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Put health first, raise tobacco tax
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“So what’s new?” the reporter asked. “Haven’t we heard this all before?” His inquiry was striking in its simplicity, yet it was a harsh wake-up call to reality.
His question came at the end of a recent news conference at the state Capitol where physicians, public-health professionals and advocates from a spectrum of consumer-health groups had just finished describing the compelling human and financial burden of tobacco-associated disease on our country and Georgia. That journalist, in spite of the plethora of facts and the credentials and credibility of the presenters, remained unmoved.
His skepticism is, unfortunately, very prescient because in spite of the fact that more than 70 percent of Georgia’s residents and a large portion of the Legislature now support a $1-increase on the per-pack tax on cigarettes, the legislative and state leadership apparently remain unmoved — more bound by political pledges of “no new taxes” than their duty of office, which requires them to act in the best health interests of Georgia’s citizens.
Tobacco is the leading cause of preventable illness and death in the United States — more than obesity, poor diet and lack of physical activity. Cigarette smoking is responsible for one out of every five deaths. More than 440,000 people die each year from diseases due to smoking, including more than 10,000 Georgians. That’s more than 1,200 people each day nationally and more than one person each hour in Georgia.
Yet almost one in five people still smoke, including one in five high school students, most of whom will continue smoking into adulthood. Seventy percent of adult smokers began before the age of 18.
Physicians see patients and their families paying the price for tobacco-related illnesses every day. In our offices and hospitals all over the state, it shows up as preventable cancers, heart disease, stroke and chronic lung disease. For the children of smokers, it presents as low-birthweight babies, increased asthma, respiratory infections and ear infections. Most of us have lost a friend or family member to premature death that was a result of cigarettes.
We all pay for it, not only emotionally and in lost lives, but in the shared health-care costs. Nonsmokers subsidize the health-care costs of smokers. We spend more than $2 billion a year in Georgia for tobacco-related illness.
That includes more than $537 million in Medicaid alone. That doesn’t include the indirect costs due to missed work and reduced productivity estimated at over $3 billion per year, according to researchers. Every taxpayer pays for the costs of tobacco-associated illness.
The real tragedy is that there are proven policies that not only reduce smoking in adults, but reduce the number of young people who start smoking. And that’s important because one-half of all smokers — especially those who start as teens — are likely to die from tobacco use. In his 2000 report, U.S. Surgeon General David Satcher said, “Our lack of greater progress is more the result of failure to implement proven strategies than it is a lack of knowledge about what to do.”
Raising the price of cigarettes reduces cigarette use: It motivates adults to quit and discourages   children from starting. This is not a matter of opinion or an issue that is subject to debate, much to the disappointment of tobacco companies. Raising the price through increased taxes saves lives and saves money. It is the most powerful investment we can make in our state’s health and in our children’s health.
Raising our tobacco tax by $1 costs nothing, and the return on investment is more than $350 million a year, not counting the savings in reduced health-care costs and improved health for the people of our state.
I have heard the complaints of those opposed to raising the tobacco tax. They are concerned about Georgia smokers going to other states to buy cigarettes or buying them on the Internet. While an interesting concern, evidence from states where tobacco taxes have been increased have disproved the myths regarding cross-border sales or effects on convenience stores.
Tobacco has no redeeming qualities. It is a killer. It is the No.1 cause of preventable death in Georgia. At a time when we are scrambling to find the dollars to fund critical needs and services, our state leaders need to put forth a policy that puts the health of our state first. It is time to increase the per-pack tax by $1.

Heiman is the director of health policy for the Satcher Health Leadership Institute at the Morehouse School of Medicine. This editorial is courtesy of Georgia Health News, an independent, nonprofit news service.

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