CDC says state spends less than 8% of what it should on preventing use of tobacco; companies spend 13 times as much

Kentucky spends only 7.6 percent of what it should spend on preventing the use of tobacco, the federal Centers for Disease Control and Prevention says in its latest annual report on the subject.

The state spent $4.33 million on tobacco-control programs in 2011, the year covered by the report. The CDC said spending of $57.2 million was called for, since 29 percent of Kentuckians smoked that year. Tobacco-related illnesses are estimated to cost Kentuckians $3.3 billion a year.

South Carolina and Texas, which spent 6.5 percent and 7 percent of the recommended amounts, were also singled out for criticism by the CDC. Nationally, states spend less than 18 percent of what they should, $3.7 billion, in the agency's view. "Only Alaska and North Dakota funded programs at the CDC-recommended levels, $10.7 million and $9.3 million, respectively," Samantha Ehlinger of McClatchy Newspapers reports.

Read more here: http://www.kentucky.com/2015/06/25/3918046/cdc-says-kentucky-isnt-spending.html#storylink=cpy

"States that made larger investments in tobacco prevention and control have seen larger declines in cigarettes sales than the United States as a whole, and the prevalence of smoking has declined faster as spending for tobacco control programs has increased," the CDC report said. "Evidence suggests that funding tobacco prevention and control efforts at the levels recommended . . . could achieve larger and more rapid reductions in tobacco use and associated morbidity and mortality."

In contrast to the state spending of $658 million on tobacco control, tobacco companies spent more than 13 times as much on advertising and promotion in 2011: $8.8 billion, or $24 million per day, the report noted.

"During the same period, more than 3,200 youth younger than 18 years of age smoked their first cigarette and another 2,100 youth and young adults who are occasional smokers progressed to become daily smokers," the report said. "If current rates continue, 5.6 million Americans younger than 18 years of age who are alive today are projected to die prematurely from smoking-related disease. However, the tobacco-use epidemic can be markedly reduced by implementing interventions that are known to work."

For the CDC's latest comprehensive report on tobacco use in Kentucky, with data from 2012, click here. For county-by-county figures on adults smoking in Kentucky in 2011-13, click here.

Study outlines historical barriers to tobacco prevention in Kentucky and other tobacco-growing states

A University of Kentucky College of Nursing study published in The Milbank Quarterly has shown that five major tobacco-growing states—Kentucky, North Carolina, Virginia, South Carolina and Tennessee—fall behind the rest of the states in enacting laws to reduce tobacco use.

Tobacco and the diseases it causes affect those five states more than others across the nation, and tobacco is the leading cause of preventable death in the U.S. Those states also have fewer smoke-free laws and lower tobacco taxes, which are two evidence-based policies that help reduce tobacco use, write the authors, Amanda Fallin and Stanton A. Glantz.

The researchers used five case studies chronicling the history of tobacco-control policy "based on public records, key informant interviews, media articles and previously secret internal tobacco industry documents available in the Legacy Tobacco Documents Library," they write.

They found that beginning in the late 1960s, tobacco companies focused on creating a pro-tobacco culture to block tobacco-control policies. However, since 2003, tobacco-growing states have seen passage of more state ad local smoking bans, partly because the alliance between tobacco companies and the tobacco farmers dissolved and hospitality organizations stopped objecting to such bans. National Cancer Institute research projects also built infrastructure that led to tobacco-control coalitions. "Although tobacco production has dramatically fallen in these states, pro-tobacco sentiment still hinders tobacco-control policies in the major tobacco-growing states," the researchers write.

To continue the progress, health advocates need to teach the public as well as policymakers about "the changing reality in the tobacco-growing states, notably the great reduction in the number of tobacco farmers as well as in the volume of tobacco produced," Fallin and Glantz write. Kentucky once had about 50,000 tobacco farmers; today it has about 5,000, and production is dominated by large farmers. The study is behind a paywall; to read its abstract, click here.

Lake Cumberland District Health Department using polls in an effort to get school boards to make campuses tobacco-free

Countywide smoking bans are unlikely to pass anytime soon in most of rural Kentucky, but more county school districts are making their campuses tobacco-free. Now a multi-county health department is trying to get rural school boards to do that, with public-opinion polls showing that county residents overwhelmingly favor the move.

Department logo has been altered to
show Clinton County in yellow.

The Lake Cumberland District Health Department conducted the poll in Clinton County, and said it found that 86.55 percent were in favor and 7.16 percent were opposed. The rest had no opinion.

Making a campus tobacco-free means that members of the public are not free to smoke at school athletic events, so the poll also asked, “Would you like to see our school become tobacco-free at all events?” The results were virtually the same: 85.3 percent answered yes and 8.7 percent answered no, even though one-fourth to one-fifth of the county's residents smoke and it has a long history of raising tobacco.

