Advertisements for cigarettes outside the Shell station in downtown Franklin on Feb. 2. Johnson County, and Indiana as a whole, has shown poor progress in addressing smoking and tobacco use, though officials hope to ramp up efforts.
RYAN TRARES | DAILY JOURNAL
The statistics are uglier than a hacking cough.
Among Johnson County residents, 20% of adults are smokers — higher than the Indiana average and national average. The county reported 44.2 lung cancer deaths and 179.5 heart disease deaths per 100,000 residents, according to the Indiana Department of Health.
In 2022, Johnson County had 265 deaths attributed to smoking.
“The state has been terrible when it comes to smoking, and on a lot things, we look worse,” said Michelle McMahon, community coordinator for Upstream Prevention, which works to improve community health in the county.
In Johnson County, and across Indiana, progress has been slow in reducing the number of smokers in the community — despite it remaining one of the county’s most pressing public health issues. The American Cancer Society’s “State of Tobacco Control,” released on Jan. 25, shows Indiana with poor and failing grades in addressing smoking cessation.
Programs in Johnson County have been ongoing, both to help current smokers quit and to target young people to ensure they never start.
But funding has been difficult to obtain to address the problem, said Tiffany Nichols, director of advocacy for the American Lung Association in Indiana.
“This legislative session, we’ll be advocating for an increase in funding for our state’s tobacco and smoking cessation program,” she said. “For a state our size, we’re not putting nearly enough money toward the problem.”
The “State of Tobacco Control” is released by the American Lung Association every year to evaluate evaluates state and federal policies on actions taken to eliminate tobacco use and recommends proven-effective tobacco control laws and policies to save lives.
Tobacco use remains the leading cause of preventable death and disease in America and kills more than 11,000 Indiana residents each year, according to the association.
This year’s report was not kind to the state.
”Indiana lags behind when it comes to tobacco control policies, and as a result, we have higher than average adult smoking rates at 17.3% and 22.9% of high school students use a tobacco product,” Nichols said.
The report grades states in five areas that have shown to be key to reducing smoking. Indiana received a “C” in the strength of its smoke-free workplace law, which was the highest mark that it was given.
The state earned a “D” in its coverage and access to services to quit tobacco. And Indiana failed three areas — funding for state tobacco prevention programs, level of state tobacco taxes and ending the sale of all flavored tobacco products.
In light of the report’s results, officials from the American Lung Association hope to use it to generate action on the issue, Nichols said.
“This gives us an important opportunity to improve the health of our state through proven policies, such as increasing the funding for the Indiana Tobacco Prevention and Cessation Commission,” she said.
The results of the report spotlights what local anti-tobacco advocates have already known.
Officials with Upstream Prevention, through its Empower Johnson County initiative, has worked to support community-level change related to substance use, particularly among young people. Reducing tobacco use is a large part of that work.
Johnson County formerly had a coalition focused specifically on tobacco use, but lack of funding from the state led to its dissolution, McMahon said.
“But as that has dissolved, a lot of the members with that coalition have said they still want to do something. So we’ve created a work-group within our coalition to target tobacco and smoke-free air and vaping,” she said.
Through Empower, efforts have mainly been focused on preventing youth tobacco use and vaping.
“We know when we do this, it will also help with the adult reduction and prevention. Obviously, we’ll be looking at and talking about opportunities to increase smoking cessation,” she said.
The group has partnered with the Indiana Department of Health to participate in audits of tobacco retail outlets. Volunteers receive a list from the state of all stores and other retailers that sell tobacco products, and make observations about product placement and how consumers are targeted.
During counts held at 102 retailers between February and April 2022, volunteers found that 59% of retailers in Johnson County displayed exterior ads for tobacco products. In 74% of stores, price promotions for any type of tobacco product was offered. Flavored tobacco products were sold in 99% of stores.
Research by the Center for Public Health Systems Science has shown this type of marketing and placement encouraged youth to start using tobacco, makes quitting more difficult and disproportionately targets certain groups.”
“We’re looking at what is being sold at our local retail environment, and the proximity to schools and youth access,” McMahon said. “With that, we can provide education to Johnson County residents and educators about what to look for.”
This year’s report noted the need for Indiana policymakers to focus on enacting legislation that allocates $30 million biennially to the Indiana Tobacco Prevention and Cessation Commission, which works to eliminate the disease and economic burden associated with tobacco addiction and exposure to commercial tobacco products.
The association also is pushing lawmakers to pass legislation to increase the cigarette tax by at least $2. Multiple studies have shown that every 10% increase in the price of cigarettes reduces consumption by about 4% among adults and about 7% among youth.
“Increasing out tobacco tax is an evidence-based approach to tobacco cessation,” Nichols said.
Local officials working to reduce tobacco use have also advocated for raising the tobacco tax in past legislative sessions, and will continue to do that.
“We know that one of the best ways we can reduce tobacco use is to increase that tax. It will help more adults quit, provide revenue for prevention and health efforts, and prevent fewer kids from ever starting to smoke,” McMahon said.
BY THE NUMBERS
Tobacco and Health in Johnson County, 2022
Deaths attributed to smoking: 265
Deaths due to second-hand smoke: 43
Smoking-related illness: 7,939
Adults who smoke: 20%
Lung cancer deaths per 100,000 residents: 44.4
Heart disease deaths per 100,000 residents: 179.5
Asthma-related emergency room visits per 100,000 residents: 39
Births affected by smoking: 182
Pregnant women who smoke: 10.1%
— Information from the Indiana Department of Health
