The Journal of the Arkansas Medical Society Med Journal March 2020 Final 2 | Page 17

From 1996 to 2010, cigarette use steadily declined in Arkansas due to actions associated with the Master Settlement Agreement (MSA) of 1998, as well as changes in public policy. 7 The MSA mandated that the companies pay dam- ages to the states to counteract the economic burden associated with the harmful effects of tobacco use. The Tobacco Settlement Proceeds Act of 2000, initiated by the citizens of Arkan- sas, appropriated funds annually to promote public health initiatives such as the creation of the Tobacco Prevention and Cessation Program (TPCP); this was operated and maintained by the Arkansas Department of Health, the forma- tion of the UAMS Fay W. Boozman College of Public Health, funding for tobacco related re- search, and other programs. 7 Policy reform has reduced the use of ciga- rettes by enacting laws and imposing excise taxes on tobacco products. The Arkansas Clean Indoor Air Act of 2006 and the Arkansas Protection from Secondhand Smoke for Children Act of 2006 re- stricted the use of cigarettes in areas deemed “public spaces” and in vehicles with passengers under the age of 14, respectively. 7 In addition, U.S. Federal District Court Judge Gladys Kessler ruled that the tobacco companies lied to the pub- lic about dangers of smoking in 2006. Excise taxes have been an important and effective approach to reducing cigarette use. Arkansas began taxing cigarettes as early as 1929 at $0.04 per pack with marginal increases throughout the years. 8 In 2009, the cigarette ex- cise tax increased to $1.15 per pack and is the current tax amount. The purpose of this report is to describe the change in smoking behavior and lung cancer inci- dence and mortality patterns in Arkansas. Home Ownership Made Easy for You You have unique financial needs. Whether you are a seasoned physician or just beginning residency, our Doctor Mortgage Program is designed with you in mind. This top-class loan program meets the special demands of physicians seeking home financing on their primary residence. Contact me today to learn more about Regions’ Doctor Mortgage Program. Matthew Lewis Mortgage Production Manager | NMLS #546435 p - 501.371.6411 | c- 501.690.8568 [email protected] regionsmortgage.com/MatthewLewis © 2019 Regions Bank. Member FDIC. NMLS# 174490. All loans subject to qualification, required documentation and credit approval. Certain exclusions may apply. Loan terms and availability subject to change. The Annual Percentage Rate on all adjustable rate mortgages is subject to change after consummation period. Regions and the Regions logo are registered trademarks of Regions Bank. The LifeGreen color is a trademark of Regions Bank. (11/04) Don’t be the missing piece Methodology Lung cancer incidence was defined using the International Classification for Diseases for Oncol- ogy (ICD-O), Third Edition, using standard primary site and histology codes for years 1997 to 2015, the most recent year of complete data available. Lung cancer mortality was defined using Inter- national Classification of Diseases and Related Health Problems (ICD-10), Tenth Edition, stan- dard codes from the CDC WONDER Compressed Mortality file from the Centers for Disease Control and Prevention for years 1999 to 2015. Smoking prevalence rates were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) responses to surveys from 1995 to 2017. 9 In 2011, BRFSS had substantial meth- odological changes; therefore, data from 1995 to 2010 are not comparable to subsequent years. >>Continued on page 210. Volume 116 • Number 9 The only way we can succeed is to work together. We need YOU to join us in 2020. Visit ARKMED.org to renew your membership today! March 1, 2020 is the membership renewal deadline. Don’t miss out! MARCH 2020 • 209