Report Shows Majority of States Not Measuring Up On Laws and Policies to Fight Cancer

August 9, 2012

WASHINGTON, D.C. August 9, 2012 A majority of states are not measuring up on legislative solutions that prevent and fight cancer, according to a new report released today by the American Cancer Society Cancer Action Network (ACS CAN). As states continue to struggle with budget shortfalls and legislative challenges, many state legislatures missed opportunities to enact laws and policies that could not only generate new revenue and long-term health savings, but also save lives.ξ

The report, How Do You Measure Up?: A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality, was released at the National Conference of State Legislatures annual meeting in Chicago, IL. The annual report found that 32 states have reached benchmarks in only two or fewer of the seven legislative priority areas measured by ACS CAN, the advocacy affiliate of the American Cancer Society. Only two states met five of the benchmarks Vermont and Delaware. The remainder of the states, and the District of Columbia, received mixed reviews, with much more work left to be done.

Effective public policy measures in the states that encourage prevention, guarantee access to affordable health care, curb tobacco use and focus on patients ' quality of life have been proven to dramatically reduce the burden of cancer, a disease that still kills 1,500 people in this country every day, said John R. Seffrin, PhD, chief executive officer of ACS CAN. The failure to enact laws or policies that fight and prevent cancer not only costs countless lives, but leaves new state revenue and health savings on the table.

Now in its tenth year, How Do You Measure Up? identifies and ranks specific policy actions that state legislatures can take to fight cancer, including adequate breast and cervical cancer early detection program funding; colorectal screening coverage laws; comprehensive smoke-free laws; tobacco prevention program funding; and increased tobacco taxes. The 2012 report adds two new measures, tanning bed bans for minors and access to palliative care to treat pain and other symptoms of the disease. 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.ξ

No state received greens in six or seven of the measures. Only Delaware and Vermont reached a benchmark in five legislative areas in the fight against cancer and only seven states Hawaii, Illinois, Maine Maryland, New Jersey, Rhode Island and Washington and the District of Columbia, reached benchmarks in four of the seven areas. Seven states Alabama, Florida, Idaho, Mississippi, Oklahoma, South Carolina and Tennessee did not meet the benchmark on any of the seven issues and another 17 received high marks on only one issue.

How Do You Measure Up? also offers a blueprint for effective implementation of provisions of the Affordable Care Act that benefit cancer patients and their families, such as creating consumer-friendly state health exchanges, expanding health coverage to new populations through Medicaid and ensuring that health plans cover essential health benefits for chronic disease patients. In addition, the report provides guidance on matters such as tobacco cessation funding; emerging tobacco products; obesity, nutrition and physical activity; and oral chemotherapy parity.

We know what needs to be done to save more lives from cancer, but we cannot be successful unless state and local policymakers take action to deter tobacco use and guarantee funding and access to programs and services that are proven to work, said Chris Hansen, president of ACS CAN. State legislatures continue to miss opportunities to decrease cancer diagnoses and save lives and, in most cases, small upfront investments by a state can save millions of dollars in health care costs in the long run.

Tobacco Control

In the past 10 years, only three states California, Missouri and North Dakota have not raised their cigarette tax. The current average state cigarette tax is $1.49, with 20 states and the District of Columbia still having taxes of less than $1.00 per pack. No state comes close to matching the health and economic costs attributed to smoking, which are estimated at $10.47 per pack.

Earlier this year, the Illinois state legislature increased the state 's cigarette tax by $1.00,ξ to $1.98 per pack. In June 2012, California voters considered a $1.00 increase in their state 's cigarette excise tax and an equivalent increase in the tax on other tobacco products.ξ The lifesaving initiative was defeated by Big Tobacco 's $50 million campaign of deception.

On Nov. 6, voters in Missouri will consider an increase of 73 cents per pack in their state 's cigarette tax, which is currently the lowest cigarette tax in the nation, at 17 cents per pack.

No state passed comprehensive smoke-free legislation in the recent legislative session; however, a number of cities and counties were able to pass laws making them 100 percent smoke-free. Currently, 23 states, Puerto Rico, the U.S. Virgin Islands and the District of Columbia have a comprehensive smoke-free law in place that covers all types of workplaces, bars and restaurants.

Indiana missed becoming green this year when, despite overwhelming public support, the Indiana General Assembly passed a version of a smoke-free workplace law that is filled with exemptions for bars, taverns and gaming facilities leaving too many workers unprotected from the deadly effects 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 and venue employees.

Access to Health Care

To date, 14 states have established health insurance exchanges where consumers will be able to shop for and compare plans under the Affordable Care Act, states must be on track to receive certification for their exchange by January 1, 2013.

Unfortunately, many states are slashing funding to the National Breast and Cervical Cancer Early Detection Program (BCCEDP), which provides low-income and uninsured women with access to life-saving mammograms and Pap tests. Only eight states have reached the benchmark in providing screenings for breast and cervical cancer early detection. Nearly half of all states have reduced state funding for their BCCEDP, meaning fewer eligible women across the United States have access to lifesaving screenings.

Other findings in the report:

  • Twenty-eight states and the District of Columbia have laws that ensure private insurance coverage for the full range of colon cancer screenings tests.
  • Only two states California and Vermont have enacted laws banning tanning for minors under 18.Œæ
  • Only seven states and the District of Columbia have palliative care programs in 80 percent or more of their hospitals. Thirty seven states have programs in 42-80 percent of hospitals.
  • When federal and state funds are counted together, Alaska and North Dakota are the only two states currently funding their tobacco prevention programs above Centers for Disease Control and Prevention (CDC) recommended levels. Only four additional states are funding at even half of the CDC 's recommended spending levels.
  • To date, 18 states and the District of Columbia have passed oral chemotherapy parity legislation to help equalize patient out-of-pocket costs for oral chemotherapies and IV chemotherapies.Œæ

An estimated 1.6 million people in the United States will be diagnosed with cancer and more than 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.ξ 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