Tobacco tax: Move for $2 per pack gains momentum in CA

By Dr. Nicholas Leeper | Special to the Mercury News

The changing of the New Year brings about a fresh start. If you are one of the estimated 46.6 million Americans who smoke cigarettes, quitting the habit is likely being considered for a New Year’s resolution. Polls have shown that a vast majority of smokers would like to quit, and we at the American Heart Association are dedicated to giving smokers every edge we can to put their habit in the past. One such proven way to encourage quitting is a tobacco tax.

This is why we are joining with doctors, health care workers, taxpayers and other nonprofit health organizations to support a $2-per-package tax on the cost of tobacco.

The benefits to our state would be enormous and would more accurately account for the true cost of tobacco. Currently, California spends about $9 billion a year on tobacco-related medical care, with taxpayers footing about a third of that. In fact, in data compiled from the Centers for Disease Control, the true cost to society in California is $15 for every pack sold. Our current tobacco tax is 87 cents.

A tobacco tax is also a particularly effective way to prevent younger people from ever taking up the habit. A staggering 80 percent of smokers start before they are 18, while only one in 100 begin at age 26 or older. The Congressional Budget Office estimates that, based on previous research, a 10 percent increase in the cost of tobacco will result in a five to 15 percent decrease in youth tobacco usage. This compares to three to seven percent for adults.

Education about the ill effects of tobacco over the past several decades has been instrumental in lowering the rate of smoking in the United States. Toward that end, the tax would bolster proven youth prevention programs to deter smoking. A few years ago, it was estimated that even the $1 added tobacco tax then proposed in California would have prevented 200,000 children in California from becoming adult smokers.

Given that tobacco is a major contributor to coronary disease in our nation, we at the American Heart Association are always looking at effective policies that result in fewer smokers. The Congressional Budget Office estimates that if even a roughly $1 per package tax were to be instituted on cigarettes next year, there would be 2.6 million fewer adult smokers over the age of 18 by 2021. This would certainly be helpful in a nation where 443,000 people die from smoking-related diseases yearly, including 46,000 heart-related deaths attributed to secondhand smoke.

If these statistics just seem like numbers on a page, just think about the intangibles, such as the value added from having more years with a grandparent, or not watching a loved one suffer through the pain of emphysema, heart disease or cancer. These are things on which it’s impossible to place a monetary value, but with an estimated 100,000 California lives that will be saved in future years through a tobacco tax, they are nonetheless primary benefits.

So, in the New Year, if you need help to quit smoking, please visit our website, http://www.heart.org, for more information. And please join with us at http://www.savelivesca.com and support a $2-per-package tobacco tax next year. The life you save may be yours or a loved one’s.

Dr. Nicholas Leeper is Assistant Professor of Cardiovascular Surgery and Medicine at Stanford University Medical Center and president of the American Heart Association, Silicon Valley Division. He wrote this for this newspaper.

http://www.mercurynews.com/opinion/ci_27190645/tobacco-tax-move-2-per-pack-gains-momentum

Higher tobacco taxes save lives

By: Vincent DeMarco, Baltimore

A recent op-ed criticizing Maryland’s tobacco tax increases ignores the most important consequence of these measures: a dramatic decrease in tobacco use by teens that has saved thousands of young people from preventable tobacco-related deaths and serious illnesses (“Md. cigarette taxes have unintended consequences,” Dec. 18).

According to data compiled by the Campaign For Tobacco Free kids, within two years after the 2008 increase in the state cigarette tax, from $1 per pack to $2 per pack, there was a 29 percent drop in teen smoking in Maryland.

That translated into 15,000 fewer high school smokers (some of whom have become non-smoking young adults by now); more than 70,000 kids today who will not become adult smokers; more than 30,000 kids alive today who will avoid future premature smoking-related deaths; and more than $1.5 billion in long-term health care cost savings tp the state.

The Maryland Department of Health and Mental Hygiene recently released a study showing that between 2010 and 2013 there was an 18 percent drop in Maryland teens smoking cigars. This happened at a time when nationally there was no statistically significant change in teen cigar smoking.

This progress, which also resulted in saving thousands of Maryland youth from tobacco addiction and preventable death and illnesses, occurred in part because of the 2012 increase in the state tax on cigars, along with an effective public education campaign by the state health department.

Granted, there will always be some people who will seek to avoid the tobacco tax by going to other states or resorting to smuggling. But very seldom will this involve children, whose lives we are saving in record numbers.

And we know from experience that the drop in cigarette sales in Maryland far outweighed the increase in sales in neighboring states that didn’t increase their tobacco tax. And were are fully confident in Maryland Comptroller Peter Franchot’s ability to prevent and prosecute those who would try to illegally smuggle cigarettes into the state.

