State launching tobacco study

Josh Gowan, 26, bar manager at Port Cape, took a drag from his cigarette Friday. The Department of Health and Senior Services is going to conduct a statewide study of tobacco use. (DON FRAZIER ~ dfrazier@semissourian.com) [Click to enlarge]

The way Josh Gowan sees it, how could he not be a smoker?

"I'm a bartender, it's what we do," Gowan said recently in between drags off a Marlboro Light from his job behind the bar at Port Cape Girardeau.

For the 26-year-old Gowan, it began at the age 16 in his hometown of Portageville, Mo., where smoking was as common for teenagers as homework and after-school video games.

"We lived in the country," Gowan said. "There was not a whole lot to do out there. I didn't take to dip, so I took to cigarettes."

But, at 26, it's a decision he's lived to regret, especially with the birth of his 2-year-old son, Jameson. His wife, Staci, is in the medical field and comes home talking of X-ray images showing formerly vibrant, pink lungs now charred black by smoke.

Disconcerting words now pop into his head occasionally: Emphysema. Heart attacks. Cancer.

"It's horrible," he said before snuffing out his smoke. "Wouldn't it have been nice if there had never been cigarettes in the first place and we wouldn't have this dependency?"

It's too late for that, but a new statewide tobacco study in the works intends to take a closer look at tobacco use and the prevalence of associated chronic diseases among Missouri residents. The Missouri Foundation for Health has awarded a $1.4 million grant to the state Department of Health and Senior Services to conduct a county-level study of the issue.

'Historic contribution'

Plans call for the one-year study to begin in February and to interview about 49,000 Missourians over the telephone, which will make it the largest adult health survey ever conducted in the state, according to the foundation.

The state health department will partner with the University of Missouri-Columbia's Health and Behavioral Risk Research Center.

"Our goal is to provide a historic contribution to the state's public health data system," said Dr. James Kimmey, the foundation's president and CEO.

When the study is complete, health-care institutions will have access to accurate, local-level data to support and enhance programming activities, he said. The foundation -- established in 2000 through the for-profit conversion of Blue Cross Blue Shield of Missouri -- is funding the study as part of its nine-year, $40 million Tobacco Prevention and Cessation Initiative, which is intended to reduce Missouri's use of tobacco products.

The survey will be large enough to allow researchers to generate county-specific demographics -- for example, categorizing county smoking rates by race, income and education level, said Janet Wilson, the project coordinator in the state health department.

The department is seeking to supplement the health foundation grant with money from the federal Centers for Disease Control and Prevention so that it can also ask questions about fruit and vegetable consumption and various preventive health practices. The total cost, including staff time, should be about $2.3 million, Wilson said.

Charlotte Craig, director of the Cape Girardeau County Public Health Center, said she has not been contacted about local participation yet, but she imagines the center will likely become involved at some point.

"But obviously it's a problem," said Craig, a former smoker. "I can't begin to tell you how many people might smoke, but any is too much."

The foundation said the grant was in the works before Missouri voters rejected a proposed tobacco tax increase last month. Revenue from that tax increase would have gone to health-care efforts and anti-tobacco initiatives.

Kimmey called the defeat of that proposal "a major setback" to tobacco control efforts.

Reports on file with the state department of health show that smoking is indeed a problem in Missouri, a fact unlikely to surprise many. During 2000-2004, almost 10,000 Missourians died annually from tobacco-related diseases, primarily cancer, cardiovascular and respiratory diseases. This number includes 29 infants who died due to the fact that their mothers smoked while pregnant. Second-hand smoke causes an average of 1,150 deaths in Missouri each year, the department said.

Tobacco use is costly in other ways, too. Missouri spends $2.13 billion -- including $488 million by Medicaid -- annually to treat smoking-related illnesses and $10.1 million for care of newborns due to smoking during pregnancy.

Those behind the study hope that the study's findings may be able to do something to curb those figures.

Gowan, the bartender, still hasn't made serious attempts at quitting. While he thinks about the health risks, they are still not enough to deter him. Yet.

"I'm too busy in life to stop and think about it," he said.

smoyers@semissourian.com

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