Report Finds Majority of States Falling Short on Laws and Policies that Prevent Cancer and Save Lives

August 11, 2011

WASHINGTON, D.C. – August 11, 2011 – A majority of states are falling short on legislative solutions to prevent and fight cancer, according to a new report released today by the American Cancer Society Cancer Action Network (ACS CAN). In a year consumed by budget shortfalls and legislative challenges, many state legislatures missed opportunities to enact laws and policies that could not only save money and generate revenue, but also save lives.

The report, How Do You Measure Up?: A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality, was released today at the National Conference of State Legislatures annual meeting in San Antonio, TX. The report finds that 24 states have reached benchmarks on none or only one of the five legislative priority areas measured by ACS CAN, the advocacy affiliate of the American Cancer Society. Only four states met four or five of the benchmarks for effective cancer-fighting policies.

“State legislators should support laws and policies that help people fight cancer by emphasizing disease prevention, making health care affordable and accessible and focusing on quality of life,” said John R. Seffrin, PhD, chief executive officer of ACS CAN. “Missed opportunities to pass laws that fight and prevent cancer not only leave new state revenue and health savings on the table, but deny the potential for saving countless lives from a disease that still kills 1,500 people every day.”

How Do You Measure Up? ranks state policies in five priority areas: breast and cervical cancer early detection program funding; colorectal screening coverage laws; smoke-free laws; tobacco prevention program funding; and tobacco taxes. A color-coded system is used to identify how well a state is doing. Green represents the benchmark position, showing that a state has adopted well-balanced policies and good practices; yellow indicates moderate movement toward the benchmark and red shows where states are falling short.

Only Delaware reached a benchmark in all five legislative areas in the fight against cancer and only three states – Hawaii, Maine and New Jersey – reached benchmarks in four of the five areas. Seven states – Alabama, Florida, Idaho, Mississippi, Oklahoma, South Carolina and Tennessee – did not meet the benchmark on any of the five issues, and another 17 received high marks on only one issue.

The report also offers a blueprint for effective legislation on matters such as tobacco cessation funding; regulating indoor tanning devices; obesity, nutrition and physical activity; and quality of life. To assist state lawmakers with the implementation of the Affordable Care Act, the report provides a model framework for establishing consumer-friendly state health exchanges and protecting Medicaid programs – a critical lifeline for many cancer patients.

“As advocates, we have the responsibility to educate the public on how to prevent and treat cancer, but we cannot do it unless state and local policymakers take action to guarantee funding and access to programs and services that are proven to work,” said Christopher W. Hansen, president of ACS CAN. “The most effective solutions will curb cancer diagnoses and save lives, and in most cases, small upfront investments by the state can save millions of dollars in health care costs in the long run.”

Tobacco Control

During the past 10 years, 47 states and the District of Columbia have raised their cigarette taxes in more than 100 separate instances. The current average state tobacco tax is $1.46, with 21 states still having taxes of less than $1.00 per pack. New York has the highest cigarette tax at $4.35 per pack and Missouri has the lowest cigarette tax at 17 cents per pack. No state comes close to matching the health and economic costs attributed to smoking, which are estimated at $10.28 per pack.

In the past legislative session several states, including New Hampshire, Rhode Island, Texas and Louisiana tried either to roll back their taxes or allow current levels of taxation to sunset. Such efforts drain state budgets of needed revenue, weaken a proven method for discouraging smoking and they jeopardize public health.

No states passed smoke-free legislation in the past legislative session; however, a number of cities were able to pass laws making them 100 percent smoke-free. Currently, 23 states and the District of Columbia have a comprehensive smoke-free law in place that covers all types of workplaces, bars and restaurants. Keeping all workplaces, restaurants and bars in a state 100 percent smoke-free is the best way to protect all residents from the dangers of secondhand smoke.

Many states still need to close loopholes that allow for smoking in ventilated areas, casinos, bingo parlors, hookah bars or cigar bars, at certain times of day in some venues or for certain events. These exemptions weaken the laws and do not adequately protect the public. It is also critical for states that currently have strong laws in place to work to protect them and not allow any new exemptions that may put the public, especially service and hospitality workers, at risk for increased exposure to secondhand smoke.

Access to Health Care

With the passage of the health care law in March 2010, many states have started the process of establishing health benefit exchanges. These exchanges will serve as the central marketplace where consumers can compare and buy health insurance plans in the individual and small group markets. States must be on track to receive certification or conditional certification for their exchange by January 1, 2013.

In the past year, 11 states—California, Connecticut, Colorado, Hawaii, Illinois, Maryland, Nevada, Oregon, Vermont, Washington and West Virginia—have passed legislation to set up a health exchange, and more than half of all states introduced exchange legislation or passed legislation signaling the intent to establish an exchange. Next year all states without an exchange will face the pressure of needing to establish a program in time to meet the certification deadline.

Additional Findings

Unfortunately, many states are slashing funding to the National Breast and Cervical Cancer Early Detection Program, which provides low-income and uninsured women with access to life-saving mammograms and Pap tests. Decreased funding means that fewer eligible women across the United States have access to lifesaving screenings.

States are also working on policies and programs to reduce cancer risk related to poor nutrition, lack of physical activity and obesity. During the 2011 legislative session, Virginia legislators led the charge to pass legislation that would have required all students in kindergarten through eighth grade to receive 150 minutes per week of physical education. The Virginia General Assembly passed the bill before the Governor ultimately vetoed it.

Other findings in the report:
• Only eight states have reached the benchmark in providing screenings for breast and cervical cancer early detection.
• Twenty-eight states and the District of Columbia have laws that ensure private insurance coverage for the full range of colon cancer screenings tests.
• Alaska and North Dakota are the only two states currently funding their tobacco prevention programs above levels recommended by the Centers for Disease Control and Prevention (CDC). Only seven states are funding at even half of the CDC’s recommended levels.
• As of January 2011, only seven states provided Medicaid coverage (or Medicaid-comparable coverage) to low-income adults without dependent children.

An estimated 1.6 million people in the United States will be diagnosed with cancer and nearly 570,000 will die from the disease this year. Roughly half of all cancer deaths in the United States could be prevented if everyone in America were to stop smoking, get screened for cancer, eat a healthy diet and exercise regularly.

For state-by-state details or a copy of the complete report, please 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


Nicole Bender or Steve Weiss
American Cancer Society Cancer Action Network
Phone: (202) 661-5773 or (202) 661-5711
Email: [email protected] or [email protected]

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