"The results are perhaps surprising to some, considering the rate of tobacco usage in the county," reports the Clinton County News. The poll of 749 residents has an error margin of plus or minus 3.6 percentage points.

The department also surveyed 100 teachers in the school system and found that 77 percent would "definitely" support making the schools 100 percent tobacco-free.

The health department presented the survey and other findings to the Clinton County Board of Education June 15, but the board took no action. The department noted that a recent survey found that 28 percent of the county's students in eighth through 12th grades had used smokeless tobacco in the previous 30 days. "That level was the highest in the Lake Cumberland District," the Clinton County News reports.

The Casey County Board of Education adopted a smoke-free policy after a poll by the health department showed 70 percent of the county's residents favored it, the Casey County News reported.

Combination of tobacco smoke and high radon levels increase Kentuckians' risk of getting lung cancer by a factor of 10

Red counties are expected to have an indoor radon level high
enough to require a radon mitigation system. (USEPA map)

Combined exposure to tobacco smoke and radon, an odorless gas that comes from small amounts of radioactive minerals in limestone bedrock, contribute to increased risk of lung cancer for Kentuckians.

Not only do high smoking rates and lack of smoking bans expose Kentuckians to high levels of tobacco smoke, the state's laws don't require testing and monitoring of radon, Elizabeth Adams notes in a University of Kentucky news release that gives this warning: "The risk of lung cancer increases 10-fold when a person is exposed to both high levels of radon and tobacco smoke." She gives two steps to reduce the risk:

Reduce exposure to second- and third-hand smoke. Do not allow smoking in your home or car, and ask smokers who go outside to smoke need to cover their clothes with a jacket before returning inside, or they will bring third hand smoke in with them. Of course, quitting smoking is the best way to protect your health and the health of your family.

Test your home for radon every two years. One can often obtain a free test kit from the health department or purchase one at a home improvement store. Renters can ask their landlord about radon testing. If the radon level reaches 4.0 or above, a radon mitigation system will become necessary. Opening windows or increasing ventilation won't solve the problem. Instead, call a certified radon mitigation company.

If someone living in your house smokes cigarettes, cigars or pipes, you might be eligible to participate in a UK research study examining the combined effects of smoke and radon. To learn more about the study, send an email to ukfresh@lsv.uky.edu or call 859-323-4587.

Bourbon Co. teen named South's top youth anti-tobacco advocate for his efforts in pushing for county smoking ban

Tyler Boyle (Photo from
Lexington Herald-Leader)

Tyler Boyle, a Bourbon County High School senior and president of Students Making A Change in the Community, was named the South Region Youth Advocate of the Year by the Campaign for Tobacco Free Kids for his efforts to push a smoking ban in Bourbon County, Lashana Harney reports for the Lexington Herald-Leader.

Boyle has been a part of SMACC since it was re-established in 2013. The club is a place for youth voices to be heard on smoking issues, with the ultimate goal of a countywide smoking ban -- but in the meantime, working for a school regulation that would ban electronic cigarettes.

The smoking ban has yet to pass, but the schools have added e-cigarettes to their comprehensive tobacco policy, which banned tobacco products of any kind on school grounds.

Boyle told the Herald-Leader that he applied for the award in hopes of bringing more attention to the anti-tobacco cause in his county, which has a long history of tobacco production and sales.

"I applied for this award because of all of the work that I've done in my home community and state for tobacco control," he told Harney. "I thought that if I could make national attention, maybe, it would make the officials in my community take this issue more seriously."

Boyle said that he was honored to receive the award, which was presented at a gala in Washington, D.C., in mid-May. He plans to attend a symposium sponsored by the Campaign for Tobacco Free Kids in Washington in July and the Philip Morris Cos. international shareholder meeting next May.

Boyle told Harney that sometimes he gets frustrated because change is slow to take place, but the will to keep pushing forward always comes back.

"After attending the award gala, I was revitalized and I'm ready for the next step in tobacco control," he said.

Boyle will attend Vassar College in the fall to study political science with a focus on advocacy work and said he would continue his work with the Campaign for Tobacco Free Kids.

"Tobacco advocacy is something near to my heart," Boyle said. "Vassar is actually going smoke free in July 2015. So, I plan to work hard to implement and support their new policy."

Even nicotine-free electronic cigarettes can damage lungs; parents urged to warn teens about dangers of e-cig smoking

Kentucky has one of the nation's highest smoking rates, but electronic cigarettes, or e-cigs, are becoming more popular. These battery-powered vaporizers produce a vapor that usually does not contain nicotine. Some have claimed that e-cigs can help people quit smoking because the amount of nicotine can be reduced until it isn't present in the vapor. However, new research shows that other substances in e-cigs may damage the lungs.

