Fifty years ago, the United States government required the packaging of a product used by 42 percent of Americans to include a new sentence that would shape public health policy for the following half-century: “Caution: Cigarette Smoking May Be Hazardous to Your Health.”

The Federal Cigarette Labeling and Advertising Act came a year after the surgeon general released a report confirming what is now considered common knowledge regarding smoking and tobacco use and adverse health effects. Based on new statistics, however, the American Lung Association says that the Indiana government hasn’t prioritized reducing tobacco use and the health of Hoosiers through legislation.

In the American Lung Association’s “State of Tobacco Control 2015” report, Indiana received failing grades in four out of five evaluated policies. Indiana received “F” grades for tobacco use prevention and control program funding, tobacco taxes and access to cessation services. On a national level, the federal government also received “F’ grades in U.S. Food and Drug Administration regulation of tobacco products and tobacco taxes.

States that have high taxes on tobacco products, spend more on smoking cessation programs and have strong smoke-free air laws have lower rates of smoking among adults, according to Jon Macy, an assistant professor of applied health science at Indiana University. The adult smoking rate in Indiana is 21.9 percent, according to the U.S. Centers for Disease Control and Prevention’s 2013 Behavioral Risk Factor Surveillance System.

“We sort of know the formula that works, and Indiana’s bad at it, end of story,” Macy said. “It’s not a super complicated formula, but for whatever reason Indiana seems to fall short.”

Indiana’s total funding for state tobacco control programs for fiscal year 2015 is $7,237,274, according to the American Lung Association’s report, while state tobacco-related revenue in the past year totaled $536,900,000. The CDC’s “best practices” state spending recommendation is $73,500,000.

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