A new collaborative study found positive effects from Minnesota’s comprehensive statewide tobacco control program, including more than 4,000 lives saved and over $5 billion in saved health care and productivity costs. Conducted by ClearWay Minnesota and HealthPartners Institute, the research validates two decades’ worth of smoking prevention and cessation efforts at a time when funding for such efforts will soon run out.
“These findings show the importance of investing in tobacco prevention and cessation, both statewide and locally,” said study coauthor Ann St. Claire, Director of Evaluation and Survey Research at ClearWay Minnesota. “The benefits of tobacco control efforts accrue gradually over time, and we know that even now the impact of these programs is continuing to grow. But with the impending end of ClearWay Minnesota, big changes are on the horizon. In order for these effects to continue growing, Minnesota will need to continue and expand similar efforts into the future.”
ClearWay Minnesota, a nonprofit organization created by Minnesota’s tobacco settlement, currently provides nearly 70 percent of total funding for cessation and prevention efforts around the state, but the organization is set to sunset in 2022.
Published in the journal Tobacco Control, the study examines ModelHealth Tobacco: Minnesota, a microsimulation model that used smoking prevalence rates to estimate the impact of tobacco control programs and quantify savings from smokers who quit or never started. The researchers used data from 1998 to 2017 to calculate their findings.
The research found that because of Minnesota’s strong tobacco prevention and cessation programs:
- 4,560 cancers were prevented
- 31,691 hospitalizations for smoking-attributable cardiovascular disease and diabetes were prevented
- 12,881 hospitalizations for smoking-attributable respiratory disease were prevented
- 4,118 smoking-attributable deaths were prevented
- $2.7 billion in medical care costs was saved
- $2.4 billion in worker productivity was saved
“For decades, the success of Minnesota’s investment in tobacco control has largely been measured through smoking rates,” said Michael Maciosek, Ph.D., the HealthPartners Institute economist who led the study. “Now for the first time, we have conclusive proof that such efforts truly are preventing disease, saving individuals and employers money, and helping people live longer, healthier lives on a large scale.”
For 20 years, Minnesota has enjoyed one of the most comprehensive tobacco control programs in the nation. Partnerships between state agencies, nonprofits and health insurers have established free quitting resources for Minnesota smokers, helped pass public policies protecting Minnesotans from secondhand smoke and making tobacco products less accessible to youth, funded outreach among diverse communities and created powerful media campaigns, among other achievements.
Findings from the latest Minnesota Adult Tobacco Survey (MATS) show that Minnesota’s progress in reducing smoking has stalled. The state’s adult smoking rate has declined to 13.8 percent, down from 14.4 percent in 2014. The decrease was not statistically significant and is the smallest decline seen since the MATS study began in 1999.
Conducted by ClearWay Minnesota and the Minnesota Department of Health, MATS surveyed Minnesota residents about smoking, e-cigarette and other tobacco use, and secondhand smoke exposure.
“Minnesota has long been a leader in tobacco prevention and cessation, but we are seeing that progress stalling,” said lead researcher Ann St. Claire, Associate Director of Evaluation and Survey Research for ClearWay Minnesota. “Research shows that policies like price increases and clean indoor air laws help drive down smoking rates, and we’ve seen the impact of those policies in past MATS reports. Today, we must continue using proven approaches to reduce the smoking rate, such as additional price increases and raising the tobacco age to 21.”
MATS found dramatic shifts in who was using e-cigarettes. The rate of e-cigarette use among all adults remained unchanged from 2014 (6 percent in 2018 vs. 5.9 percent in 2014). However, while the rate of cigarette smoking among young adults aged 18-24 fell significantly, from 15.3 percent to 8.5 percent, ecigarette use in this age group nearly doubled, from 12.8 percent to 21.9 percent, reflecting trends also seen in 2017’s Minnesota Youth Tobacco Survey.
Disturbingly, the study also found a sharp increase in e-cigarette use among people who have no prior history of smoking. Forty-four percent of e-cigarette users in 2018 said they had never smoked cigarettes – a significant increase from 2014 (11.7 percent).
“Over the past 20 years, Minnesota made great strides in reducing tobacco use,” said Minnesota Health Commissioner Jan Malcolm. “But in the face of new challenges from the tobacco industry, like e-cigarettes, the future of tobacco use in our state is once again uncertain. We must do everything we can to prevent our young people from starting tobacco use, including e-cigarettes, and we must provide current smokers free and easy help to quit.”