Research has found that nicotine in any form damages the endothelial cells that line the lungs, and can cause them to become inflamed or injured. The new research has found that e-cigarette solutions without nicotine contain other substances like acrolein, which damage the lungs in other ways.

"This research reports that components found in commercially available e-cigarette solutions and vapors generated by heating them may cause lung inflammation," said lead researcher Irina Petrache. Long-term effects haven't yet been studied, but the results of this study warn that e-cig inhalation may involve adverse effects on lung health, she said.

Centers for Disease Control and Prevention research shows that e-cigarette use among middle and high school students has tripled. "The development and marketing of e-cigarettes has the potential of hooking a whole new generation on nicotine," Garry Sigman, director of the Loyola University Health System Adolescent Medicine Program, said. It's very addictive and can lead to health issues such as lung disease, heart disease, hypertension and nervous system problems, he said.

Sigman said parents need to made sure their children understand that e-cigarettes are just as addictive as other substances. "Nicotine is so addictive that with only a few inhales, it can create an addiction," he said. Because adolescents enjoy and use technology so much, the modern qualities of the e-cigs might make them seem cool. "Setting rules and monitoring behavior is essential to keeping our teens safe," Sigman said.

Kentucky's seniors rank 48th in insurance firm's health rankings

Click here to go to interactive map.

Kentucky seniors ranked in the bottom 10 states for 23 of the 35 measures ranked by the 2015 America's Health Ranking Seniors Report, placing Kentucky in 48th place for the second year in a row.

“The report is a call to action. We believe you can’t improve what you don’t measure,” Dr. Julie Daftari, market medical director for United Health Care of Kentucky told Alyssa Harvey of the Bowling Green Daily News. “It may start with seniors taking individual action. If we live long enough, we’ll be part of these statistics in the future."

Kentucky seniors ranked last in two areas, total health outcomes and preventable hospitalizations; next to last in premature deaths and education and in the bottom three states for smoking, seniors who are considered underweight, and poor mental health days.

The report notes that smoking is the leading cause of preventable death in the U.S. and "older smokers are at an increased risk of smoking-related illness as they tend to be heavy smokers with an average smoking duration of 40 years" and "are less likely than younger smokers to believe that smoking harms their health." Kentucky, with 11.8 percent of its seniors regularly smoking, ranked third highest in senior smoking, behind Nevada and Mississippi.

The report is intended to point out the health challenges facing today's seniors and offer a starting point to help states determine what needs to change. That being said, Kentucky ranks very low in an area that could help improve these outcomes: community support, where it ranks 45th.

The report did say that Kentucky seniors do have some strengths. They have a low prevalence of chronic drinking, low percentage of adults needing pain management, high flu vaccination coverage and a low percentage of low-care nursing home residents.

More Kentucky seniors also reported very good or excellent health since last year's report, up to 33.7 percent from 31.2 percent.

The report noted that a decrease in physical inactivity is a nationwide problem for seniors, with 33.1 percent of seniors nationwide reporting they did not get enough physical activity. This percentage was even higher in Kentucky at 40.2 percent, which is higher than the previous two years (34.5 percent in 2014 and 17 percent in 2013).

The report notes that today, one in seven Americans are aged 65 and older, and in the next two decades the rest of the 77 million baby boomers will move into this demographic. The report also projected the increase in Kentucky's senior population between 2015 to 2030 will be 41.8 percent.

“The fact that we were able to identify key strengths and challenges gives Kentucky an opportunity to address those specific issues,” Daftari told Harvey. “If these challenges aren’t addressed, there may be a significant strain on health care in the future.”

The rankings were based on 35 measures of senior health including behavior determinants like smoking and dental visits; micro and macro community and environmental determinants like poverty and social support; policy issues like percentage of seniors on SNAP; and measures of clinical care like the percentage of seniors who receive home health.; and outcomes like the percentage of seniors who have fallen. It also included measures like education and cognition.

Deep in the brain may lie the secret of why some smokers quit easily and some find it nearly impossible

When a person tries to quit smoking, the cravings, headaches and lethargy that come from the nicotine withdrawal makes it near impossible for many to be successful. But this lack of success could also be a result of how a smoker's brain is wired, according to a study from Duke University.

The study, published in the journal Neuropsychopharmacology, used magnetic resonance imaging to look at the brain activity of 85 smokers who smoked at least 10 cigarettes a day.

Image from CNN (Click on it to see a larger version)

MRI revealed that "people who had stronger connections between two regions of the brain -- one involved in reward and the other in controlling impulsive behavior-- were more likely to be successful at giving up smoking, at least for 10 weeks," Carina Storrs reports for CNN.

"This is the largest study to date where we've attempted to identify neural markers, or predictors, of later success in quitting smoking," Joseph McClernon, associate professor of psychiatry and behavioral sciences at Duke, who led the current study, told Storrs.

