When it comes to suffering the costs of a tobacco habit, a cancer patient might know best.
“I can barely pay for my smokes,” a man with kidney cancer once told me after I explained to him how often he’d have to come in for chemotherapy (twice a month). He lived in a motel, almost one hundred miles away from our clinic. There was no way he could afford the drive, even though public insurance was picking up his treatment bill.
Given the financial burdens many smokers face, some argue that upping the tobacco tax isn’t fair. Oregon recently defeated an 84¢ per pack tax increase; the funds from this proposal would have been used to pay for children’s health insurance. Similarly, President Bush vetoed the hotly debated State Children’s Health Insurance Program (SCHIP), primarily because it was to be funded by a 61¢ increase on the federal tobacco tax.
Increasing any type of tax may cause a knee-jerk reaction for most, but after reading online comments for and against the tobacco tax, I realized this one is seriously misunderstood. Increasing the price of tobacco products does much more than just raise funds for the short term. The most important outcome is the long-term effect: raising the price of tobacco products significantly decreases the number of adolescents and young adults that start smoking.
In fact, increasing the price of cigarettes is the best way to prevent a completely new generation of smokers from entering the marketplace. In their book Tobacco Control in Developing Countries, the health economists Jha and Chaloupka state that “tax increases are the single most effective policy measure for reducing children’s consumption of tobacco products.”
This is the fundamental reason why the tobacco industry spent twelve million dollars in Oregon to defeat the tobacco tax and is lobbying to prevent the passage of the SCHIP bill. The industry needs young people. As old customers die off or quit, new consumers need to be recruited, or profits decrease. Targeting teenagers and young adults has been the backbone of this strategy, since most people start their lifelong addiction around the same time they are able to vote.
Sure, increasing the price of cigarettes does tax smokers, the majority of whom are low and middle income. However, evidence shows that increasing the price of tobacco products reduces consumption more among the poor and less educated than among the rich and more educated. Because the poor spend a greater percentage of their income on tobacco products than do rich, decreasing consumption in this population has a double benefit—they have more money to spend on other necessary items, and are less likely to suffer illnesses which they cannot afford to treat. Furthermore, if tobacco taxes are used for health and social programs—as was to be the case in both Oregon and SCHIP—low-income families benefit.
Even if taxation reduces consumption and prevents some young people from puffing, most smokers don’t want a price increase. But most non-smokers should. Regardless of whether you prefer universal health care or a free market approach, we all end up paying for tobacco’s ill effects. According to the Center for Disease Control, cigarette smoking was estimated to be responsible for $167 billion in annual health-related economic losses in the United States over a four-year period. Loss of productivity and increased health care expenditures means increased costs for all of us. Chronic illnesses among the poor and uninsured result in overburdened and underfunded public health care programs. Cessation is difficult; treatment is expensive, leaving prevention as the most logical way to contain costs.
Increasing price provides the biggest short- and long-term benefits, but the tax-averse feel that tobacco taxation is a slippery slope. If we tax tobacco, why don’t we tax obese people or increase the tax on alcohol? But tobacco is a product with unique characteristics. While obesity has a multitude of contributing factors, many diseases (lung cancer, kidney cancer, and emphysema, just to name a few) can be directly attributed to tobacco. Unlike alcohol, which can be relatively safe when used in moderation, there is no safe level of tobacco or secondhand smoke exposure. And it packs the biggest punch. According to the Institute of Medicine, smoking-related deaths account for more deaths than AIDS, alcohol, cocaine, heroin, homicide, suicide, motor vehicle crashes, and fires combined. If we really want to get serious about saving lives, making an addictive and harmful product cheap and accessible is not the way to do it.
