent fewer youths smoke when there is a ban in place.

"When we wholeheartedly support these kinds of measures, things start to happen," he said.

New York City implemented all of the measures in the early 2000s, and its smoking rate declined. Among teens, it dropped from 18 percent to 8 percent. The adult smoking rate went from 21 percent to 15 percent.

In Kansas, the rate has dropped modestly over the past decade. The adult smoking rate is 18 percent, and the high school smoking rate is 20 percent.

"We have a long, long way to go," Eberhart-Phillips said.

Eberhart-Phillips said he could talk and talk about how nonsmokers live longer, are better workers and happier people, but that generally doesn't do much good.

In a tight budget year, he thinks money might make a difference.

He said a heart attack costs about $50,000.

"Passing a statewide smoking ban would be like putting $5 million back into the economy if it prevents 100 heart attacks a year."

So far, the Kansas Legislature has failed to pass a smoking ban, but it will be on the agenda again this session. The Kansas Senate passed two similar proposals last year. Both have stalled in the House.

State Rep. Brenda Landwehr, R-Wichita, and chairwoman of the House Health and Human Services Committee, described the proposals as "watered down."

She opposes the plans for a number of reasons. One is they impose a ban in restaurants and bars and exempt state-owned casinos. Another is there are no enforcement policies.

"It's no different than if you get pulled over for speeding, an officer has an option of giving us a ticket or not giving us a ticket," she said.

Kansas Gov. Mark Parkinson has proposed raising the cigarette tax by 55 cents per pack to $1.34, which is the national average.

Despite the mounting evidence of benefits, five state lawmakers said Friday if the cigarette tax passed, it likely would be by a small margin.

State Sen. Derek Schmidt, R-Independence, and Senate majority leader, said that's because business owners worry that Kansans who live close to Missouri will buy cigarettes there, where cigarette taxes are 17 cents per pack — the second lowest in the nation.

State Rep. Paul Davis, D-Lawrence, House minority leader, said many people are opposed to "selected tax increases."

He described any tax increase as "an uphill battle."

Growing girth

Policies to help curb the obesity epidemic have been on the agenda as well.

For example, Landwehr said her committee looked at eliminating junk food in vending machines.

"The schools came out big time opposing that because they make money on those vending machines," she said.

Lawmakers said implementing policies that affect behavior isn't easy.

"Kansans don't like to be told what to do," said State Rep. Jim Ward, D-Wichita.

But, Eberhart-Phillips said something needs to be done.

Twenty-five percent of high school students are overweight or obese in Kansas.

Some of the reasons:

  • 79 percent don't get at least five servings of fruits or vegetables per day.
  • 33 percent consume more than one can or bottle of soda daily.
  • 55 percent don't get an hour of physical activity at least five times a week.

"This may be the first generation of Americans ever to die younger than their parents," Eberhart-Phillips said.

Obesity can cause a plethora of health problems such as stroke, osteoarthritis, cancer and hypertension.

Diabetes is one of the most common obesity-related diseases, and is rising at a rapid rate. In the past five years, 35,000 Kansans were newly diagnosed.

"Every woman, man and child in Kansas is paying a diabetes tax. You are paying about $566 per year because of this problem and it's going up by 32 percent," Eberhart-Phillips said.

It is costing the nation $174 billion.

"If the diabetes treatment industry in the United States were its own country, it would be the 45th largest economy in the world. We spend more on diabetes drug treatment in the United States — for this one disease — than people in Pakistan or the Philippines or Kuwait or Egypt spend on everything in their lives for an entire year. It's bigger than their whole economy," he said.

To help curb the epidemic, KDHE suggests:

  • Increasing exposure to healthy foods. For example, providing subsidies to farmers' markets.
  • Limiting consumption of sugar-sweetened drinks and junk foods. Only 3 percent of schools have exemplary health policies on vending machines. "We put kids in high school through health class where they learn all about good nutrition. The bell rings and then they are turned loose on a bank of vending machines that have nothing but junk," Eberhart-Phillips said.
  • Modifying the "built environment" to enable more physical activity.
  • Requiring restaurants to put nutrition labels on menus. A recent study found people consumed 14 percent fewer calories at restaurants where nutrition content was listed.

Eberhart-Phillips offered this food for thought:

"You want to have tax cuts? You want to improve the investment in education? ... You need to address this problem. This is eating up our national wealth."


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