The scans were taken one month before the quit date. Then, on their quit date, participants were given nicotine patches and were asked to check in with the researchers to report any relapses over the following 10 weeks.

The study found that the "key difference" was that those who were able to quit had more activity in the insula, a prune-sized section that lies deep in the brain, than those who did not quit.

Researchers can't explain why,but speculate that the insula "acts like a bridge, connecting the reward region with the behavior control regions," Storrs reports, noting that it has also been linked to other types of drug addictions such as alcoholism.

This study offers hope that doctors might come to identify smokers who have poor connectivity in their insula and offer them treatment to strengthen this connectivity. That could be good news for Kentucky, where almost 30 percent of adults smoke and many are trying to quit. Forty-five percent of Kentuckians reported in the CDC's Behavioral Risk Factor Surveillance System that they had tried to quit in 2012.

Jonathan Foulds, professor of public health sciences and psychiatry at Penn State, was not so hopeful, telling Storrs that not enough is known about specific treatments to tell whether they will increase insula connectivity, and that any such treatments will likely "not be affordable options anyway."

Supporters of smoking bans fear letter from Ky. Association of Counties will halt local efforts to pass such measures

An insurer's letter has warned counties that they may face rate increases if they are sued about local ordinances, including those against smoking. According to a legal consultant to the Kentucky Center for Smoke-free Policy, the letter from the Kentucky Association of Counties "does not square with laws and a Supreme Court decision under which local governments have authority to bar smoking in public buildings," Bill Estep reports for the Lexington Herald-Leader.

In February, the McCreary County Fiscal Court voted 4-1 on first reading for an ordinance to ban smoking in public buildings. After KACo sent the governing body a letter warning them of higher premiums, the ordinance died on second reading, Judge-Executive Doug Stephens said. "Stephens said that some residents objected to the law after the first vote but that the notice from KACo was certainly a factor in the decision to drop the issue," Estep writes.

The letter may also discourage other counties and cities from passing ordinances to protect people from exposure to secondhand smoke, said Ellen Hahn, a professor of nursing at the University of Kentucky and head of the Center for Smoke-free Policy.

However, Denny Nunnelley, KACo's executive director and chief executive officer, said the association didn't intend to discourage counties from passing such laws, Estep reports: "Nunnelley said . . . KACo officials thought it made sense to send a reminder that lawsuits challenging ordinances could result in higher insurance costs."

The letter, which addressed smoking in public places, same-sex marriage, right-to-work laws and minimum wage, was sent to all 113 counties for which the organization provides coverage.

One issue with the letter is that the state constitution, state law and a state Supreme Court case all clearly state that counties have the authority to pass and enforce smoke-free laws, said Judy Owens, a lawyer and consultant for the smoke-free policy center. (Read more)

Teen use of electronic cigarettes has tripled in one year

By Melissa Patrick
Kentucky Health News

The number of middle- and high-school students using electronic cigarettes tripled from 2013 to 2014, surpassing the current use of all teen use of tobacco products, including conventional cigarettes, according to the federal Centers for Disease Control and Prevention.

Data from CDC/CDC National Youth
Tobacco Survey; Image: NPR

The findings came from CDC's 2014 National Youth Tobacco Survey,which found that e-cigarette use by high-school students increased to 13.4 percent in 2014 from 4.5 percent in 2013, and to 3.9 percent in 2014 from 1.1 percent in 2013 for middle-school students. That amounts to 2 million high school students and 450,000 middle school students smoking e-cigarettes.

The report also found that the use of traditional cigarettes remained the same for middle-school students at 7.7 percent, but fell among high-schoolers to 9.2 percent in 2014 from 12.7 percent in 2013, the "lowest level in years," CDC said in a press release.

“We want parents to know that nicotine is dangerous for kids at any age, whether it’s an e-cigarette, hookah, cigarette or cigar,” CDC Director Tom Frieden said. “Adolescence is a critical time for brain development. Nicotine exposure at a young age may cause lasting harm to brain development, promote addiction, and lead to sustained tobacco use.”

There is great debate about how safe e-cigarettes are. Most public-health officials have called for them to be controlled by government regulations, including advertising regulations, and say more controlled studies need to be done to determine their safety.

And while many proponents of e-cigarettes say the devices may be helpful in helping some smokers give up traditional cigarettes and are safer than traditional cigarettes, a recent study published in the American Journal of Public Health says that using electronic cigarettes doesn't help smokers quit, and Brady Dennis of The Washington Post reports that another study, published in the journal Tobacco Control, found that the chemicals used to flavor e-cigarettes could prove unsafe when inhaled over time.

