Two Decades of Tobacco Use Reduction Results in $1B Healthcare Savings

The Hawai‘i Department of Health shared the results of 20 years of tobacco prevention, and control policies and programs on Thursday, March 15, 2018, with an estimated total savings of $1 billion in healthcare costs to the state.

By reducing the number of youth, adult and pregnant smokers over the past two decades, Hawaiʻi saved $1 billion from 2000 to 2017. The analysis, conducted by DOH, showed $6.34 in direct health care costs was saved for every dollar spent on tobacco prevention.

“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 Health 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 Hawaiʻi’s children today will become smokers by early adulthood.”

These latest findings are highlighted in department’s new publication, Hawaiʻi’s Tobacco Landscape: The Faces Behind the Figures. It features policy and program achievements from the Hawai‘i Tobacco Prevention and Control Trust Fund since its inception in 1999, and spotlights the significant challenges to tobacco prevention and control that remain.

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 Hawaiʻi Tobacco Quitline. The Hawai‘i Community Foundation (HCF) administers the trust fund, which supports the Hawai‘i Tobacco Quitline and 16 community tobacco cessation programs.

While Hawai‘i ranks third lowest in the nation for smoking prevalence among average adults at 13.1%, 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,” said Dr. Elizabeth Tam, pulmonologist and chair of the Tobacco Prevention and Control Advisory Board. “This is an important message to healthcare providers to keep talking to their patients,”

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 Hawaiʻi, 25.5% of high school and 15.7% 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).

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

“In spite of the gains resulting from these policies, there are important regulations that still do not exist,” stated Jessica Yamauchi, executive director of the Hawai‘i Public Health Institute and its program, Coalition for a Tobacco-Free Hawai‘i. “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.”

To download Hawaiʻi’s Tobacco Landscape: The Faces Behind the Figures, go online.