乌鸦传媒

Twelve contiguous U.S. states, dubbed "Tobacco Nation" by the advocacy group , continue to use tobacco at rates far above the rest of the country and lag markedly in anti-smoking initiatives and overall population health.

Stretching from the upper Midwest through much of the South, the 12 states -- Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Oklahoma, Tennessee, and West Virginia -- have smoking rates that exceed "many of the most smoking-dependent countries in the world," the reported noted.

In the 12 states, 22% of adults continue to use tobacco products, compared with 15% of adults in the rest of the U.S.

And smokers in these states also light up more than smokers in the rest of the country, according to the report: "A smoker in Tobacco Nation smokes 26 more packs of cigarettes on average per year, which means they could be inhaling 500 more cigarettes than the average smoker in the rest of the U.S."

The report declared, "Tobacco Nation's high smoking rates, along with its relatively poor health outcomes and lack of access to care, make it a disadvantaged country within a country."

Truth Initiative's president and CEO, Robin Koval, noted the dramatic progress in tobacco control in the U.S., with smoking rates among youth declining to 6% and rates among adults declining to 15%.

"But there really are two stories here, and that is what this report highlights," Koval told 乌鸦传媒. "We have known that disparities exist, but it's shocking to think that in these 12 states, with a population of 56 million people, tobacco prevalence is more similar to countries like Indonesia and the Philippines than the richest country in the world."

She said residents of Tobacco Nation have higher rates of chronic obstructive pulmonary disease (7.9% versus 54%), and higher rates of heart disease, lung cancer, and death from lung cancer than residents of the 38 other states.

The report noted that the 12 states invest less in public health funding (roughly $81 per person annually) than the rest of the nation ($98 per person) and these states also spend less on tobacco control.

A pack of cigarettes is, on average, 19% less expensive in the 12 Tobacco Nation states ($5.48) compared with the average for the rest of the U.S. ($6.72), due to lower excise taxes and the fact that these states tend to have fewer smoke-free laws.

Just two Tobacco Nation states -- Ohio and Michigan -- have comprehensive smoke-free laws in place banning smoking in workplaces, restaurants, and bars, compared with more than half of states in the rest of the country that have the laws.

"Despite the success of decades of progress in lowering the smoking rate in the U.S., it is clear that much work remains in the fight against tobacco," the report concluded, adding: "We cannot move forward as a country when so many of our states lag far behind."

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