The U.S. Food and Drug Administration has yet to issue new regulations for e-cigarettes, despite its announced plans to do so last April. Meanwhile, Kentucky enacted a law last year banning the sale of "alternative nicotine products" such as e-cigarettes to minors, and local Kentucky smoking bans have slowly been adding e-cigs to their local ordinances. Several Kentucky schools have also added language to their school policies to include e-cigarettes in their smoking bans, with one school official in Webster County recently saying e-cigarettes are "high on every school system's radar right now."

But not everyone sees this increase in teen use of e-cigarette use as a cause for alarm.

“The CDC should really be jumping for joy at the fact that smoking rates are declining. This is a huge success,” Michael Siegel, a professor and tobacco-control specialist at Boston University’s School of Public Health, told Dennis. “Instead, they are using this as another opportunity to demonize e-cigarettes.”

Siegel said that while minors shouldn't have access to any tobacco products, the CDC numbers also suggest that e-cigarettes are not serving as a gateway to traditional cigarettes and might be diverting them away from them, Dennis reports.

Gregory Conley of the American Vaping Association told NPR that the data, which show a decrease in tobacco smoking by teens as they have increased experimentation with vaping "should be part of the discussion."

Elementary-school students prompt Middlesboro smoking ban

UPDATE, May 20: The council passed the ban with one member opposing it. Gary Mills said, “I don’t think it’s the government’s right to intrude on businesses owned by individuals. If the public doesn’t like it, they won’t come. . . . This is too intrusive by the government.” Two non-smoking business owners expressed similar sentiments.

The Middlesboro City Council has approved on first reading an ordinance that would ban smoking in public, enclosed spaces. "It remains unclear if the ban would apply to the use of e-cigarettes and vaping products," William Tribell reports for the Middlesboro Daily News.

The ordinance was prompted in part by a March presentation and petition from a group of Middlesboro Elementary School students involved in Destination Imagination, "a volunteer-led, educational nonprofit organization whose purpose is to inspire and equip students to become the next generation of leaders," Tribell writes. "The team was awarded the DaVinci Award for Outstanding Creativity for their efforts and will now compete at the world competition May 20 in Knoxville."

The students drafted the ordinance after researching those in other cities, Tribell reports: "In their presentation to the city council, the team said that 33 percent of Bell County’s population smoke, and they discussed the health effects it has on the community at large."

"The council voted unanimously in favor of the ban ordinance, and it will go up for a second-reading vote at their meeting on May 19," Tribell reports.

Anthem gives $140,000 for 3-county program to cut smoking by pregnant women, still at 21.9% in Ky., among highest in U.S.

Health departments in Christian, Hopkins and Madison counties will start a program called Giving Infants and Families Tobacco Free Starts, with a $140,000 grant to the state health department from the Anthem Foundation.

The GIFTS program was created to help decrease the number of women who smoke during pregnancy and reduce exposure to secondhand smoke for the pregnant woman and her infant, a state news release said. Smoking before and during pregnancy is the single most preventable cause of illness and death among mothers and infants, according to the federal Centers for Disease Control and Prevention.

“Tobacco use is a serious problem in Kentucky, but it is an even more serious issue for women who smoke during pregnancy,” said Dr. Ruth Shepherd, director of the state health department's Division of Maternal and Child Health. “Smoking during pregnancy and infant exposure to secondhand smoke create numerous risks for babies, including pre-maturity and low birth weight, and risks for developing certain conditions like asthma.”

Smoking rates among pregnant Kentucky women dropped from 26.3 percent in 2004 to 21.9 percent in 2013, but that is still among the highest rates in the U.S. In 2013, 13.3 percent of Kentucky births to smoking mothers were premature, compared to 10.2 percent of births to mothers who did not smoke. Even more striking were these numbers: 13.6 percent of babies born to smokers had low birth weight, compared to only 7.5 percent of those born to non-smokers.

The GIFTS program includes a screening tool for assessing tobacco dependence; screening for depression, social support and domestic violence; individualized counseling and support; referral to a service that helps smokers quit; and educational materials, including relapse prevention and the risks of secondhand smoke exposure in the home.

“Reducing the amount of tobacco use and secondhand smoke exposure is not only crucial for improving the health of our state,” state Health Commissioner Stephanie Mayfield said in the news release. “We are thrilled to receive this grant from the Anthem Foundation and look forward to building on the success of GIFTS and working toward reaching our state’s health goals.”

Smokers using electronic cigarettes are less likely to quit smoking than those who don't use the devices, California study finds

The sudden increase in use of electronic cigarettes has prompted questions about whether they actually help people quit smoking. A study published online in the American Journal of Public Health found that individuals who use e-cigarettes are actually less likely to quit smoking than those who do not. In Kentucky, 24 percent of adults and 41 percent of those aged 18 to 29 reported using e-cigarettes, according to a Kentucky Health Issues Poll.

