MD/DC outpace VA in Implementing Proven Cancer-Fighting Policies

Action on tobacco-related policies contributes to lower lung cancer rates in Maryland and DC

August 9, 2018

WASHINGTON, D.C. Virginia lags behind Maryland and D.C. in implementing proven cancer-fighting public health policies according to a new report released today by the American Cancer Society Cancer Action Network (ACS CAN). The Virginia Legislature’s inaction on these policies contributes to higher lung cancer incidence and death rates.

The report, “How Do You Measure Up?,” measures progress state legislatures are making on implementing nine evidenced-based policies that are proven to reduce the cancer burden. While Maryland has earned the highest possible rating in five categories and the District of Columbia has earned the highest rating in four categories, Virginia has earned the highest rating in only two categories. 

“Maryland and the District of Columbia have actively pursued public policies to prevent, detect and treat cancer, but unfortunately Virginia lags behind,” said Brian Donohue, government relations director for ACS CAN in Virginia. "While it is not surprising that Virginia, the home state for Altria, parent company of Philip Morris USA, would fall short in tobacco-fighting policies, lawmakers must act to reverse the health and economic toll that these products take on citizens of the Commonwealth.”

Based on data from the National Vital Statistics System from 2011 to 2015, Virginia’s lung cancer mortality rate is six percent higher than Maryland’s rate and 12 percent higher than the District’s. The disparity among men is even greater, with the lung cancer death rate in Virginia ten percent higher than in Maryland and 17 percent higher than the District’s.

Maryland and D.C. both earned “green” ratings for their state cigarette excise taxes, which stand at $2 and $2.50 per pack respectively. (The D.C. City Council recently passed an additional $2 per pack increase to its tax, which is expected to go into effect later this year.) By comparison, Virginia’s state cigarette excise tax is only 30 cents per pack and is the second lowest in the country. The average state cigarette tax as of July 1, 2018 is $1.75 per pack.

Maryland and D.C. also earned “green” ratings for implementing comprehensive smoke-free laws that protect people from the proven health hazards of secondhand smoke. Virginia has not passed a similar statewide policy.

“I am proud to live in Virginia—but why should that put my family and me at a greater risk of cancer or for shouldering the economic burden of tobacco use?” asked Donohue. “Virginians should have public policies that actively discourage tobacco consumption and support cessation programs for those trying to quit.”

One critical tobacco-control policy that none of the three states have earned a passing grade for is fully funding and implementing statewide tobacco prevention and cessation programs in accordance with best practice recommendations from the U.S. Centers for Disease Control and Prevention (CDC). Maryland, Virginia and the District of Columbia all earned “red” ratings, indicating funding levels for fiscal year 2018 were below 25 percent of the CDC’s recommendation.

This year’s report also highlights a significant trend: in 2015, there were fewer than 80 state legislative proposals introduced related to pain management and opioid issues nationwide; in 2018, there have been more than 470 state legislative proposals introduced across the country regarding these same issues. Hanging in the Balance: A Special Section on the Impact of Pain Policy evaluates whether states are implementing balanced pain policies and takes a deeper dive into how states can reduce opioid abuse while ensuring patients who legitimately need these drugs maintain access to them.

A color-coded system classifies how well a state is doing in each issue. Green shows that a state has adopted evidence-based policies and best practices; yellow indicates moderate movement toward the benchmark and red shows where states are falling short.  


                                                                                                VA                  MD                 DC

Cigarette Tax Rates                                                              Red                 Green              Green

Smoke-free Laws                                                                  Red                 Green              Green

Tobacco Prevention and Cessation Program Funding     Red                 Red                 Red

Medicaid Coverage of Tobacco Cessation Services           Red                 Yellow            Yellow

Indoor Tanning Device Use Restrictions                            Red                 Red                 Green

Increased Access to Medicaid                                              Green              Green              Green

Breast and Cervical Cancer Early Detection Funding     Red                 Green              Yellow

Access to Palliative Care                                                      Yellow            Green              Red

Pain Policy                                                                             Green              Red                 Yellow


To view the complete report and details on each state’s grades, visit .                                                                                   

ACS CAN, the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem.  ACS CAN works to encourage elected officials and candidates to make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer with the training and tools they need to make their voices heard. For more information, visit

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