approaches must be pursued for physicians, communities, schools, and workplaces, and each must identify potential barriers to implementing local programs.77


Invest in tobacco cessation


Texas pays a high price for tobacco addiction. Each Texas household pays an average of $568 in state and federal taxes each year for smoking-related costs.79


The direct and indirect costs to Texas businesses from tobacco use are significant, and there are significant medical savings when a smoking worker stops smoking. For Texas businesses,


“smoking cessation is the gold standard of health care cost effectiveness.”81


America’s Health


Insurance Plans and Kaiser Permanente developed a return on investment calculator for health plans and employers that helps employers understand the cost-effectiveness of different types of tobacco cessation programs, up to $197 per $1 invested over five years.


More than 24,000 Texans die each year from smoking-related illness. Tobacco is the single greatest cause of preventable and premature death and illness in the world.82


Adults who smoke


are at substantially greater risk of developing chronic diseases and conditions including multiple types of cancer, increasing their risk of diabetes complications, cardiovascular disease, and stroke.


A PHYSICIAN’S STORY


Kimberly Avila Edwards, MD Austin


Safe Sidewalks and Neighborhoods, and Healthy Foods Help Prevent Obesity


Annual Medical Savings by Condition for Each Smoker Who Quits80


Condition


Coronary heart disease and stroke Childhood asthma


Low-birth-weight babies


Other childhood respiratory conditions Childhood otitis media Adult pneumonia Annual Total


Annual Savings $153 $14 $9 $8 $5 $3


$192 November 2012 TEXAS MEDICINE 69


“We are focused on the clinical aspect, which is a very big need. Not only do we need to treat obesity and its medical consequences from mental health to hypertension to after-school obesity intervention, but we also need to educate future health care professionals on all aspects of this disease. We need to be advocates; we need evidence-based community strategies that are proven to prevent and target obesity: improving access to sidewalks, improving access to healthy foods, improving the walkability of the neighborhood and the safety of neighborhoods. It’s something that we are very committed to, and we’ve been able to actually implement a program to train health care professionals to do this.”


Children exposed to secondhand smoke are more likely to develop respiratory problems and acute illnesses. Almost every major system in your body is affected by smoking or secondhand smoke.


In 2012, total revenue to Texas from tobacco taxes and fees and tobacco settlement funds is expected to be $1.9 billion. But Texas will spend less on tobacco prevention in 2012 than most other states, ranking 39th in the nation for tobacco prevention


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