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COPD Research and Public Policies Paul Billings Senior 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.

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COPD Research and Public PoliciesPaul BillingsSenior Vice President, Advocacy and EducationAmerican Lung AssociationApril 9, 2013



  • Congress

    • Budgets & Appropriations

    • Tobacco issues

    • Healthy air issues

  • Administration

  • Call to action

Two kinds of advocacy

Two Kinds of Advocacy

Advocating for all Patients

Advocating for a Patient

The time is now to take action on copd

The time is NOW to take action on COPD!



Federal funding for COPD research funding

Federal COPD action plan

Access to heath care

Preventing tobacco use

Tobacco cessation

Healthy air



Budget & Appropriations

Current programs

Current Programs

FY 2013 – Post sequestration

  • 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



Beyond sequestration

Beyond Sequestration

Same number of people/programs competing for increasingly smaller budget



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.



Tobacco Control

Before the tobacco control act

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

Passage of Tobacco Control Act


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

Protect FDA’s authority over all tobacco products

The cigar industry wants a sweetheart deal

Tobacco Control Act: the Latest Challenge

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 excise taxes

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

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

State Excise Taxes

Highest: New York, $4.35

Lowest: Missouri, 17 cents

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

Average state cigarette excise tax: $1.49/pack

Smokefree air

Smokefree Air

Tobacco cessation

Tobacco Cessation

  • State Medicaid coverage

    • Only 2 states cover a comprehensive benefit

    • Removing barriers to treatment

  • Affordable Care Implementation

  • Tips from Former Smokers



Healthy Air

Copd the air we breathe

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

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

The Obama Administration

Tobacco regulations

Tobacco Regulations

FDA deeming authority

Menthol report/status


Healthcare Access

  • Affordable Care Act Implementation

    • Essential Health Benefits

    • Exchanges

    • Medicaid expansion

  • Slow and confusing implementation

  • Not enough focus on protecting patients

    • Access to medicine

Healthy air regulations

Healthy Air Regulations

  • EPA has a mixed record

    • Ozone

    • Power Plants

    • Particulate Matter

    • Cars and gasoline

Call to action

Call to Action

Copd needs to raise its visibility

COPD needs to raise its visibility

Be present

Be active

Be loud

Be here

Be a storyteller stand with dan

Be a Storyteller: Stand with Dan!

End-stage COPD

Received double lung transplant

Testified at EPA hearing on proposed Carbon standard

Come together

Come together

National copd call in day

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 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.

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