Showing posts with label Cigarette taxes. Show all posts
Showing posts with label Cigarette taxes. Show all posts

Lance Armstrong has it right: Why tobacco taxes matter

News came out this week that Lance Armstrong will team up with a new partner - the California Cancer Research Act. The Act proposes increasing the state's tobacco tax by $1 and funneling that money toward cancer research. California is facing a budget crisis and may be cutting huge (billions) sums of money from health care funds. California was one of the states at the front edge of reducing tobacco use through community-wide campaigns and tax measures. We don't know how it will play out, but the proposal has the potential to improve health in the state in two different ways. First, tobacco taxes reduce consumption. Second, by putting the revenue gained toward cancer research, the monies go toward prevention and treatment of smoking's leading health outcomes.

Research has shown time and again that increasing taxes reduces consumption of tobacco, particularly among those in younger age groups. In fact, the World Health Organization has called taxation the single most effective method for reducing the demand for tobacco products. After previously increasing taxes and funneling money toward cessation programs, California saw a 16 percent per capita decline in cigarette consumption. In part, this is because youth are highly sensitive to price changes and the higher cost deters many from taking up smoking. Basically, they have trouble coming with the extra cash.

Proponents of the legislation have offered another benefit of the tax - jobs creation. With state universities facing major budget shortfalls, the revenue being directed toward research could create jobs.

Exactly where the money would wind up is always a little unclear, however.  Despite the best of intentions, politicians have ways of directing tobacco money away from intended programs, as we learned when the tobacco companies settled with the states in 1998.  From a health standpoint, though, the money raised from the tax would almost be secondary; the real payoff would be the drop in smoking rates.  And if the lure of extra state revenue gets the new tax on the books, so much the better for everyone. 

State policies drive cancer burden


Recent media reports highlight how a lack of state policy on cigarette taxes can drive a state to have high cancer rates. Missouri is a fine US example which now has the lowest tax on cigarettes in the nation (17 cents per pack).

State level policy impacting cancer is not limited to just cigarettes and increased burden from smoking-related cancers, however. With reductions in resources available to the state, Missouri cut back funding for the Breast and Cervical Cancer Screening Program (in Missouri called Show Me Healthy Women). This added t to the existing language in qualifying for treatment after diagnosis among women without health insurance leads poor rural areas to have low breast cancer incidence (lack of screening) and high mortality. This morality is driven by late stage at diagnosis and limited access to current standard quality of care for breast cancer.  Maps at the county level show rural Missouri dominates the state with high cancer mortality.

If we are to overcome disparities in access to detection and care for cancer patients, then state policies must foster access for all. Access has to be not only for detection methods (breast, cervix, and colon cancer screening) but also to effective programs to aid cessation from smoking.  Programs must also seamlessly link those diagnosed with cancer to effective care.