Another factor that contributed to the stalled progress was fewer Minnesotans quitting smoking. Fewer smokers made quit attempts, and fewer successfully quit.
“We know that easy access to help like counseling and medications can double a smoker’s chance of quitting for good,” said ClearWay Minnesota Vice President Paula Keller. “Minnesota tobacco users currently have free quitting help available to them through QUITPLAN Services, but more can be done to encourage them to take advantage of that help. We also need to ensure there is dedicated funding for ongoing services to help people quit once QUITPLAN Services closes its doors early next year.”
Other findings from MATS 2018 include:
*Approximately 574,000 adult Minnesotans continue to smoke. Smoking rates are highest among Minnesotans who have completed fewer years of education and have lower incomes than nonsmokers.
*Minnesotans with less than a high school education have the highest smoking rate at 33.4 percent.
* Fewer smokers are making quit attempts. Fewer than half of all smokers, 45.7 percent, reported making a quit attempt in the past 12 months, down from 53.4 percent in 2014.
*Menthol cigarettes are used by more than a quarter (27.5 percent) of all smokers. Women smokers use menthol cigarettes at a rate of 33.8 percent, while those with less than a high school education have the highest menthol use rate of all education groups at 37.2 percent.
*Flavored e-cigarettes attract young adults. Nearly all young adult e-cigarette users (96.7 percent) report their usual brand of e-cigarettes is flavored.
*Minnesotans value smoke-free air. The percentage of Minnesotans with smoke-free home rules has increased to 92 percent (from 89.3 percent in 2014). Even 66.3 percent of smokers have smoke-free home rules.
Released approximately every four years, MATS provides comprehensive information about smoking rates and tobacco-related behaviors, attitudes and beliefs in the adult Minnesota population, and serves as a tool for measuring the progress of Minnesota’s tobacco prevention efforts. Previous surveys were conducted in 1999, 2003, 2007, 2010 and 2014. The full report and a fact sheet are available at ClearWay Minnesota’s Minnesota Adult Tobacco Survey webpage.
This month, ClearWay Minnesota launched a new campaign to shed light on the hidden harms of tobacco addiction. The campaign highlights teen tobacco use, the smoking-related costs borne by all Minnesotans, and Big Tobacco’s youth-focused marketing tactics – all under the theme of See What You’ve Been Missing.
“The tobacco industry is still causing tremendous harm, but it’s more hidden from view than it used to be,” said Michael Sheldon, ClearWay Minnesota’s Director of Marketing. “Through this campaign, ClearWay Minnesota hopes to bring attention to how the tobacco industry targets our youth and costs all of us money, even Minnesotans who don’t smoke.”
While Minnesota has made significant progress in the last two decades to reduce tobacco’s harm, tobacco use remains the leading cause of preventable death and disease. New tobacco products also threaten to disrupt efforts to reduce youth smoking. For the first time in 17 years, the rate of youth tobacco use rose in Minnesota in 2017, due to large increases in teens using e-cigarettes and flavored tobacco products.
The See What You’ve Been Missing campaign began as the U.S. Food and Drug Administration (FDA) announced new proposals to curb youth e-cigarette addiction, which the agency calls an epidemic. Through powerful ads, See What You’ve Been Missing calls attention to rising youth tobacco rates and to the dangers of e-cigarettes and flavored tobacco products.
The campaign website, MissingItMN.org, includes helpful information for parents and adults about e-cigarettes and what the latest products look like, signs a child might be vaping, a smoking-related cost calculator and information on tobacco industry marketing. The campaign launched November 12 and includes TV, radio, digital and out-of-home advertising, paid social and search, and an interactive website. The campaign will run through late 2019. Haberman is the creative partner for the campaign.
“In the face of rising health care costs and the new threat of youth e-cigarette use, Minnesotans need to re-commit to making tobacco prevention a public health priority,” Sheldon added. “Big Tobacco is still up to their old tricks, but is using new tactics. We hope highlighting the tobacco industry’s addictive and costly schemes will bring urgency to the tobacco issues we face, so Minnesotans will take action to prevent a generation of youth nicotine addiction.”
You can view the new ads below.