Michelle Brown remembers the sound that day of a bell ringing.
It was a cancer patient, ringing a bell at a Tulsa hospital, signifying that she was finished with treatment.
Brown has experienced a lot of moments like this.
The Henryetta resident is an advocate with the American Cancer Society's Cancer Action Network, an organization that released a report Thursday that alleges Oklahoma is lagging behind in legislative work to combat cancer.
Brown doesn't charge Oklahoma with being the worst state — she has seen improvements — but the state still has what she believes are its pitfalls.
“I have seen great improvement in the research that is continuing to grow and develop, but things change, and our health landscape changes, too, so there needs to be continued funding for research,” she said.
The American Cancer Society network's report ranks states on their legislative activity to reduce cancer rates and deaths.
The report uses green, yellow and red to signify how states are doing in each category, with green being the best and red being the worst. Oklahoma did not have any green categories listed.
For example, Oklahoma ranks in the middle range of states for its cigarette excise tax rate, which is $1.03. States with higher rankings include several in the New England region, which have rates ranging from $1.60 in Delaware to $4.35 in New York.
Meanwhile, most states, including Oklahoma, are ranked low for either not increasing the tax over the past six years, or increasing it less than 50 cents.
State tobacco prevention spending is another area where Oklahoma isn't among the bottom states. Oklahoma spends $19.7 million, according to the report. The study uses the Centers for Disease Control and Prevention recommendations for state tobacco prevention spending to rank states. For example, the CDC recommends Oklahoma spend $45 million.
Oklahoma joins several other states in the South, including Mississippi, West Virginia and Louisiana, that don't have “100 percent smoke-free” state laws. These are the same states that often rank worst in the nation in rates of obesity, diabetes and heart disease.
State health officials have advocated for at least five years that the Oklahoma Legislature pass a bill that would allow cities to pass their own smoking ordinances. Current Oklahoma law does not allow cities to pass smoking laws stricter than state law.
Terry Cline, the state health commissioner, has been an outspoken advocate of the bill.
Cline said the American Cancer Society report is a reminder that the Legislature has the power to affect cancer rates in Oklahoma.
“(The report) validates the intervention that we, from the public health perspective, have been promoting and what science tells us,” he said. “If you do these things, you can be bring these rates down and literally save lives. The Legislature has chosen to ignore the science, and as a result, we have way too many people who are dying, 8,000 people every year who are dying from the No. 1 preventable cause of death.”
In Oklahoma, as the level of education increases, the percentage of smokers decrease:
• Less than high school: 37 percent
• High school: 31 percent
• Some college: 26 percent
• College: 11 percent.
Meanwhile, in 2010, cancer in Oklahoma accounted for almost 12,000 hospital discharges, totaling 79,145 total days in the hospital. That amounts to $638 million, according to the state Health Department.
Cline said Oklahoma has seen some progress, with the state recently ranking No. 39 nationwide in smoking prevalence, the lowest the rate has been in several years.
“We're seeing progress, but I would say, 8,000 deaths a year is still too high, and we still have 23 percent of our population smoking, engaging in the No. 1 preventable cause of death,” he said. “That's what needs to change, and every year we don't address that, we have way too many people dying unnecessarily.”