In addition to saving lives, tobacco tax increases are good for Maryland taxpayers because they both reduce the health-care cost for tobacco-related illnesses and help fund critical health care programs. The 2008 tobacco tax increase partially funded the expansion of health care to over 100,000 uninsured Marylanders.

Although the Maryland Taxpayers’ Association doesn’t seem to want Marylanders to have these benefits, many independent polls show the vast majority of Marylanders clearly understand these benefits and would strongly support further increases in the tobacco tax to save more lives and money for the state.

-The writer is president of the Maryland Citizens’ Health Initiative.

http://www.baltimoresun.com/news/opinion/bs-ed-tobacco-letter-20141222-story.html

Forum editorial: Close off e-cig sales to minors

Fargo Forum Editorial

The Legislature should follow the lead of several North Dakota cities and ban the sale of e-cigarettes to minors. As it stands now, even with sales bans in Fargo, Bismarck, Casselton, Mapleton and other cities, e-cigs can be (and likely are being) sold to minors all over the state. It’s a gaping loophole in a state law that in every other way treats e-cigs like tobacco products.

E-cigs are touted as an effective option for tobacco users to get off cigarettes, although the research is inconclusive. But they also appeal to kids because they are used by some minors for “vaping,” which kids think is “cool,” according to public health experts. E-cigs don’t contain tobacco, but they can be nicotine delivery devices. Often the substances in e-cigs include candy flavors. There is little doubt the products are aimed at adolescents, according to new research. And kids are taking them up at alarming rates.

That being said, e-cig sellers in Fargo insist it is against company policy to sell to anyone under age 18, no matter what a state’s law or city’s ordinances allow or prohibit. In fact, e-cig retailers say they want a state law that bans sales to minors, and will work with legislators in the upcoming session.

While the retailers’ public attitude is good news, questions remain. Where are kids getting e-cigs? Why is use up among minors? Who is policing what?

Most troubling: There is no question e-cigs are a gateway to smoking among teens. New studies indicate that as more minors try e-cigs (up in several states), chances increase that they will try tobacco and get hooked. Nicotine, whether in an e-cig or a cigarette, is addictive. It should come as no surprise that big tobacco companies are in the e-cig business.

The state of North Dakota, with what appears to be support from e-cig sellers, should close the sales-to-minors loophole. Without informed and firm action, e-cigs could erode the progress that’s been made to reduce tobacco use in the 50 years since the first surgeon general’s report revealed the health risks of smoking.

Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.

