Nevada leads states in smoking Md. adult rate is below norm, high among teens


The first state-by-state profile of the nation's tobacco use, the huge economic penalty it exacts and the various state tobacco-control laws was released yesterday by the federal government, highlighting startling disparities.

The report by the Centers for Disease Control and Prevention showed adult smoking rates varying from slightly more than 15 percent of the population in Utah to more than 30 percent in neighboring Nevada.

Twenty percent of Maryland adults are smokers, compared with nearly 23 percent nationwide.

Deaths related to smoking followed a similar but not identical pattern, although Nevada again ranked last, with a death rate more than twice that of Utah's.

Other parts of the report noted how far each state was from meeting national goals for reducing smoking by 2000, big differences in the percentages of teen-agers smoking, and medical costs ranging from nearly $4 billion annually in California to less than $100 million in less populous states.

The report was hailed by anti-tobacco groups as more proof of the need for strict national regulations recently proposed by the Food and Drug Administration. It was dismissed by the tobacco industry as old news.

The government itself said that the comparisons might stimulate changes in some states but that the report was not part of any particular policy drive.

"This is a snapshot, not an evaluation of what reduces tobacco use and what doesn't," said Michael P. Eriksen, director of the Office on Smoking and Health at the centers, a federal agency whose headquarters are in Atlanta.

"There's no analysis, no recommendations, no conclusions."

The data most likely to attract attention related to smoking among high-school-age students because underage smokers are the target of the proposed FDA rules.

The figures, which date from 1993, show West Virginia facing the biggest problems -- just under 39 percent of its students in the ninth through the 12th grades reported smoking within the month in which they were surveyed.

Nearly 30 percent of Maryland students in those grades smoke, and more than 14 percent are frequent smokers, according to the report.

Only 16.7 percent of the high-school-age children in Washington, D.C., had smoked, though, a reflection of the generally lower smoking rate among black adolescents.

"These tremendous disparities show the need for national action," said Dr. Michele Bloch, who spoke for the Campaign for Tobacco-Free Kids, which joined other anti-tobacco advocates in Washington yesterday to urge Congress to support the Clinton administration's FDA initiative.

That proposal would severely restrict the advertising and marketing of tobacco products and would ban some forms of distribution.

Walker Merryman, a spokesman for the Tobacco Institute, a Washington-based industry trade group, said: "This report is more rehash than research. It's not terribly useful for understanding why kids smoke."

A federal study released last month found more teens are smoking, with 21.6 percent of high school seniors reporting they smoke daily, up from 19.4 in 1994.

Mr. Merryman also disputed the data cited on the medical cost of treating tobacco-related illnesses, saying there was little scientific basis for the calculations.

The government has estimated that the direct medical cost of treating smoking-related illnesses in 1993 was about $50 billion nationwide. The figures in the report are lower because they date from 1990.

The estimate does not include the indirect costs of smoking, such as time lost from work. The government is working on a new estimate of such costs, which public health experts say run at least as high as the direct costs.

Anti-smoking groups said the report pointed to the impact of higher taxes. Eight of the 10 states with the lowest cigarette taxes have a higher than average number of smokers.

The figures are muddy, though, because many states have raised taxes recently while the number of smokers has been built up over decades. The state of Washington, which has the highest taxes at 81.5 cents a pack, ranks in the middle on percentage of smokers, below states like Alabama and Georgia, which are among the lowest taxers.

Public health officials in several states said that having so much comparative data available would be helpful in pushing legislators to back new restrictions or reverse measures passed with the backing of the tobacco industry.

Anti-smoking groups are particularly worried about cases where states have passed industry-backed laws banning cities and towns from imposing their own restrictions. The report shows that one-third of the states now have such pre-emptory laws.

Some of the states worst off in the rankings are the least likely to be affected by the report.

"Our legislature doesn't even meet this year," said Willie Davis, Nevada's tobacco education and information officer. Mr. Davis said the comparisons might help in 1997, but he was not optimistic.

"It's hard when the state's economy is so linked to gaming, which is linked to tobacco," he said.

"They have the same lobbyists and they are the most influential in the state."

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