Two decades of tobacco reduction saves Hawaii $1 billion in health costs

HONOLULU – Hawaii has saved an estimated $1 billion in health care costs thanks to 20 years of tobacco prevention and control policies and programs, according to the Hawaii Department of Health.

The savings are due to a reduction in the number of youth, adult, and pregnant smokers from 2000 to 2017, DOH said. Its analysis showed $6.34 in direct health care costs was saved for every dollar spent on tobacco prevention.

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“One billion dollars in cost savings is an impressive figure, but we cannot afford to lose sight of the lives that have yet to be saved,” said DOH director Dr. Virginia Pressler. “There is no time to waste when it comes to protecting our children and youth. We must do more. Without intervention, it is estimated that 54,000 of Hawaii’s children today will become smokers by early adulthood.”

Most adults begin tobacco-use before age 21, and quitting is difficult. The publication features stories of individuals who quit smoking with the help of programs funded through the Trust Fund. For example, Kalela Minnoch, a single mom who started smoking at age 15, has been tobacco-free for 20 months after receiving help from the Hawaii Tobacco Quitline. The Hawaii Community Foundation (HCF) administers the Trust Fund, which supports the Hawaii Tobacco Quitline and 16 community tobacco cessation programs.

While Hawaii ranks third lowest in the nation for smoking prevalence among average adults at 13.1 percent, there are serious disparities among at-risk groups. The state Tobacco Use Prevention &Control – 5 Year Strategic Plan focuses community efforts on priority populations that have not equally felt the decline in smoking prevalence. Native Hawaiians, people with lower socio-economic status, people who identify as lesbian, gay, bisexual and transgender (LGBT), and people with behavioral health conditions continue to smoke at much higher rates.

“While the U.S. Centers for Disease Control and Prevention estimates it takes smokers 12 to 14 attempts to quit smoking, a recent long-term study found it took smokers 30 or more attempts. This is an important message to healthcare providers to keep talking to their patients,” said Dr. Elizabeth Tam, pulmonologist and chair of the Tobacco Prevention and Control Advisory Board.

Additionally, the publication shines a spotlight on the need to address the rapid rise of electronic smoking among youth. More than one-third of youth in a national survey (National Youth Tobacco Survey 2016) did not think e-cigarettes are harmful, and those who didn’t were more likely to use e-cigarettes. In Hawaii, 25.5 percent of high school and 15.7 percent of middle school students use e-cigarettes, exposing them to dangerous chemicals such as nicotine and potential cancer-causing metals and solvents (Youth Risk Behavior Survey 2017).

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The publication features a timeline highlighting two decades of smoking policies in Hawaii that contributed to the $1 billion in healthcare savings. The timeline includes both county and state legislation spanning from 1997-2017.

“In spite of the gains resulting from these policies, there are important regulations that still do not exist. The rise and popularity of vaping among our youth is alarming. There is a need for standardized policies and regulatory legislation to stop electronic smoking device use,” stated Jessica Yamauchi, executive director of the Hawaii Public Health Institute and its program, Coalition for a Tobacco-Free Hawaii.