http://www.inforum.com/opinion/3637026-forum-editorial-close-e-cig-sales-minors

Don't fall for tobacco industry e-cigarette smokescreen

By Michaeline Fedder, Deborah P. Brown and Bonita Pennino
No one should have to choose between their health and a paycheck. Which is why, with all that is still unknown about the dangers of e-cigarette use, we must put public health first and prohibit the use of these unregulated products in all workplaces, including restaurants, bars and casinos. Unfortunately a bill recently passed by the Baltimore City Council purporting to ban e-cigarette use in the city allows restaurants, taverns and casinos to opt out, which not only weakens Baltimore and Maryland’s longstanding and popular smoke-free laws, it threatens the health of many city workers. We urge Mayor Rawlings-Blake to see through the tobacco industry smokescreen and use her power to veto this ordinance.
Turning the clock back by allowing the use of e-cigarettes in public places could create a host of new problems — encouraging new tobacco users, reversing efforts that have made smoking socially unacceptable, creating enforcement confusion for business owners and the public, and potentially putting the health of Baltimore’s restaurant, bar and casino workers and patrons at risk.
While e-cigarette manufacturers may make unverified claims that the ingredients are just “water vapor” or “safe,” without further research and federal regulation there is no sure way for e-cigarette users to know what they are consuming. Nor is there any way of knowing what nonusers are exposed to and the extent of the risk to their health. There are hundreds of types of e-cigarettes on the market today, and the products vary considerably by ingredients and quality control and assurance. Prohibiting the use of e-cigarettes in workplaces, restaurants and bars can protect the public health by preventing nonusers from being exposed to the potentially harmful chemicals in these products.
An increasing number of studies have examined the contents of e-cigarette aerosol. Unlike a vapor, an aerosol contains fine particles of liquid, solid or both. Propylene glycol, nicotine and flavorings were most commonly found in e-cigarette aerosol. Other studies have found the aerosol to contain heavy metals, volatile organic compounds and tobacco-specific nitrosamines, among other potentially harmful chemicals. A 2009 study done by the U.S. Food and Drug Administration (FDA) found cancer-causing substances in several of the e-cigarette samples tested. FDA tests also found nicotine in some e-cigarettes that claimed to contain no nicotine.
The public should know more about e-cigarettes before allowing users to expose others to potential dangers. Studies have already shown that the use of e-cigarettes can cause short-term lung changes and irritations, while the long-term health effects are unknown.Both exposure to and health effects of secondhand aerosol from e-cigarettes require further research, but preliminary studies indicate nonusers can be exposed to the same potentially harmful chemicals as users, including nicotine, ultrafine particles and volatile organic compounds. This exposure could be especially problematic for vulnerable populations such as children, pregnant women and people with heart disease. No worker or patron should be subject to inhaling the unknown aerosol emitted from electronic smoking devices.
By passing this reckless measure allowing the use of e-cigarettes in workplaces, Baltimore City Council members have fallen for the tobacco industry’s tricks. We are all too familiar with the age-old tactics of the tobacco industry such as designating smoking areas and notifying the public when smoking is allowed. We learned the hard way that these strategies do nothing to protect the health of workers and patrons from the dangers of secondhand smoke. These tactics are nothing but a ruse to promote smoking in public places, thus continuing addiction to a deadly product and guaranteeing sales of cigarettes well into the future. We should not repeat the same mistake now in Baltimore with e-cigarettes. No one, regardless in which section of a restaurant, tavern or casino they are working, dining or gaming, should have to choose between their health and a good job or a good time.
It is well understood that smoke-free laws are popular in Maryland and should not be weakened. And laws prohibiting the use of e-cigarettes in public places are steadily on the rise — with 156 municipalities and counting already prohibiting the use of e-cigarettes in all workplaces, including restaurants, bars and gaming facilities. Everyone has the right to breathe safe smoke-free and aerosol-free air in their place of work or leisure, and Mayor Rawlings-Blake should protect that right by vetoing this ordinance.
Michaeline Fedder is director of government relations in Maryland for the American Heart Association; Deborah P. Brown is president and CEO of the American Lung Association of the Mid-Atlantic; Bonita Pennino is the Maryland government relations director for the American Cancer Society Cancer Action Network.

Our View: Do more to keep e-cigs, youths apart

The Times Editorial Board, SC Times

Surveys of Minnesota and U.S. youth show alarming increase in e-cigarette use. Lawmakers can slow this increase by immediately acting to limit access.

Two surveys released the past week — one state and one national — deliver a powerful message about the most pressing issue regarding e-cigarettes:
Government needs to lead a stronger charge to keep them out of the hands — and bodies — of minors.
To this point, most of the e-cigarette debate has been about whether e-cigarettes — which electronically convert liquid nicotine into vapor to be inhaled — are as harmful as traditional tobacco and secondhand smoke.
That debate has raged for years, even decades. A resolution seems months, or more likely, years away.
What’s more pressing to resolve — as evidenced by two surveys of youths’ nicotine use — is slowing the fast-rising number of minors who are trying these devices.
How fast?
The 2014 Minnesota Youth Tobacco Survey released Monday found 28 percent of high school students have tried e-cigarettes. On Thursday, the Centers for Disease Control and Prevention reported 4.5 percent of high school students nationally used e-cigarettes regularly in 2013 — triple the percent from 2011. Equally disturbing: 12 percent of U.S. high school students and 3 percent of middle-schoolers had tried them at least once.
And remember, e-cigarettes have been widely available in America for only about seven years.
Such findings make it clear e-cigarettes hold potential for creating countless new generations with unhealthy and high rates of nicotine addiction.
Hasn’t America learned enough hard lessons from 50 years of tobacco-based nicotine addiction to know it needs to snuff out that potential now instead of waiting for more research?
Ultimately, there is no debate that nicotine is a potent, addictive drug. E-cigarettes are simply a delivery mechanism.
So lawmakers should act now to keep the drug and the delivery system out of the hands of minors.
An easy decision is to enact a federal ban on selling minors e-cigarettes, “e-juice” and related products. Minnesota is one of about 35 states with such bans. However, sales via the Internet still provide youth access.
Another important step is to apply the same rules to the marketing of e-cigarettes that are applied to traditional tobacco.
After all, even a cursory glance at products and advertising makes it clear many producers are targeting youth. Think everything from trendy-looking e-cigarettes (and accessories) to bubble-gum flavored e-juice.
Finally, there is merit in increasing the taxes paid on all e-cigarette products.
Such an approach proved successful in reducing youth use of traditional tobacco. And it might even dissuade adults from nicotine addiction.
Again, too much of the debate about whether and how to regulate e-cigarettes remains focused on comparisons to traditional tobacco.
Seeing how e-cigarettes are gaining traction among youth, the focus needs to shift to keeping these nicotine-delivery devices out of their hands — at least until they are legal adults.
http://www.sctimes.com/story/opinion/2014/11/16/view-keep-e-cigs-youths-apart/19089759/

