In the Dec. 5, 2006 issue of the Annals of Internal Medicine, The National Institute of Health (NIH) published a review of the current status of smoking in the United States. According to their review, roughly 21% of adults and 22% of high school students smoke equating roughly 44 million adults and 4 million students.

Tobacco-related diseases account for 440,000 thousands deaths a year, or roughly 1 in every 5. Cigarettes are responsible for 30% of cancer deaths; smoking also contributes to a substantial proportion of deaths related to heart disease, stroke and lung disease.

The annual direct medical cost of smoking in 1999 was about $75 billion and the loss of productivity cost was around $82 billion which works out to about $500 for every man, woman and child. Some have labeled this a “tobacco tax.” With about 1 in 5 being a smoker, the cost per smoker averages $2500. This is roughly equivalent to $6 of economic cost for each pack smoked. This does not take into account the expense of buying tobacco products; these estimates are related only to smokers and do not include the effects of second hand smoke.

Applying this data to Nebraska yields an annual cost of about $1 billion. This of course does not even consider the human cost related to the death and disability of family members.

The NIH suggests a number of proven strategies to lower tobacco use especially among adolescents and young adults. These include the following: 1. increased prices through taxes on tobacco products, 2. laws and regulations that prevent access to tobacco for adolescents, 3. restrictions on advertising, 4. mass media campaigns.

This document addresses only smokers, not the issue of second hand smoke. Recently, Great Plains Regional Medical Center in North Platte, in conjunction with The Mayo Clinic, sponsored a program dealing with the treatment of smoking and nicotine addiction. One of the startling facts is that second hand smoke accounts for over 50,000 deaths in this country. Within minutes of exposure to second smoke, flow of blood in the major blood vessels becomes sluggish. Freedom from second hand smoke will bring significant health and economic benefits. One of the most straight forward and direct ways to accomplish this is through a smoke free workplace.

It is clear from this information that a smoke free workplace will make Nebraska a healthier, more productive and enjoyable place. All Nebraskans have seen the progress made in Lincoln and Omaha in creating a smoke free workplace. It is time to bring these health benefits to all Nebraskans and it is time to reap the economic benefits of a healthier Nebraska. Is there any reason to continue to burden each and every Nebraskan with the economic and health costs of second hand smoke? My hope is that many of you will be part of the movement to make the work place safer, healthier and more prosperous.

Ron Asher, M.D., North Platte