1. COPD Research and Public Policies Paul Billings Senior Vice President, Advocacy and Education American Lung Association April 9, 2013

2. Agenda Congress –Budgets & Appropriations –Tobacco issues –Healthy air issues Administration Call to action

3. Two Kinds of Advocacy Advocating for a Patient Advocating for all Patients

4. The time is NOW to take action on COPD!

5. Issues Federal funding for COPD research funding Federal COPD action plan Access to heath care Preventing tobacco use Tobacco cessation Healthy air

6. Congress Budget & Appropriations

7. Current Programs 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 FY 2013 – Post sequestration

8. Sequestration

9. Beyond Sequestration Same number of people/programs competing for increasingly smaller budget

10. Actions 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.

11. Congress Tobacco Control

12. Before the Tobacco Control Act No oversight Candy flavors in cigarettes allowed Joe Camel Manipulation of ingredients “Light” and “Low” cigarettes

13. Passage of Tobacco Control Act 2009 Gave FDA immediate authority over cigarettes, smokeless and roll- your-own Gave FDA option to “deem” authority over other products

14. Protect FDA’s authority over all tobacco products

15. The cigar industry wants a “sweetheart” deal Cigar bill in 112 th 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

16. Cigar bill in the 113 th Congress –HR 792 in the House: 41 cosponsors –Senate bill – Nelson Rubio Bill – expected any day –New, highly technical definition of “premium” cigars Tobacco Control Act: the Latest Challenge

17. 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

18. 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

19. State Excise Taxes Average state cigarette excise tax: $1.49/pack Lowest: Missouri, 17 cents Highest: New York, $4.35 Current campaigns: Louisiana, Massachusetts, Minnesota, Ohio and West Virginia

20. Smokefree Air Comprehensive Law, Including Bars and Restaurants Comprehensive Law Passed, Not Yet in Effect Strong Law in Effect Weaker Restrictions

21. Tobacco Cessation State Medicaid coverage –Only 2 states cover a comprehensive benefit –Removing barriers to treatment Affordable Care Implementation Tips from Former Smokers

22. Congress Healthy Air

23. 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)

24. Defending the Clean Air Act Some in Congress want to weaken clean air health protections 112 th Congress voted nearly 100 times to weaken or dismantle the law

25. The Obama Administration

26. Tobacco Regulations FDA deeming authority Menthol report/status

27. Affordable Care Act Implementation –Essential Health Benefits –Exchanges –Medicaid expansion Slow and confusing implementation Not enough focus on protecting patients –Access to medicine Healthcare Access

28. Healthy Air Regulations EPA has a mixed record –Ozone –Power Plants –Particulate Matter –Cars and gasoline

29. Call to Action

30. COPD needs to raise its visibility Be present Be active Be loud Be here

31. Be a Storyteller: Stand with Dan! End-stage COPD Received double lung transplant Testified at EPA hearing on proposed Carbon standard

32. Come together

33. 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 www.lung.org/callinday for more information & to receive talking points www.lung.org/callinday

34. We will breathe easier when the air in every American community is clean and healthy. We will breathe easier when people are free from the addictive grip of cigarettes and the debilitating effects of lung disease. We will breathe easier when the air in our public spaces and workplaces is clear of secondhand smoke. We will breathe easier when children no longer battle airborne poisons or fear an asthma attack. Until then, we are fighting for air.