Letter: Raise state cigarette tax, protect ND kids

By Nicholas Thies, Fargo

I have a friend who started smoking in ninth grade, roughly seven years ago, and he is still addicted to this day. The tobacco companies are aware of these trends and spend millions of dollars on new products and deceptive marketing with the goal of turning children into lifelong customers, as is the case with my friend. I have talked with him, and he has told me how raising the tobacco tax would greatly encourage him to quit smoking.

One of the best ways to prevent kids from ever starting the deadly addiction is to increase the price of tobacco products so they can’t afford to purchase them. States have been successfully using this tactic over the past decade by increasing local tobacco taxes. It can also help detract adult smokers from continuing the habit. Many of my aunts and uncles have been smoking for decades, and I always wished for something that would make them quit.

I’m suggesting we raise North Dakota’s cigarette tax significantly. Of the surrounding states, North Dakota’s tobacco tax is incredibly cheaper.

This one simple act can keep nearly 7,900 North Dakota kids from ever becoming adult smokers. And, more importantly, it means that more than 4,700 caused deaths would be prevented.

North Dakota, this is a win-win idea. You can decrease long-term health care costs and protect our children. I urge you to write your legislator and ask them to consider increasing North Dakota’s tax on all tobacco products.

It’s the right choice for our kids.

http://www.inforum.com/content/letter-raise-state-cigarette-tax-protect-nd%E2%80%88kids

LLOYD OMDAHL: Legislature questions intelligence of voters

By: Lloyd Omdahl, Grand Forks Herald
Measure 4 on the November ballot is the latest attempt by the Legislature to restrict citizen use of the initiative process by which voters can propose measures for a vote of the people.
If passed, it would prohibit the secretary of state from putting on the ballot any citizen proposal that would direct the expenditure of money for a specific purpose. Apparently, legislators question the intelligence of the voters.
This is the latest in a never-ending series of attempts by the Legislature to make it more difficult for North Dakotans to use the initiative. In the past, most attempts have been aimed at raising the number of signatures required for filing petitions. They all failed.
This time, the Legislature wants to be sure that it has exclusive control over the huge surpluses in the state treasury. It is afraid that citizens who see neglected needs will win the support of the electorate to appropriate money.
The Legislature should be reminded that these surpluses would not exist without the adoption in 1980 of a measure initiated by the people to add a 6½ percent tax on oil production. The Legislature was doing nothing about the puny oil tax it had levied 25 years earlier.
Let’s look at the Legislature’s track record.
First, there’s the Legislature’s mismanagement of the money from the tobacco settlement in which North Dakota was awarded over $800 million. Even though Former Attorney General Heidi Heitkamp won the lawsuit, the Legislature was quick to grab the money for programs other than fighting tobacco addiction.
To get the Legislature back on track, Heitkamp and other tobacco fighters initiated a measure directing the Legislature to spend tobacco settlement money on tobacco addiction. The voters approved the measure.
But the 2013 Legislature, in a petulant fit, refused to accept the decision of the voters. It started stripping out key provisions of the initiated measure. The effort failed only when the leadership could not muster the two-thirds vote needed to change an initiated measure.
Meanwhile, the Legislature held the appropriation hostage until the last day of the session when it relented and belligerently approved funding the program to fight tobacco addiction.
By proposing Measure 4, the Legislature is telling North Dakotans that they are not to be trusted with money. Many residents feel the same way about the Legislature. That is why we have provisions in the state constitution for the initiative and the referendum.
There are pressing needs that have been neglected by the Legislature and may require initiative petitions to appropriate money in the future.
One is the need for more support for clean water, conservation and parks. Even if Measure 5 proposing a significance increase in such funding is defeated, the need will not go away. A new initiated measure may be necessary.
A recent public opinion poll revealed strong public support for such programs.
Another critical need is funding for statewide preschool education. The last session did nothing except authorize cash-strapped school districts to raise their own money for preschool. There is wide public support for preschool education. This may require an initiated measure.
Generally speaking, the governor and the Legislature have done quite well with state money. Nevertheless, the Legislature sometimes develops blind spots when it comes to new needs and new opportunities.
Historically, North Dakota voters have been very responsible in dealing with money issues on the ballot. There is no justification for questioning their intelligence. Measure 4 is an unnecessary restriction on citizens participating in their government.
http://www.grandforksherald.com/content/lloyd-omdahl-legislature-questions-intelligence-voters

Raise tobacco tax to discourage kids

By KATHLEEN DONAHUE Bismarck

Almost all tobacco users became addicted before age 26. Thousands of kids try their first cigarette every day.

