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By Jeremy Bond
Capital News Service
Tuesday, Sept. 30, 2003

WASHINGTON - Maryland has done an unsatisfactory job of reducing smoking rates among women and implementing policies that the federal government says would reduce those rates, a new report says.

The state does score higher than most states and the District of Columbia in a number of areas, earning Maryland an "unsatisfactory" rather than the "failing" grade of 39 states.

The study by the National Women's Law Center and Oregon Health & Science University measured the extent to which states are working toward the reduced smoking objectives outlined in the federal government's "Healthy People 2010" agenda.

"Quite simply, we have failed," said Michelle Berlin of the OHSU. "The death and diseases from smoking are deplorable and preventable."

Maryland hasn't come close to meeting the goals. And anti-smoking activists fear that things will only get worse.

Kari Appler, director of the Smoke Free Maryland coalition, said the state recently slashed funding for tobacco-cessation programs by 50 percent. Former Gov. Parris Glendening was committed to reducing youth smoking, she said, but "so far we've only seen funding cuts" under Gov. Bob Ehrlich.

"We're very hopeful that this is caused solely by the budget situation," Appler said.

Appler said the report is "further evidence that we have a long way to go." But a lobbyist for the tobacco industry said the report just shows that the federal goals were unrealistic in the first place.

"It doesn't surprise me that states have failed," said Bruce Bereano, who lobbies for the Maryland Association of Tobacco and Candy Distributors.

While Maryland has the sixth-lowest percentage of women who smoke, 18.7 percent, that was still well shy of the federal goal of 12 percent, the report said. Only Utah reached that goal.

The report also said that 9.3 percent of pregnant women in Maryland smoke, well above the federal goal of 1 percent. The District had the lowest rate, 2.6 percent, while West Virginia had the highest, 26.3 percent.

Maryland ranks relatively high when it comes to policies aimed at reducing secondhand smoke in public areas. An estimated 83.3 percent of Maryland workplaces ban smoking, the second-highest rate in the country.

But the state has high rates of smoking-related diseases: It has the 11th-highest rate of lung cancer among states and the District and 19th-highest rate of coronary heart disease. Lung cancer is the most fatal cancer among American women and heart disease is the leading cause of death among American women.

The report is the first to assess smoking rates among women on the state level, including the effects of 10 tobacco-control policies on 11 separate health indicators. It recommended that states implement a cigarette excise tax, which only five states have, and that they restrict secondhand smoke.

Maryland is among five states that have strict laws that prohibit smoking in almost all public indoor sites.

Bereano calls such prohibitions "social game playing."

"Government should really just stay out of people's lives," he said. Smoking is "a legal, lawful activity among adults, by adults."

"There are so many activities that we do that have particular health consequences," such as speeding in a car, he said.

But Judy Waxman, vice president for health at the National Women's Law Center, said anti-smoking policies save health care cost in the long run -- a particular boon during lean budget times.

Tight budgets have led many states to cut funding for smoking-cessation programs. Maryland is one of only four states to fund tobacco prevention at a level that falls within the range recommended by the Centers for Disease Control and Prevention.

Bereano said he never really bought the argument that smoking prevention saves states money.

Virginia Ernster, a professor of epidemiology at the University of California San Francisco, contributed to the 2001 surgeon general's report on women and smoking from which Tuesday's study was drawn. She said the new data "gives legs" to the earlier report by comparing states, where tobacco policies originate.

While smoking hurts both sexes, girls face unique problems, said Neena Chaudhry, senior counsel at NWLC. Girls are more likely to smoke to control weight, and prolonged tobacco use has been associated with menstrual irregularity and early menopause.

Copyright © 2003 University of Maryland College of Journalism