In Oregon over the past several months there have been a lot of conversations about reforming our health system.
Health reform is not just about making coverage more available to more people. It's also about transforming the way people receive health care – and how that care is paid for – so as to improve quality and make it more affordable to us all. It's also about making sure communities have the flexibility to address their local health care needs and better coordination of mental, dental and physical health.
But it's also about much more than that. Real health reform is about keeping people healthy. It's about preventing and reducing illness so we can lessen the need to treat those things we can prevent and focus on having the most effective care for those things that cannot yet be prevented.
One of the best and simplest examples of preventing illness comes from preventing tobacco use. We all know the direct connection between smoking and lung disease, heart disease and other illnesses. There is an equally direct connection between ending tobacco use and preventing diseases. It's an investment that reaps huge human and financial returns.
Every $1 spent on preventing or ending tobacco use prevents at least $45 in future health care costs. People who smoke are at a greater risk for diseases such as cancer, heart disease and emphysema. We know how expensive medical care can be – a single visit to the hospital can cost thousands of dollars. Because smokers are much more likely to get sick, they run up thousands of dollars more in health care costs than do non-smokers. We all pay the costs of tobacco use.
Between 1996 and 2009, thanks to Oregon Public Health's Tobacco Prevention and Education Program (TPEP) and its work with local communities, Oregon had a 48 percent decrease in per-capita cigarette purchases and a 26 percent decline in the number of people who smoke. Over the same period of time, tobacco-related cancer deaths dropped 4.7 percent, more than 1,000 people.
Preventing tobacco hospitalizations and death is about much more than having skull-and-crossbones warning labels on packs of cigarettes or tobacco. It's about taking a comprehensive approach that involves local communities and using evidence-based approaches to protect people from secondhand smoke and help smokers quit.
We have made some great strides in Oregon, going tobacco free for better health and lower costs.
For example, all Oregon workplaces including restaurants and bars are smoke free. All Oregon Health Authority and Oregon DHS campuses are smoke free, including Oregon State Hospital. Beginning next year, all treatment facilities licensed through our Addictions and Mental Health Division will have completely smoke-free grounds as well, although many providers are not waiting for that change and are already providing a healthier environment for clients. More than 25 Oregon colleges and universities, both public and private, have gone tobacco free. In addition, Public Health is working with DHS and our Division of Medical Assistance Programs to reduce the very high rate of smoking among our clients.
You can read more about how these policies work and hear directly from ex-smokers, business owners, college students and others about how they are going tobacco free here.
These are great accomplishments. We also have more work to do. Today, even with all these efforts, an estimated 17.5 percent of Oregonians smoke. Statewide, 20 kids start smoking every day, and one-third of them will eventually die of a tobacco-related disease. Ninety percent of current adult smokers started smoking before they turned 18. While these rates are better than they used to be, they aren't as good as they are going to be, because we are going to keep at this, year after year, until Oregon is a healthier place for all.