Experts Say W.Va. Must Spend More On Tobacco Prevention

West Virginia invests less than one percent of its earnings from tobacco settlement money in prevention and cessation programs. A new report on lung cancer shows the disease is the leading cause of cancer-related deaths in West Virginia. Advocates say lawmakers must make funding tobacco prevention a priority for the state’s health outcomes to improve.

The American Lung Association (ALA) released its seventh annual “State of Lung Cancer” report in November for Lung Cancer Awareness Month.

The 2024 report found West Virginia ranks 49th among all states in rates of new lung cancer cases, placing the state in the bottom tier of the report.

Even that failing grade is an improvement for the state. Over the last five years, the rate of new cases of lung cancer in West Virginia improved by 12 percent, down from 88 percent in 2019.

Also in the last five years, West Virginia has seen a 34 percent improvement in lung cancer survival rates.

However, the report also found West Virginia ranks worst in the nation for adult smoking with 21 percent of all adults currently smoking.

West Virginia receives more than $232.6 million in tobacco revenue annually from tobacco settlement payments and taxes combined but invests less than one percent of that total, about $450,000, in tobacco prevention and cessation programs.

The Centers for Disease Control and Prevention recommends that West Virginia spend $24.7 million annually to combat the health and economic consequences of tobacco use.

The report highlights how the toll of lung cancer varies by state and examines key indicators like new cases, survival, early diagnosis, surgical treatment, lack of treatment, screening rates and insurance coverage of comprehensive biomarker testing.

Elizabeth Hensil is the ALA’s advocacy director for Pennsylvania and West Virginia, two states with very different health outcomes.

“One of the big things, big differences between Pennsylvania and West Virginia is the amount of money that the state invests in tobacco prevention and control,” Hensil said. “West Virginia spends some of the least amount of money in the country.”

Hensil said that small prevention investment is reflected in the high number of smokers in the state.

In West Virginia, 76.5 of 100,000 people were diagnosed with lung cancer in the last year.

“There have been really great programs in the past in West Virginia on a regional basis, with people doing education, and, you know, boots on the ground, and that money was taken away about five years ago, I think, and that lack of education in a rural state is detrimental to the health of the citizens,” Hensil said.

Hensil emphasizes the importance of education and prevention before cessation to reduce smoking rates.

Dr. Robert Herron is a general thoracic surgeon at West Virginia University’s Wheeling Hospital. He agrees that education is vital to solving West Virginia’s tobacco problem and slowing rates of lung cancer.

“I think if you have to put it in one word, it’d be education,” Herron said. “So yeah, smoking is bad for you, at least the lung cancer, and not only that, but peripheral vascular disease and other types of primary cancers, namely, pancreatic, esophageal.”

Herron says improvements to West Virginia’s screening rates could quell the rise of lung cancer.

“Between stages one and two, I mean, you’re talking about a 25 to 30 percent discrepancy in prognosis,” Herron said. “For example, stage one lung cancers, you can tell a patient you have about an 80, 85 percent chance of five year survival, versus a stage two, where you’re dropping into the 30 and 40 percent range. So finding it early is, is the main thing, I think, if we’re going to, if we’re going to put a put a dent in improving this thing.”

Only 13.5 percent of high-risk individuals in West Virginia are currently getting screened, which is much lower than the national average of 16 percent.

“We should be at the same rates as people getting mammograms and colonoscopies and things like that,” Hensil said. “So it’s just really important that people that are at high risk tell their doctors, I want to be screened and then they can have that done.”

Hensil says lung cancer cases in West Virginia are stable but remain high. She suggests that West Virginia should pass legislation to require insurance companies to cover biomarker testing for cancer patients.

“It would really help the outcomes of people with cancer in West Virginia,” Hensil said. “So that’s one thing Pennsylvania did, actually just passed that in our last legislative session, and another thing that’s just really so important. And this goes back to, you know, the education is lung cancer screenings.”

Lung cancer screenings involve a low-dose CT scan to detect early signs of the disease. Hensil says health insurance covers lung cancer screening for high-risk individuals 50 years and older.

The Centers for Disease Control and Prevention, or CDC, defines a high-risk individual as someone with a medical condition or risk factor that increases their chance of severe illness or complications.

Hensil encourages people at high risk to discuss screening with their doctors and emphasizes the need for increased awareness and funding.

“If we can’t increase the funding for education, if we can’t get the biomarker testing covered by insurance in West Virginia, if nothing else already out there is lung cancer screening,” Hensil said.

The West Virginia Division of Tobacco Prevention operates a Tobacco Quit Line, where callers can get information, advice, support and referrals for resources.

The West Virginia Tobacco Quitline is 1-877-966-8784.