By Melissa Patrick
Kentucky Health News
More than 100 people representing at least 84 groups gathered at the state Capitol Annex Oct. 18 to launch the Coalition for a Smoke-Free Tomorrow, with its leader boldly stating they hope to add $1 to Kentucky’s 60-cent-per-pack cigarette tax in the 2018 legislative session.
“We hope that we can make some progress on this cigarette tax in this session that is coming up,” Ben Chandler, chair of the coalition and president and CEO of the Foundation for a Healthy Kentucky, said. Noting that the big news of the day was a plan for the state’s expensive pension crisis, he said, “We have one of the answers,” revenue from the tax.
Coalition for a Smokefree Tomorrow (Photos by Melissa Patrick)
The foundation recently adopted smoke-free advocacy as its leading cause and is coordinating the coalition — to the extent of lending it a modified version of its logo, which advocates held up during the launch.
Ellen Hahn, director of the University of Kentucky’s Kentucky Center for Smoke-free Policy and a long-time advocate for a statewide ban on smoking in enclosed public places, said after the meeting that the Foundation is a “bully pulpit” that will speak for all of the advocates, and the coalition represents the federal Centers for Disease Control and Prevention’s best practices for tobacco control — increased taxes to discourage smoking, smoke-free policies, and helping people who want to quit.
“It’s nice to have a fresh voice,” she said. “I’ve said for years we need a bully pulpit. We need somebody who will speak up and say we need to do this.”
At 24.5 percent, Kentucky has the second highest smoking rate in the nation, barely behind West Virginia’s 24.8 percent. The national average is 15.1 percent. Almost 17 percent of Kentucky’s high-school students are smokers, more than double the national average of 8 percent. Nearly 9,000 Kentuckians die from cancer or another smoking-related illness each year, and the state spends about $2 billion annually on smoking-related health care.
Ben Chandler
“Welcome to the cancer capital of the nation,” Chandler said, noting that cancer hasn’t declined as much in Kentucky as it has nationally, and cancer rates are increasing in parts of the state. He said the high smoking rate is partly to blame.
The coalition has set three goals: the $1 increase in the cigarette tax, with parallel increases in taxes on other tobacco products; helping counties and cities enact comprehensive smoking bans; and educating the public and health-care providers about a new law that requires health insurers to provide barrier-free coverage for all federally approved tobacco-cessation medications and programs.
“These are proven laws and policy changes that will reduce our smoking rates, that will reduce our health care costs, that will in fact improve our health,” Chandler said. “What’s more, these policy changes don’t cost an arm and a leg. In fact, they can dramatically improve Kentucky’s troubling budget situation.”
Chandler said Republican Sen. Stephen Meredith, a retired CEO of Twin Lakes Regional Medical Center in Leitchfield, has told him he plans to pre-file a bill to raise the cigarette tax by $1.
The current 60-cent tax is about a third of the national average of $1.71 per pack. The coalition projects that a hike to $1.60 a pack would bring in $266 million the first year.
Republican Sen. Ralph Alvarado, a Winchester physician who has sponsored several unsuccessful smoke-free bills, including one last session to make schools and school activities smoke-free, says he thinks the timing could be ripe to pass a cigarette tax because the pension system needs more money and Gov. Matt Bevin wants to reform the state’s tax system.
Sen. Alvarado
“The governor has charged that everything will be on the table when it comes to this tax proposal, so consequently now is the time to start looking at proposals that by themselves maybe would not pass, but as part of a larger reform has a chance to become law,” Alvarado said.
Chandler said anything less than a $1 increase wouldn’t work because it could be absorbed by the tobacco companies through things like temporary price cuts or other promotional discounting. He also noted that it has to be high enough to make people want to quit. “Otherwise it’s just a tax increase with no health benefits, and what we care about are the health benefits,”he said.
Skeptics of a cigarette-tax increase say its revenue would decline as more people stop smoking, but Chandler said “We don’t think it’ll decline a whole lot,” based on other states’ experience. “Of course, the more it declines, the better. Any decline that does take place in the revenue the state receives is more than made up in savings on health-care cost. Anyway you look at it, it is a win for the state budget.”
David Adkisson, president and CEO of the Kentucky Chamber of Commerce, said 90 percent of the chamber’s members support a statewide smoking ban and legislation that would increase the cigarette tax. He added that the the costs of smoking to employers, in extra health care costs and reduced productivity, is almost $6,000 per smoking employee each year.
Jacob Steward
Jacob Steward of Bourbon County High School won applause.
“Our smoking situation in Kentucky is not only killing us, it’s bankrupting us,” he said.
Jacob Steward, a sophomore at Bourbon County High School and a member of a group called Students Making a Community Change, said he thought the additional tax would “significantly help” teenagers quit smoking because they would no longer be able to afford them, but he also suggested that it’s also important to figure out why they ever started smoking in the first place.
“I think that one thing that should come out of this is maybe better outreach for those students. For people to actually empathize with them and understand why they started smoking to begin with,” he said to a room full of applause.
