Minnesota has strong past, uncertain future in tobacco fight

This week, nearly 2,000 researchers, health experts and advocates from all over the country will come to Minneapolis for the National Conference on Tobacco or Health. ClearWay Minnesota, the largest Minnesota nonprofit working to reduce tobacco's harm, is proud to welcome this event organized by the National Network of Public Health Institutes and a steering committee of partner organizations. On Tuesday, U.S. Surgeon General Jerome Adams will kick off several days of meetings, presentations and discussions focused on sharing our best research and strategies for ending tobacco's harm for good.

This meeting occurs just over 20 years after historic tobacco settlements set into motion a comprehensive program of tobacco prevention and control. We look forward to celebrating our successes and gearing up to take on our present challenges, which include a youth e-cigarette epidemic and stubborn tobacco-related health disparities.

Minnesota was chosen to host this gathering in part because of our long history of lowering smoking rates. Our work to address tobacco addiction involves many organizations including state and local public health units, nonprofit organizations, health care providers and insurers, community advocates, and institutions like Mayo Clinic and the University of Minnesota. We've partnered to provide free cessation help, pass seminal health advances such as cigarette price increases and clean indoor air laws, educate the public, motivate smokers to quit, and prevent kids from ever starting commercial tobacco. Some of ClearWay Minnesota's specific efforts have gained national attention, including collaborations with American Indian tribes and communities of color, and a $30 million grant program funding research on tobacco use and ways to prevent it.

Just this month, a new research study by HealthPartners Institute and ClearWay Minnesota was published in the peer-reviewed journal Tobacco Control. The study quantifies the outcomes of Minnesota's "great experiment" in prevention and cessation. Over 20 years, our collective efforts have resulted in more than 4,500 cancers prevented, nearly 47,000 fewer hospitalizations for smoking-related diseases, and $5.1 billion — more than $900 per Minnesotan — saved in health costs and work productivity.

Finally, we've prevented more than 4,000 smoking-attributable deaths: That's 4,000 family members and friends having more time with each other because they've been spared the death and disease caused by smoking. Since the benefits of prevention and cessation grow over time, we expect these numbers will continue increasing, as nonsmokers live longer and have healthier lives in the future.

Additionally, over the past 20 years these initiatives have equaled the lowest smoking rates for adults and children in Minnesota history — from 22% down to 14% for adults, and from 32% down to 10% for kids.

These are numbers to celebrate — and yet not all the news is good. Youth smoking has declined, but the most recent Minnesota Youth Tobacco Survey found that overall, tobacco use among young people actually rose for the first time in a generation. That study was conducted in early 2017, so it doesn't even account for the surge in popularity of products like Juul.

Nicotine is addictive, harms the adolescent brain and creates pathways for addiction to other substances. Despite these facts, recently exposed documents revealed Juul Labs deliberately marketed to young people, paid for opportunities to give "addiction education" presentations in schools, and sponsored youth camps for kids as young as 8. Not only is the popularity of these new tobacco products creating an epidemic of youth use, it is raising even more immediate concerns for young people's health. Earlier this month, the Minnesota Department of Health issued an advisory when hospitals reported at least four teenagers in the state experienced severe lung injuries after using e-cigarettes. Investigations into these cases continue.

Here in Minnesota, health efforts are also approaching a crossroads, with an uncertain future for tobacco control in our state. ClearWay Minnesota is a life-limited organization that will end in 2022, and the organization currently provides over two-thirds of the funding for this work. Minnesota needs to make sure tobacco prevention remains high on the list of priorities, even after the nonprofit sunsets. Our kids shouldn't start, and our smokers deserve help to quit. It's as simple as that — and yet many people, including some policymakers and decisionmakers in this state, simply don't know how easily this progress can slip away.

The dramatic decrease in smoking in recent decades is one of Minnesota's greatest public health accomplishments. As we welcome conference attendees to Minneapolis, we hope our state will continue to be a bright spot in the national tobacco-control movement, long into the future.

David Willoughby is CEO of ClearWay Minnesota. On Twitter: @ClearWayMN.