Rick Gaston was about to leave for work when it hit him.
“I got dizzy,” he said. “I started throwing up. I just thought I had a bug but it didn’t go away. Something said, ‘Go to the hospital.’”
Doctors at the Gulf Coast Veterans Health Care System in Biloxi told them they had found a mass in the right upper lobe, one of the three lobes in his right lung.
“When they said mass, I think I automatically knew what it was,” he said. “It was that simple.”
That was March of this year. Since then, the 61-year-old casino dealer has undergone 33 doses of radiation and will soon undergo his sixth round of chemotherapy at Memorial Hospital at Gulfport. But he has had some good news, the mass is shrinking.
“It just changes your life,” he said. “I doing good but I’m sitting down. If I start walking around, I have very little energy and a shortness of breath.”
Still, Gaston feels he’s fortunate after seeing all the people — from ages 20 to 80 — who show up in the infusion lab at Memorial for chemo.
“I’m so blessed I don’t have the problems they have,” he said. “I cannot wrap my head around the fact that so many people have so many kinds of cancer.”
He has an active support group encouraging him on social media and raising money to help him pay his medical expenses. He said the VA and Memorial have been fantastic.
But he hasn’t been able to work and casino dealers rely on tips as much as their hourly wage. Cancer, he said, has given new perspective on life. He’s getting by on disability benefits now.
“I was going to wait until I was 66 to get my Social Security, but this has changed my whole attitude,” he said. He’ll be taking retirement in November at 62 because “you don’t know what tomorrow will bring.”
“It was the last thing I expected,” said Gaston, who hadn’t smoked in about 10 years. “They can’t tell you how you get it. I asked if it was environmental or something I did. They said they can’t even tell you how long it’s been there.”
Gaston’s is a story the American Cancer Society would rather not be repeated so often. On Thursday, it released its How Do You Measure Up? report on Mississippi’s cancer prevention efforts. The state, in short, doesn’t measure up so well.
Mississippi, in the nonprofit’s eyes, falls shorts on its cigarette tax rate, smoke-free laws, Medicaid coverage of cessation programs, use of indoor tanning devices, early detection of breast and cervical cancer, access to palliative care and access to Medicaid.
Medicaid expansion is pretty much a lost cause, ACS Mississippi Government Relations Director Kimberly Hughes says. And there is much work to do elsewhere.
“I call it job security,” she said.
Even though Mississippi Republicans aren’t the most tax-loving bunch, she has hope they’ll increase the tax on cigarettes and little cigars. First of all, she said, lawmakers seem more apt to raise a user fee, which is how she sees the tax, than any other tax. And, she said, increasing the tax has been shown to reduce the number of smokers, which over the long haul reduces health care costs, saving the state money.
A study group this month is poring over the state’s tax and budget systems looking for savings and inefficiencies.
Everything on the table
“While that specific tax has not been mentioned, every form of taxation is up for review with the goal of finding ways for Mississippians to keep more money in their pockets,” said Laura Hipp, spokeswoman for Lt. Gov. Tate Reeves, one of the leaders of the group.
The tax was last raised in 2009 when it was bumped up by 50 cents a pack. Mississippi taxes cigarettes at .68 cents a pack but the national average is $1.65.
“We definitely could use another increase,” said Hughes. “Tobacco continues to be the No. 1 preventable cause of death. So our biggest opportunity to save lives and reduce health care costs is to address our state’s current tobacco control policy.”
And, she said, even though fewer people would be smoking the tax increase could still bring an increase in state revenue.
“Sometimes desperate times require desperate measures,” she said.
The Surgeon General’s Office said in a 2014 report smoke caused 20 million premature deaths over the past 50 years. It said smoking costs the nation $289 billion in health care costs and lost productivity each year.
In Mississippi, the Department of Health figures secondhand smoke cost Medicaid $15.3 million in the one-year period that ended in June 2013 just on the care of low-birth weight babies caused by exposure to secondhand smoke. During the same period, smoking by parents was partly to blame for the $19.3 million Medicaid spent on childhood respiratory illnesses, asthma and ear infections, MDHS says.
Another $1.4 million was spent on adults suffering from serious diseases attributable to secondhand smoke. In all, MDHS said, secondhand smoke cost the state $36.1 million.
Hughes said one of the biggest success stories was reducing exposure to secondhand smoke. While it hasn’t had much success getting a statewide smoke-free law passed, more and more communities are passing such laws.
It started with the Delta town of Metcalf, which went 100 percent smoke free in 2002. Now there are at least 123 communities with smoke-free laws, said Hughes. Two more have passed laws recently that haven’t been reviewed by the ACS.
“It hasn’t cost them any money,” Hughes said. “They are seeing it’s the way to go.”
She also said smoking bans have a positive economic impact, according to the Social Science Research Center at Mississippi State University.
In Clinton, for example, revenue from tourism and economic development taxes — the taxes on hotels/motels and/or restaurants — increased 27 percent after its law was passed. During the same period, those revenues declined by an average of 4.8 percent in cities without laws.
The bad news, Hughes said, is less than a third of the people are covered by laws that protect them from secondhand smoke. And even if every city had a smoking ban, that would cover only about 55 percent of the people.
“Because we’re such a rural state, it’s going to take a lot of activity for us to protect the majority of Mississippians from second-hand smoke,” said Hughes.
Smoking may be the big killer, but Mississippi is lagging on at least one other front. The Legislature this year once again failed to pass a limit on the use of tanning beds. Hughes said at a minimum the state should restrict the use to those 18 or older.
“We made a great effort to strengthen Mississippi’s tanning bed law,” she said. “We seemed to have a lot of support in the Legislature, just not among the leaders. So many people are getting diagnosed with skin cancer at a younger age and that is attributed to the use of tanning beds.
“I worked with dermatologists to help put that legislation together and they will tell you rays tanning beds are much more dangerous than moderate exposure to the sun.”