Cigarette Taxes, Public Health Show Little Correlation

People who smoke are an easy mark for state policy makers desperately searching for government revenues to see them through these economic hard times. New York and Connecticut Govs George Pataki and John Rowland recently signed cigarette tax increases and 21 other states are considering similar measures.

Anti-smoking advocates are thrilled. “Raising taxes saves lives,” says Dr. Thomas Houston, director of the American Medical Association’s Smokeless States National Tobacco Policy Initiative.

But there’s more to improving health status than just increasing the cigarette tax. Virginia, which has the nation’s lowest tax at 5 cents per pack, scored higher on a 2001 state health survey than New York, which boasts a much higher cigarette tax (.11 now, $1.50 when the increase becomes effective April 1). Conducted by the nonprofit Minnesota-based United Health Foundation, the state assessment measured things like smoking prevalence, premature death and infant mortality.

Despite the disparity in taxes, cigarette smoking rates in 2000 in New York and Virginia are nearly identical: 21.6 and 21.4, respectively. And the number of cancer deaths in each state is also similar, with Virginia showing 126 per 100,000 people and New York tallying 119 in 1998, the most recent year for which figures are available.

A rise in cigarette prices does cause a small drop in demand which means fewer people are smoking the cancer-causing product, researchers say. What’s really important, though, is for states to take the tax money and pump it into what’s known as a comprehensive tobacco prevention program, says Bill Corr, executive vice president of the Campaign for Tobacco Free Kids , a group that’s lobbying for states to increase cigarette taxes.

According to the U.S. Centers for Disease Control and Prevention (CDC), comprehensive prevention programs discourage young people from starting to smoke, help kids and adults quit smoking and create cleaner indoor air for nonsmokers. The programs also target tobacco use and its effects among different population groups.

Arizona, California, Maine and Massachusetts have done that, and all have had great successes in reducing smoking, saving lives and saving money, Corr says. But most state programs are relatively new, and hard data proving the systems work only exists in California and Massachusetts, which have had comprehensive programs in place for awhile.

Greg Connolly, who runs the Massachusetts Tobacco Control Program, says economists estimate $3 of savings in health care costs for every dollar spent in tobacco control in the Commonwealth. “Ten years ago, one out of every four pregnant women in Massachusetts smoked. Now that figure is down to one out of every 10,” Connolly says.

What’s more, Massachusetts saves more than $15 million every year because fewer low birth-weight babies are being born, thanks to the tobacco prevention programs. “We are saving this money today that we’ll realize in (more) cost savings to other Medicaid and health programs,” says Connolly.

But Massachusetts’ improved health factors and cost savings are now in jeopardy. Two months ago, Acting Gov. Jane Swift unveiled a budget with $22 million cuts from smoking cessation programs.

Connolly says the cuts will make his job more difficult. “Right now we’re suffering, but hopefully we’ll see (the cuts) reversed,” he says.