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Cancer Society study has mixed grades for NH's policy efforts

New Hampshire Union Leader

August 07. 2017 11:28PM

CONCORD — When it comes to having policies in place to prevent and reduce suffering and death from cancer, New Hampshire gets both high-flying and flunking grades in a new national survey.

The American Cancer Society Cancer Action Network last week released the 15th edition of its “How Do You Measure Up? A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality.”

“This year, New Hampshire is hovering around the middle of the pack, and ranks as measuring up in four of the nine areas analyzed — which of course, means there are five areas that the state has opportunities to improve and catch up with many of its New England neighbors when it comes to cancer fighting public policy,” said Amber Herting, associate director of media advocacy for the Cancer Cation Network in Framingham, Mass.

“The report lays out what lawmakers can do to help increase New Hampshire’s ranking and make the Granite State a better place for cancer patients and survivors.”

The report scores states in nine specific areas of public policy that can help fight cancer, including smoking laws, cigarette tax levels, funding for tobacco prevention and cessation programs and coverage under Medicaid, funding for cancer screening programs, and restrictions on indoor tanning devices for minors.

It also looks at whether a state has passed policies proven to increase patient quality of life and offers a well-balanced approach to pain medications.

To read the full report, go to

Michael Rollo is director of government relations for the Cancer Society chapter, and as a former Democratic legislator he’s seen the strides New Hampshire has made over the years in some areas.

The state gets a top score for its Medicaid expansion that allowed more than 50,000 low-income adults to not only get insurance coverage — many for the first time — but to have a plan with preventative care and substance-abuse benefits that can help ward off or cope with cancer.

“The obvious challenge here is to keep it going,” Rollo said. “The program is only authorized through 2018 and the Legislature needs to make that permanent.” 

On the flip side is money states set aside for tobacco prevention control spending. 

The New Hampshire state budget relies on getting about $200 million in tobacco taxes a year and $40 million in money from the master settlement with the tobacco industry. But the last state budget set aside only $125,000 a year — less than 1 percent of the total — for tobacco control programs.

The Centers for Disease Control guideline is for New Hampshire to earmark $16.5 million a year for this purpose.

Only three states, including Connecticut, and the U.S. territory of Guam set aside less of what they raise from tobacco taxes for control programs.

When that master settlement with major tobacco companies was reached two decades ago, then-State Sen. Jim Squires, a Hollis Republican, put into the budget the requirement at least $2 million must be spent on prevention programs.

A few years after that budget, however, the Legislature ignored the mandate going forward and grabbed all the master-settlement cash to balance future state budgets.

But as low as the current spending is, for many years New Hampshire was spending no money to curb tobacco use.

Rollo credits new Gov. Chris Sununu with convincing the Legislature to bump up the most recent spending to $165,000 a year for 2018 and 2019. 

The extra money above the previous $125,000 benchmark will be spent to enhance the state’s quit smoking line and also to more broadly promote caution in messages to youths about the use of e-cigarettes.

“It was an increase and not everyone can say that,” Rollo said.

For decades, New Hampshire’s tobacco taxes were by far the lowest in the Northeast and this did help boost sales of cigarettes to out-of-state tourists and shoppers.

In the late 1990s, lawmakers steadily began raising the tax while still keeping a cushion between higher taxes in neighboring states.

Recently the tax here went above the national tax rate which is one of the four policy areas in which the state is measuring up according to the report.

“Many states increase their taxes by $1 a pack when they do it but that’s not the New Hampshire way,” Rollo said. “The increase here has been steady and incremental.”

The other areas were New Hampshire shines are the state’s access to palliative care and also the recently-adopted law that bans the use of tanning beds by minors.

New Hampshire comes out in the middle of the pack with a law that outlaws smoking in bars and restaurants but does not contain a blanket prohibition against smoking in all workplaces.

The rate of spending to battle breast and cervical cancer is woefully under the CDC level but New Hampshire does have a widely-used screening program and does have among the highest rates in the country for screening for both cancers by women here.

“It is our worst score but state officials say they believe the amount is adequate and they continue to monitor it,” Rollo said.

The state could also with its Medicaid program cover more tobacco cessation programs such as the nicotine patch and hypnotherapy.

“When folks have more opportunities for cessation, their odds are much better for successfully quitting,” said Rollo, a former cigarette smoker.

While the American Cancer Society report says more needs to be done, Rollo stressed the state is moving in the right direction.

“Overall I am proud of our state. Can we do better? We always can but we have really made strides,” Rollo summed up.

“We do the best we can with the limited resources in our state.”

General News Manchester

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