SAVI Community Trends Report: Unequal Access Tobacco Epidemic Report 2017 FINAL - Page 9

Recommendation 1 State Fund state tobacco control activities at the level recommended by the CDC. Recommendation 2 State Substantially increase excise tax rates to be more in line with level imposed by the top quintile of states. Recommendation 4 State and local Enact complete bans on smoking in all nonresidential indoor locations, including workplaces, malls, restaurants, and bars. Recommendation 16 Increase demand for effective cessation programs and activities through mass media and other general and targeted public education programs. State, heath care partners Recommendation 21 State and local Support the efforts of community coalitions to promote, disseminate, and advocate for tobacco use prevention and cessation Recommendation 22 State and local • • Consider populations disproportionately affected by tobacco addiction and tobacco when designing and implementing prevention and treatment programs. Ensure health communications are culturally-appropriate and that special outreach efforts target all high-risk populations. Recommendation 30 State Regulate retail POS of tobacco products for purpose of discouraging consumption and encouraging cessation. Recommendation 32 Restrict the number of tobacco outlets. State Recommendation 35 State Limit visually displayed tobacco advertising in all venues, including mass media and at the point of sale Table 1. State and Local Recommendations for Ending the Tobacco Problem, Institute of Medicine recommended by the IOM, but would increase our rank to 14th among states, [67] while saving countless Hoosier lives and avoiding millions in healthcare and lost productivity costs. This coalition is also advocating for Indiana legislation to raise the age of legal tobacco purchase from 18 to 21 years. $7 million per year in state and federal fund- ing, slightly under 10% of the recommended amount. [69] Meanwhile, tobacco companies spend app roximately $284.5 million annually marketing tobacco products in Indiana. [70] Passing stricter smoke-free air laws (IOM Recommendation 4) is another way Indiana could reduce exposure to the adverse effects of tobacco. The state legislature passed smoke-free air legislation in 2012, but several types of work environments were exempted from the law, thus weakening its capacity to protect citizens from tobacco smoke. [71] The Indiana State Department of Health estimates that only 31% of Indiana residents, living in the twenty-one cities and counties that have passed comprehensive laws, are nearly fully protected from second-hand smoke. [72] When the price of tobacco rises, there is a cor- responding increase in the number of tobacco users interested in quitting and in the demand for cessation services. Indiana’s state tobacco control program (IOM Recommendations 1, 16, 21, 22) has been underfunded in recent years. According to the Centers for Disease Control and Prevention (CDC), a minimum of $51.2 million should be invested in state tobacco control functions in Indiana, including $20.6 million for cessation interventions. [68] The CDC’s recommended funding level for Indiana is $73.5 million, which would provide $33.1 for cessation services. [68] Indiana’s tobacco con- trol program actually receives approximately Action Toward Equity The current study unveils new information about where and toward whom interventions 9