Dr. Patrick Withrow, a cardiologist and director of public outreach for Baptist Health Paducah, held up a huge model of a cigarette and called it one of the most effective drug-delivery devices.
“Raising the price of cigarettes is the single most effective thing we can do to decrease smoking in Kentucky. If we decrease smoking in Kentucky, we decrease smoking disease, we decrease smoking death, and we improve quality of life,” he said.
Chandler said the coalition will work systematically to help communities across the state become smoke free, with the long-term goal of passing a statewide smoke-free law. “Ultimately the goal is to get a critical mass of communities,” he said. “We have 33 percent of the population covered right now; we’d like to raise that considerably and at that point maybe the state legislature might be ready to pass a statewide law.”
The state House passed a smoking ban in 2014, but the bill died in the Senate, and Bevin, who took office in 2015, says smoking bans should be a local issue.
Chandler, who ran for governor as attorney general in 2003 and was 6th District U.S. representative from 2004 through 2012, was asked how hard politically it would be to pass the $1-a-pack tax increase.
“We are not overly sanguine about it. We do live in Kentucky and I think we all understand that, but things are changing in Kentucky,” he said, noting that there are only 4,500 tobacco farmers in the state, down from almost 60,000 in 1992. “You are seeing a lessening of the economic impact, a lessening of the number of people who benefit from tobacco, and I think all of those things ought to come together to make this a more propitious time to get these things done.”
Alvarado said opponents of the tax acknowledge that its day will come. He noted the state’s budget problems and said,”It will be an accomplishment with the largest health impact for our state, and that’s why we have to keep chasing the prize as a group.”
Chandler concluded, “Folks, we are not going away until we succeed. We are not going away until Kentucky’s smoking rate is no longer the highest in the nation. We are going to keep at it until we win this battle because our work is a win for public health, it’s a win for Kentucky’s budget and it’s a win for Kentucky businesses.”
Because everyone is failing to lower the bloated burden of the high cost of healthcare in America, ACA is failing, talk by politicians about changing it for years has failed to produce results and now the Children’s Health Insurance Program for 9,000,000 kids has expired.
Local and state governments can do their part to lower the cost of healthcare by immediate steep increases in tobacco taxes, raising the smoking age to 21 plus closing smoke shops and vape shops in their jurisdictions. A tobacco-free generation can be created because teenagers in entry level jobs are easily priced out of the tobacco market and by the time their salaries increase later in their careers they are past the age when 90% of nicotine addicts start smoking. Practically every smoker grew up reading, watching and listening to print, radio, TV and other public service announcements warning us not to smoke, but they did it anyway. Now the priority is to protect the health of clean air breathers who heeded the warnings but are now victims of smokers and vapers who assault them on a daily basis with secondhand smoke and e-cigarette environmental emissions, then hike the cost of our healthcare by needing treatment for the totally preventable diseases caused by their nicotine addiction. States and cities must make it illegal to possess and use tobacco smoking materials and e-cigarettes, due to the toxic emissions and fire dangers from both, in ALL multi-unit housing, not just public housing under the jurisdictions of HUD, colleges, universities and schools, plus ban smoking and vaping everywhere in public at all times, including bus stops, transit centers, train stations and airports. Housing and Urban Development Secretary Ben Carson, MD must immediately implement and strictly enforce the ban on smoking in public housing.
There is no constitutional right to smoke because the U.S. Constitution does not give special protection to smokers. The Equal Protection Clause of the U.S. Constitution does not include smokers as a protected class. Smoking is not a specially protected liberty right under the U.S. Constitution Due Process Clause and smoking is not included in the right to privacy. There is no right to smoke at all. Neither the Declaration of Independence nor the U.S. Constitution have the word “tobacco.” Lungs are for breathing clean air, only clean air and nothing but clean air.
Medical scientists at the Lovelace Respiratory Research Institute (LRRI) and the University of New Mexico (UNM) discovered that damage to DNA (deoxyribonucleic acid) caused by smoking, secondhand smoke and thirdhand smoke is passed on in genes to future generations resulting in health problems for their offspring which have never had any exposure to smoke.
“The American Lung Association estimates that smoking costs the American economy over $175 billion (per year) in direct medical care for adults..Since the Congressional Budget Office [CBO] estimates that Obamacare would cost… just under $140 billion/yr… reducing smoking could cover the entire cost of any new health plan – including many times over the costs attributable to pre-existing conditions – without using taxpayers’ money, or imposing higher insurance rates on the great majority of Americans who do not smoke…since neither Obamacare nor any of the major Republican approaches to change it actually reduce health-care costs, but rather simply try to shift the huge existing burden, doing something like reducing smoking may be the only way to reduce health-care costs which are now imposed on policy holders, taxpayers, medical device makers, and others…The best and most effective way to attack the health-care cost crisis is to recognize that so much of it is caused by smoking, and to start imposing… responsibility on the fifteen percent of American adults who continue smoking, expecting nonsmokers to absorb the cost, subsidize their insurance, etc…” (Smokers Continue to Cost All of Us More Than All Of Obamacare, JOHN BANZHAF. Banzhaf is founder of Action on Smoking and Health).