The study, conducted by researchers from the University of California San Diego School of Medicine, discovered that smokers who use e-cigs are 59 percent less likely reduce cigarette use and 59 percent less likely to stop smoking altogether, compared to smokers who have not used e-cigs.

"Based on the idea that smokers use e-cigarettes to quit smoking, we hypothesized that smokers who used these products would be more successful in quitting," said Wael Al-Delaimy, professor and chief of the Division of Global Public Health in UC-San Diego's Department of Family Medicine and Public Health. He said the research showed the hypothesis was false, and more studies are required to find out why these people can't stop smoking. "One hypothesis is that smokers are receiving an increase in nicotine dose by using e-cigarettes," he said.

E-cigs don't contain tobacco, but smoking them releases ultra-fine particles and volatile organic compounds such as heavy metals. The study also found that women and those who smoke daily are more likely to have tried e-cigarettes.

Burgin, in heart of Kentucky, is state's 40th school district to go tobacco-free; ban, won by students, applies to vapor products

Burgin Independent Schools, in the heart of Kentucky, will be the latest 100 percent tobacco-free schools in the state, and the first in Mercer County, which has a strong tobacco heritage.

The Burgin Board of Education voted April 8 to ban all tobacco use, including vapor products, on school grounds and during school-related student trips, Robert Moore reports for The Harrodsburg Herald. The policy becomes effective July 1 and includes any building or vehicle owned or operated by the board and applies to any renters of school property.

Burgin will be the 40th Kentucky school district to become fully tobacco-free. Kentucky has 173 public- school districts, with 1,233 public schools, according to the state Department of Education.

The Kentucky 100 percent Tobacco-Free Schools website says, "Studies show that schools with 100 percent tobacco-free school policies for three years of more have 40 percent fewer smokers than those in non-tobacco free school districts." The 2013 Kentucky Youth Risk Behavior Survey found that 18 percent of Kentucky youth smoke, and 47 percent of them have smoked at least once.

"I’m really proud we’re going to be a tobacco free campus," board member Priscilla Harris told the Herald after the meeting. "We want to set a good example." The independently owned weekly newspaper recently did a three-part series on tobacco in the county, including Burgin students' efforts to get tobacco banned.

Kentucky 100 percent Tobacco Free Schools map, with Burgin added

Electronic cigarettes are 'high on every school system's radar right now,' Western Ky. school official tells Henderson newspaper

This story has been updated to reflect recent data about teens and e-cigarette use.

School officials in northwestern Kentucky are trying deal with an increase in the use of electronic cigarettes by students, Erin Schmitt reports for The Gleaner in Henderson.

Union County Schools spokeswoman Malinda Beauchamp told Schmitt there had been 16 discipline referrals of students using e-cigarettes at Union County High School and 26 at Union County Middle School this year. There is no data from previous years for comparison, but school officials "have noticed the rise" and want to be proactive in preventing more usage, Beauchamp said.

Schmitt reported on e-cigarette usage at other schools in the region and found 15 to 20 incidents at Henderson County High, but only a few incidents in North Middle School, South Middle School and Central Academy, according to Julie Wischer, public information officer for Henderson County Schools.

The Webster County Schools did not have exact numbers of incidents of usage, but has e-cigarettes listed under its policy as a tobacco product or paraphernalia, Todd Marshall, Webster’s director of pupil personnel, told Schmidt. Though it’s a new issue, Marshall said, “It’s high on every school system’s radar right now.”

A recent report by the Centers for Disease Control and Prevention found that the number of high school students who tried e-cigarettes has tripled in one year, to more than 13 percent, while smoking of traditional cigarettes dropped to 9.2 percent from more than 13 percent, CBS News reports.

“Many users of marijuana prefer e-cigs or vapes because it’s smokeless, odorless and easy to hide or conceal,” Henderson County Supt. Patricia Sheffer told Schmitt. “This ‘vaping’ is a concern in our schools and elsewhere among youth, because it can produce a nearly instant ‘high’ with little or no detection."

The preventive measures include: a Facebook message to parents and students from her about the dangers of e-cigarettes, which not only involves nicotine usage, but also marijuana, alcohol and other drugs that can be ingested through the device; updating policies, procedures and the student code of conduct to include prohibitions on e-cigs and vapor devices on school property; a commitment to find out how the student got access to the device; and a required drug and alcohol screening if caught, with parent-paid counseling if the screen is positive.

Most Kentuckians don't think insurance rates should be higher for the obese, but are divided on increasing smokers' rates

By Melissa Patrick
Kentucky Health News

By a very small margin, Kentuckians think insurance rates should be higher for smokers if the insurance company provides a free smoking cessation program, but most don't think rates should be higher for those who are overweight, says the latest Kentucky Health Issues Poll.

The poll, taken Oct. 8 to Nov. 6, found that 50 percent of Kentucky adults said it would be justified to set higher insurance rates for people who smoke, while 45 percent said it wouldn't be justified. Five percent were undecided. This finding was basically the same whether the person had insurance or not.

