Tobacco use is the linchpin that keeps us shackled to the bottom of those ladders. The question is, are we going to continue to let it?
Northeast Indiana has great ambitions to grow to 1 million residents and become a destination region. In that quest, we have to consider what our low health rankings and high smoking rates communicate to businesses looking to relocate. This is not how we — or they — build economic prosperity.
Why take on the extra $3,000 per year it costs to ensure every fifth Hoosier employee and another $3,000 in lost productivity due to smoking-related illness, time lost to smoke breaks, and the loss of concentration, agitation, irritability and fatigue induced by nicotine withdrawal on the job? Do we have enough to offer them to offset an extra $6,000 in annual costs to employ over one-fifth of our workers? Why choose us when they have 41 other states to look at that offer better health, fewer smokers, and lower insurance costs?
Tobacco is the single greatest driver of illness and death and we need to eliminate it — now.
Consumption of toxic tobacco simply costs us way too much — and not just in lost business and high insurance premiums. It costs us in people: 11,100 Hoosiers per year, nearly 600 from Allen County, die from tobacco-induced, premature death. That’s nearly 10 times the number lost to opioid overdoses and far more than we lose to ALL other drugs and alcohol combined. Another 17,715 of our fellow Allen County residents live with diminished quality of life due to one or more tobacco-induced illnesses or chronic conditions.
It also costs us some serious cash: Hoosier taxpayers spend $2.93 billion per year to treat smoking-related illnesses, an average of $982 per household. Absorb that for a moment — wouldn’t you rather we had those resources to invest in pre-kindergarten education, hiring teachers, paying teachers better and providing better working conditions, and fixing our roads and bridges?
These dismal numbers and their costs don’t stem from who we are. They are about choices we make. We can and must end Indiana’s tobacco epidemic. We have only to follow strategies that have been proved to work across the nation and the world:
1. Smokefree air laws that protect all workplaces without exception (employees or bars, casinos and private clubs deserve to benefit from the same protections other workers have);
2. Aggressive tobacco taxes (there is no reason to enable purchase of this product and every reason to ask those buying it to pay a greater burden of the real costs that return to the state from their use);
3. Robust funding of tobacco prevention and cessation programs at levels much closer to expert recommendations than Indiana’s current spending level of $5.9 million annually, or just 77 cents per capita. This is shamefully below the $11.24 per capita recommended by the CDC as needed to turn our smoking rate around.
4. Restrictions on tobacco marketing that aggressively and shrewdly targets youth and other vulnerable populations.
States with a true commitment to ending tobacco use have taken these measures and turned around the health outcomes of their people, with tobacco use rates far lower than ours and health rankings far higher.
In the Indiana General Assembly right now is a bill that addresses two of the above, proven strategies, albeit anemically. House Bill 1001, the biennial state budget bill, passed out of the House with a proposed $1 per pack increase in the cigarette tax and a small increase in tobacco prevention and cessation funding, from $5.9 to $7.5 million (far from the CDC’s recommended $73.5 million).
Currently, fewer than half of Indiana’s 92 counties have prevention and cessation funding because our legislature has not invested at anything close to recommended levels. Even in 2001, when funding was $35 million per year, we were at half the recommended level.
Consider for a moment that Indiana receives almost $600 million per year from tobacco companies that do business in our state, monies that, per the terms of the 1998 Tobacco Master Settlement agreement, should be directed to prevention and cessation efforts. Consider also, that tobacco companies invest $284 million to market their products in Indiana every single year. That is 48 times what we currently spend on tobacco prevention. Is it any surprise we haven’t turned the corner on this thing when we throw less than $10 million at a problem they invest hundreds of millions to create?
The equation is really pretty simple. We can do little and continue to allow Big Tobacco to market aggressively to our citizens and addict our youth, coming behind to mop up the mess their products create with an expensive, $2.9 billion health care mop. Or we can invest far less than $3 billion up front to aggressively dampen their ability to addict one-fifth of our population and hold them in indentured servitude to that addiction, thus drastically cut the funds needed to treat health care problems that we should be avoiding in the first place. That initial investment will also pay off handsomely in making us a far more attractive place to do business.
We know how to do this. Tobacco control programs work. Prevention and cessation, when funded well, work. Public health policy that builds tobacco-free cultural norms works. This isn’t rocket science.
Raising the price of cigarettes is the single most-effective way to reduce smoking, especially among youth. If the increase is sharp enough to offset Big Tobacco from initially minimizing its impact with discounting, special pricing and coupon schemes, it also provides a big motivational boost to tobacco users wanting to quit but not yet committed to the effort.
Tobacco users consistently seek increased help from state tobacco cessation quitlines in the weeks and months following significant cigarette tax increases. In Minnesota, in the year immediately following the state’s 2013 $1.60 per pack cigarette tax increase, revenues increased by more than $204 million, all while pack sales declined by 54.6 million packs, and adult and youth smoking rates showed sharp reductions.
To that end, Tobacco Free Allen County asks that our state senators reconsider the health and economic benefits to the state of increasing the cigarette tax by at least $1.50 per pack and increasing prevention and cessation funding to at least $35 per year, to match 2001 levels. The difference between a $1 and $1.50 per pack increase in the cigarette tax is the difference of 16,000 more or fewer Hoosier kids becoming smokers. It is the difference between 4,500 more or fewer moms and babies with pregnancies impacted by smoking over the next five years.
This is not too much to ask. It is the minimum of what is needed to save thousands of teens from starting to use tobacco, encourage thousands of tobacco users to seek the help they need to quit, and to fund all 92 counties to provide a the kind of programming needed to drive us forward towards a healthy, tobacco-free Indiana, where businesses will have every reason to want to invest here.
Nancy Cripe is executive director of Tobacco Free Allen County.