COPD Research and Public Policies

Paul BillingsSenior Vice President, Advocacy and Education

American Lung Association

April 9, 2013

Agenda

• Congress– Budgets & Appropriations– Tobacco issues– Healthy air issues

• Administration • Call to action

Two Kinds of Advocacy

Advocating for a Patient Advocating for all Patients

The time is NOW to take action on COPD!

Issues

• Federal funding for COPD research funding• Federal COPD action plan• Access to heath care • Preventing tobacco use• Tobacco cessation• Healthy air

Congress

Budget & Appropriations

Current Programs

• National Institutes of Health = $29.1 billion– (National Heart, Lung and Blood Institute = $2.926

billion)– COPD-related grants = $108 million (estimate)

• Centers for Disease Control & Prevention = $6.524 billion– No specific COPD program

FY 2013 – Post sequestration

Sequestration

Beyond Sequestration

Same number of people/programs competing for increasingly smaller budget

Actions

• NHLBI has taken leadership role in increasing awareness of disease.

• Using NHLBI funding, CDC adding COPD tracking to BRFSS

• NHLBI to convene federal stakeholder group for COPD action plan.

Congress

Tobacco Control

Before the Tobacco Control Act

• No oversight• Candy flavors in

cigarettes allowed• Joe Camel• Manipulation of

ingredients• “Light” and “Low”

cigarettes

Passage of Tobacco Control Act

• 2009• Gave FDA

immediate authority over cigarettes, smokeless and roll-your-own

• Gave FDA option to “deem” authority over other products

Protect FDA’s authority over all tobacco products

The cigar industry wants a “sweetheart” deal

• Cigar bill in 112th Congress:– House - Posey Kastor: 220 cosponsors– Senate: Nelson Rubio Bill:14 cosponsors– Public health community pushed back on

candy-flavored cigars– Wide-ranging definition of “premium” cigars– Ultimately no vote or movement on the bill

Tobacco Control Act: the Latest Challenge

• Cigar bill in the 113th Congress– HR 792 in the House: 41

cosponsors– Senate bill – Nelson Rubio

Bill – expected any day– New, highly technical

definition of “premium” cigars

Tobacco Control Act: the Latest Challenge

Tobacco Excise Taxes

• Raising the price of tobacco products is one of the best ways to reduce consumption

• Every 10% increase in the price of cigarettes reduces consumption by– 4% among adults– 7% among youths

• Provides federal & state governments with needed revenue – should go to tobacco prevention and cessation efforts

Federal Excise Tax

• Currently $1.01 for a pack of cigarettes• Last increase was in 2009• Sen. Durbin’s S.194: Tobacco Tax Parity Equity

Act• New York Times: Obama’s budget will include an

increase in tax on cigarettes & other tobacco products including possibly equalization.– To be released tomorrow

State Excise Taxes

Average state cigarette excise tax: $1.49/pack

Lowest: Missouri, 17 cents

Highest: New York, $4.35

Current campaigns: Louisiana, Massachusetts, Minnesota, Ohio and West Virginia

Smokefree Air

Comprehensive Law, Including Bars and Restaurants

Comprehensive Law Passed, Not Yet in Effect

Strong Law in Effect

Weaker Restrictions

Tobacco Cessation

• State Medicaid coverage– Only 2 states cover a

comprehensive benefit– Removing barriers to treatment

• Affordable Care Implementation

• Tips from Former Smokers

Congress

Healthy Air

COPD & the Air We Breathe

• Breathing high levels of ozone or particle pollution can worsen COPD

• COPD patients are advised to stay inside on bad air days

• Clean Air Act prevents – 54,000 Chronic Bronchitis cases in 2010– 75,000 Chronic Bronchitis cases in 2020– 160,000 Premature Deaths in 2010 (all causes) – 230,000 Premature Deaths in 2020 (all causes)

Defending the Clean Air Act

• Some in Congress want to weaken clean air health protections

• 112th Congress voted nearly 100 times to weaken or dismantle the law

The Obama Administration

Tobacco Regulations

• FDA deeming authority• Menthol report/status

• Affordable Care Act Implementation– Essential Health Benefits– Exchanges– Medicaid expansion

• Slow and confusing implementation

• Not enough focus on protecting patients– Access to medicine

Healthcare Access

Healthy Air Regulations

• EPA has a mixed record– Ozone– Power Plants– Particulate Matter– Cars and gasoline

Call to Action

COPD needs to raise its visibility

• Be present• Be active• Be loud• Be here

Be a Storyteller: Stand with Dan!

• End-stage COPD• Received double lung

transplant• Testified at EPA hearing on

proposed Carbon standard

Come together

National COPD Call-In Day

• June 12, 2013• Call CDC to tell them we

need them to do more for our nation’s #3 killer

• Sign up at www.lung.org/callinday for more information & to receive talking points

We will breathe easier when the air in everyAmerican community is clean and healthy.

 We will breathe easier when people are free from the addictivegrip of cigarettes and the debilitating effects of lung disease. 

We will breathe easier when the air in our public spaces andworkplaces is clear of secondhand smoke.

We will breathe easier when children no longerbattle airborne poisons or fear an asthma attack. 

Until then, we are fighting for air.