The poll's margin of error was plus or minus 2.5 percentage points, which applies to each number, so the results were right on the error margin. That means in 19 of 20 cases, the results would be the same if the entire adult population of Kentucky were asked the question.

The poll found that most Kentuckians who have never smoked (63 percent) said insurance companies should not set higher insurance rates for people who smoke. Former smokers, at 51 percent, were less likely to agree with that opinion.

With about 27 percent of Kentuckians smoking, Kentucky leads the nation in smoking percentage, lung cancer and lung cancer deaths, which collectively come with a price tag.

Smoking cost the state $1.92 billion a year for health-care expenditures directly as a result of tobacco use, which amounts to $988 million a year in total taxpayer cost from smoking-related expenses, or $591 per household, Wayne Meriweather, chief executive officer of Twin Lakes Regional Medical Center in Leitchfield, representing the Kentucky Hospital Association, told legislators in December.

The poll also found that the majority of Kentucky adults, 67 percent, think it is unjustified to set higher insurance rates for people who are significantly overweight. Opposition was higher, 77 percent, among those who reported being in fair or poor health; among those who said they were in excellent or very good health, only 58 percent were opposed.

Kentucky ranks fifth in the nation for adult obesity, with one in three Kentuckians considered obese, according the "States of Obesity" report. This also comes with a price tag.

A study in the American Journal of Health Promotion found that a morbidly obese employee costs his or her employer approximately $4,000 more in health care and related costs every year than an employee of normal weight.

The poll was sponsored by the Foundation for a Healthy Kentucky and Interact for Health, formerly the Health Foundation of Greater Cincinnati, and was conducted by the Institute for Policy Research at the University of Cincinnati. It surveyed a random sample of 1,597 adults via land lines and cell phones.

Warren County school board bans tobacco use on campuses and by students and employees during extracurricular school activities

The Warren County Board of Education voted 4-1 on March 16 to ban the use of tobacco "by students, employees or those on school grounds or during extracurricular school activities" as of July 1, Charles Mason reports for the Bowling Green Daily News.

"Board Chairman Kerry Young dissented," Mason reports. "He said he wanted the district to establish designated smoking areas. Young said tobacco is legal for adults, and is a traditional cash crop for Kentuckians."

However, "Board Member Don Basham said it was in the best interest of the district to promote a tobacco-free environment," and the other three members agreed. 

About 40 of Kentucky's school districts have banned tobacco. "Warren will join Simpson County as the only two school districts in south-central Kentucky deemed 100 percent tobacco-free under state guidelines, Mason reports.

Beshear cites signs toward better health: kids are more active and getting more dental care; adults are getting more screenings

Kentucky Health News

Kentucky is moving toward achieving the broad, ambitious goals for better health that Gov. Steve Beshear laid out when he started the "Kyhealthnow" initiative in February 2014, his office says.

"More Kentuckians have health insurance, are covered by smoke-free policy, can access physical activity resources, seek care for heart disease and cancer prevention, and get dental services" since the initiative began, Beshear said in a press release.

The program builds on federal health reform, which has made Medicaid or private insurance available to hundreds of thousands of Kentuckians, many of whom were previously uninsured and unable to afford health coverage. According to a Gallup Poll released in February, 9.8 percent of Kentucky’s population is uninsured, down from 20.4 percent in 2013.

Kyhealthnow targets seven major health goals to be met by 2019, focusing on increasing health insurance coverage; reducing the smoking rate and tobacco use; lowering the prevalence of obesity; lowering cancer deaths; reducing cardiovascular disease; treating and reducing dental decay; and reducing drug overdoses and mental health issues in Kentucky.

The report said more adults have been screened and identified as having high blood pressure and are able to control their hypertension, and more adults have had their cholesterol checked.

Significantly more children on Medicaid are being seen by dentists, and the number of children enrolled in Medicaid receiving two fluoride dental varnishes per year has increased. The state has given money to five health departments for dental-hygiene programs, and will fund five more this year. "These programs broaden access to hygiene services, such as cleanings, screening and referrals, by providing staff and resources to supply mobile units to deliver care in schools," the release said.

School districts are showing an increase in the amount of time devoted to physical activity, the state reports. The Comprehensive School Physical Activity Program has been implemented at proficient or distinguished levels at all grade levels in 515 of the state's 746 elementary schools, 186 of the 329 middle schools and 109 of the 228 high schools. Also, more schools report they are using body-mass index data to inform school wellness policy.

The state health department is using federal funds to implement physical activity and obesity-prevention curricula in early-childhood care centers. "The goal is to develop healthy habits in children before the age of 5 and prevent obesity," the news release says.

