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.
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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
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MARCH 2020 • 209