Nashville,TN–The American Cancer Society’s Cancer Action Network released its annual report measuring state legislative activity focused on fighting cancer Aug. 1, with Tennessee receiving a failing grade of red.

How Do You Measure Up? A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality is a state-by-state examination of legislative actions that aim to prevent and reduce incidences of cancer and expand care, focusing on eight specific policy benchmarks used to assign a grade of green, yellow or red. Tennessee’s legislature has met only one of those bench-

Emily Ogden, Tennessee Government Relations Director for ACS CAN. Photo provided by ACS CAN.

marks, the organization said, causing it to fail. To get a grade of green, states must meet six or more of the eight policy benchmarks.

Tennessee has met the benchmark concerning access to palliative care, said Emily Ogden, Tennessee Government Relations Director for ACS CAN. Palliative care can begin at diagnosis of a disease and continue during treatment, she said, noting it “improves patient outcomes, reduces hospital readmittance and increases patient and family satisfaction, and it also saves money.” A balanced pain policy addressing access to painkillers is another benchmark making some progress here, said Ogden, but it’ll take time to navigate the balance between increasing access for patients while curbing the abuse.

Expanding care through MedicAid, enacting smoke-free laws, raising taxes on tobacco products  and appropriating funding for tobacco use prevention and cessation programs are other legislative benchmarks ACS CAN hopes progress. Ogden said Tennessee is tied for last in spending on those programs, allotting $2 million in the budget last year. 

Taking action might be expensive in the present, she said, but will save taxpayer dollars in the long-term, as well as lives– over 37,000 Tennesseans will be diagnosed with cancer this year with 32 percent of cancer deaths attributed to smoking.

Cigarette smoking is the leading cause of preventable death in the United States, the Centers for Disease Control said, and it causes harm to nearly every organ of the body. Smokers are at higher risk for cancer, heart disease, vascular disease, stroke and diabetes, among other issues. The CDC states that although African Americans usually smoke fewer cigarettes and start smoking cigarettes at an older age, they are more likely to die from smoking-related diseases than Whites, Ogden said.

The CDC noted the tobacco industry’s past advertisements in black publications, its donations to HBCUs and its use of “culturally-tailored” messaging in ads for menthol cigarettes to pull in potential black smokers. Nine out of ten black smokers aged 12 and up reported a preference of menthol cigarettes, and “menthol products are given more shelf space in retail outlets within African American and other minority neighborhoods,” the agency said, noting that tobacco retailers are often disproportionately concentrated in minority, low-income areas.

SB1200, the state Senate bill that aims to increase the age at which tobacco products can be purchased from 18 to 21, is a major focus for ACS CAN as it addresses youth tobacco use in the form of a preventative measure that could derail tobacco addiction significantly–most smokers try tobacco during adolescence, with about 90 percent first using tobacco by the age of 18 and 98 percent trying it by age 26, the CDC reported.

While cigarette smoking among young people has reportedly decreased, tobacco in the form of e-cigarettes and vape pens have driven a 36 percent increase in adolescent use over last year, the ACS said. The CDC notes that youth may be drawn to the availability of a wide range of flavors in these products, which circumvents earlier legislation that banned the sale of flavored cigarettes with the exception of menthol.

A failing grade on these measures doesn’t necessarily mean statehouses aren’t taking them seriously–it also points to systemic issues such as state preemption laws that keep legislative power at the state level as well as powerful lobbying by the tobacco industry, Ogden said. To counter, ACS CAN is gearing up for the legislative session in Jan. by getting volunteers plugged in with lawmakers now and continuing public education efforts. She also encourages constituents to engage with their representatives on their concerns before the new session begins next year.

To view the report, visit