To increase physical activity and deter obesity among older children and adults, the state is establishing “trail towns.” Morehead and Olive Hill were recently certified by the state Office of Adventure Tourism and eight more are expected to be certified this year. The Dawkins Trail, an ongoing rail-to-trail project in Eastern Kentucky, has reached a length of 18 miles.

Diabetes management has improved among adults, and a study of Medicaid patients showed an overall decrease in those with poor diabetes control, the release said. State employees now have easier access to the nationally recognized Diabetes Prevention Program, which helps people who are at risk of developing diabetes reverse the onset of the disease.

Dr. Stephanie Mayfield, the state health commissioner and vice chair of Kyhealthnow, has emphasized the importance of reducing tobacco use to make Kentuckians healthier. Beshear has expanded the ban on tobacco products and e-cigarettes on executive branch properties, making Kentucky one of only five states in the country with such a policy. Smoking bans exist in 24 communities, 37 school districts and 51 college or university campuses.

Kyhealthnow, chaired by Lt. Gov. Crit Luallen, includes people from many areas of state government who develop innovative strategies for addressing the state’s health woes and challenge local governments, businesses, schools, nonprofits and individuals to take meaningful steps toward improving health in their communities, the release said.

Former smokers get newly funded scan for lung cancer and encourage others to do the same, after finding cancer in time

The number of smokers choosing to get low-dose CT scans to see if they have lung cancer is steadily increasing, especially since this screening was recently approved for payment by Medicare, Grace Schneider reports for The Courier-Journal.

Janet Overman and Roger Cross Sr., both 70 and heavy smokers since they were teens, decided to get this screening and both learned they had lung cancer, but with different outcomes.

Overman, a retired administrative assistant from Louisville, told Schneider that she had smoked two packs a day until a health scare in the late 1990s caused her to quit after 35 years of smoking. She said that she knew she was considered a high risk for lung cancer and this prompted her decision to get screened at the James Graham Brown Cancer Center in November 2013.

Her original screening showed she had lung cancer, but a follow-up scan and biopsy showed no cancer. She has been placed on a monitoring program with no treatment necessary, Schneider reports. "I'm sure it was prayer," Overman told Schneider.

Cross, a Bullitt County resident and owner of a small freight-delivery service, said he quit smoking 18 years ago and also credits his diagnosis to "divine intervention," Schneider writes.

He told Schneider that while driving on Interstate 65, he spotted a billboard that urged people to get screened for lung cancer. "The Lord put that right on my windshield," he said.

That happened a year ago, prompting Cross to pay $185 for his screening at Norton Healthcare, where he learned that he had Stage 3 lung cancer. He has since had surgery to remove a lung lobe, plus four rounds of chemotherapy, and is doing well, Schneider reports.

Both survivors spend their time encouraging other longtime smokers and ex-smokers to get screened "while there's a chance to beat the disease," Schneider writes.

Overman's story is an example of why counseling is so important for people who get this lung cancer screening. CT scans are so much more sensitive than traditional chest X-rays, "detecting abnormalities the size of a grain of rice," and can often turn up false positive results, which requires future scans and test, Schneider writes. These scans also reveal other health conditions such as emphysema, coronary-artery disease and chronic obstructive pulmonary disease.

Kentucky leads the nation in lung cancer and deaths from lung cancer, with deaths from the disease nearly 50 percent higher than the national average, according to the Kentucky Cancer Consortium.

Medicare announced in February that it will pay for low-dose CT scans for people at high risk of getting lung cancer. This includes people from 55 to 77 who are either current smokers, have quit smoking within the last 15 years or who have smoked at least a pack a day for 30 years, or the equivalent, two packs a day for 15.

This is welcomed news because early detection is the key to survival. People diagnosed early who have Stage 1 lung cancer have a 57 percent chance of surviving for five years, Schneider reports.

Schneider noted that last November, Kentucky received a $7 million grant to improve survival rates for lung cancer through a project called Kentucky LEADS (Lung Cancer, Education, Awareness, Detection, Survivorship) Collaborative, which will be led by the University of Kentucky, the University of Louisville and the Lung Cancer Alliance.

Kenton County Schools ban use of tobacco

The Kenton County Board of Education voted unanimously March 2 to approve a smoke-free policy immediately prohibiting the use of tobacco on school property, in board-owned vehicles and on school-related trips.

“We have a responsibility to model healthy behavior for students,” Supt. Terri Cox-Cruey told the Community Press and Recorder. "Jess Dykes, director of public relations and community engagement, said the request for the district to become smoke-free came from Gov. Steve Beshear," reporter Melissa Stewart writes. "The governor has requested all school districts to consider the policy change."

Dykes said Kenton County joins six other Northern Kentucky school districts with a smoking ban: Grant County, Beechwood, Dayton, Carroll County, Gallatin County and Williamstown.