In recent years, declines in youth smoking rates have stalled and the use of other tobacco products by youth has actually increased.

The tobacco companies are aware of these trends and spend millions of dollars on new products and deceptive marketing with the goal of turning children into lifelong customers.

Advertising influenced my cousin to start smoking at an early age. Years later, his tobacco use cost him his life. I want to make sure no family experiences such a loss.

One of the best ways to prevent kids from ever starting the deadly addiction is to increase the price of tobacco products so they can’t afford to purchase them. States have been successfully using this tactic over the past decade by increasing local tobacco taxes.

I’m suggesting we raise North Dakota’s cigarette tax significantly. This one simple act can keep nearly 7,900 North Dakota kids from ever becoming adult smokers. And more importantly, it means that more than 4,700 tobacco-caused deaths like my cousin’s untimely passing would be prevented.

North Dakota, this is a win-win idea. You can decrease long-term health care costs and protect our children. I urge you to write your legislators and ask them to consider increasing North Dakota’s tax on all tobacco products. It’s the right choice for our kids.

http://bismarcktribune.com/news/opinion/mailbag/raise-tobacco-tax-to-discourage-kids/article_94347622-4046-11e4-a807-af727e9b9e46.html

Q: Is hookah or water pipe smoking a safe alternative to cigarettes?

By Sanjay Gupta, MD

A: Absolutely not. In fact, as Daniel Neides, MD, medical director of the Wellness Institute at Cleveland Clinic points out, hookah smoking “may actually be worse than smoking.”

Hookahs are water pipes in which charcoal is used to heat up flavored tobacco. An ancient form of smoking that originated in the Middle East and India, it has become increasingly popular among American adolescents and young adults. Roughly 1 out of 5 U.S. high school seniors had smoked a hookah in the past year, according to recent data.

The hookah’s gaining popularity is largely due to the misconception that it’s not harmful. That’s not the case. “First, the tobacco used in hookah contains the same cancer-causing agents found in cigarettes,” Dr. Neides says. “Secondly, there is charcoal that is used to heat the tobacco, which gives off carbon monoxide and heavy metals as a by-product when it is heated.”

A hookah session usually lasts longer than time spent smoking cigarettes, with hookah smokers puffing more frequently and inhaling more deeply. A 2010 study reported the amount of smoke inhaled during a hookah session can be nearly 200 times the amount inhaled when smoking a cigarette. Earlier this year, researchers at the University of California, San Francisco, found that hookah smoking raised nicotine urine levels as much as 73 times.

Neides adds that because water pipes are usually smoked in specialty hookah shops or bars and shared among friends, users are exposed to greater levels of secondhand smoke and are at a higher risk of contracting viruses or infections.

The bottom line, Neides says, is that “hookah smoke should be considered the same as cigarettes and cigars – a very unhealthy habit that leads to chronic disease and death.”

http://www.everydayhealth.com/columns/paging-dr-gupta/is-hookah-or-water-pipe-smoking-a-safe-alternative-to-cigarettes/

Letter to the Editor: Stop glamorizing the role of tobacco in baseball

Chris Hansen, Washington | The Washington Post

Just weeks after the early death of beloved baseball star Tony Gwynn from cancer likely caused by chewing tobacco, and just days after World Series-winning pitcher Curt Schilling told the world he attributes his cancer to years of chewing tobacco, The Post irresponsibly leads an article about the Washington Nationals with the portrayal of chewing tobacco use as a rally-inducing, lucky superstition [“Nationals’ luck runs out against Phillies thanks to stellar performance by Burnett,” Sports, Aug. 27].

To all the young baseball fans who look to The Post each morning to see if their heroes won last night: Tobacco causes those heroes to suffer nicotine addiction, disease and death. Stephen Strasburg recently stated publicly that he is trying to quit using chewing tobacco but that it is very hard to quit. It is time for the team owners and the players association to eliminate tobacco from baseball, and it is time for the media to stop characterizing tobacco as a quaint part of baseball culture.

Instead of inducing winning rallies, tobacco in baseball induces life-shortening defeats — and that is the only coverage it deserves on the sports page of The Post.

The writer is president of the American Cancer Society Cancer Action Network .

http://www.washingtonpost.com/opinions/stop-glamorizing-the-role-of-tobacco-in-baseball/2014/08/31/cdd004dc-2e08-11e4-be9e-60cc44c01e7f_story.html