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Bismarck Tribune: Legislators need to get tobacco bill right

Bismarck Tribune Editorial Board:

On the surface, a bill to raise tobacco taxes would seem a no-brainer to many North Dakotans.

The state ranks 46th nationally in tobacco taxes at 44 cents per pack, ahead of Alabama, Georgia, Louisiana and Virginia.

Supporters of a higher tax argue it will deter young people from picking up the habit, nudge smokers to quit and provide more money to the state.

House Bill 1421 would raise the state’s cigarette tax to $1.54 per pack and increase the excise tax on other tobacco products from 28 percent of the wholesale purchase price to 43.5 percent.

There have been efforts to raise tobacco taxes since 1993, with the latest failed attempt in 2013. A hearing this week on the bill pitted health care officials against business interests.

Mike Rud, president of the North Dakota Petroleum Marketers Association, suggested the state shouldn’t tamper with an economy that remains robust. He said his association opposes the bill, and that increasing the tax would make it more difficult for retailers along the Montana and South Dakota borders, states where the taxes would be lower.

However, Dr. Eric Johnson, of Grand Forks, noted the state gets a flunking grade from the American Lung Association when it comes to tobacco taxes.

Rep. Jon Nelson, R-Rugby, said the bill is intended to stop young preople from smoking, while generating an estimated $103.5 million in new revenue in the 2015-17 biennium.

Supporters of the bill expect to have it both ways. They predict the higher taxes will prevent approximately 7,500 people younger than 18 from smoking and prompt an estimated 8,000 adult smokers to quit. They also see a possible $300 million in savings in future health care expenditures. It’s likely fewer smokers will result in fewer health problems and reduce the impact on health care. Plus supporters expect the $103.5 million in new revenue.

Fewer smokers is a laudable goal — there’s no doubt that tobacco poses a health risk and increases medical costs for everyone. The bill’s health benefits should be the focus of legislative action — we shouldn’t be looking at the dollar signs.

Smoking remains legal, though where smoking can occur has been limited. Raising taxes for health reasons has merit, but raising them to punish people doesn’t.

Under the bill, 60 percent of new revenue would go toward health-related programs in the state’s Community Health Trust Fund. The rest would go to local communities for health-related programs.

Designating the money for health programs shouldn’t translate into funding more anti-smoking campaigns that already are well-financed. There are more deserving programs than can be counted. The Legislature needs to ensure the money goes to the right programs.

North Dakota needs to do everything it can to prevent more people from smoking and to encourage smokers to quit. Lawmakers need to take a close look at HB1421 to be sure it achieves those goals. It shouldn’t be done to create a new revenue stream.

Done correctly, HB1421 should be approved. Improving the health of the state’s residents should be the goal of all North Dakotans.

http://bismarcktribune.com/news/opinion/editorial/legislators-need-to-get-tobacco-bill-right/article_629fb919-ead5-52b0-b62b-0a5143d7e6a9.html

Senators Hear Tobacco Tax Bill

By Steph Scheurer, Reporter, KX News
State senators hear a bill to increase the tax on tobacco.
If passed, the tax on a pack of cigarettes would increase to two dollars.
“I support this bill whole-heartedly,” says Valerie Schoepf, Vice President, Tobacco Free Coalition.
Valerie Schoepf is Vice President of the Tobacco Free Coalition.
Today she shares her personal story in favor of a tobacco tax incentive bill.
“I was 14 years old and a freshman in high school when my dad passed away from lung and brain cancer. He got hooked as a smoker growing up in Parshall North Dakota and he was a lifelong smoker,” says Schoepf.
Senate Bill 2322 would increase taxes on tobacco products from 28 percent to 50 percent.
For cigarettes, the tax would go from 44 cents to two dollars a pack.
“The research without question says it is the cost of tobacco that drives its use,” says Tim Mathern, District 11 Senator.
The bill also adjusts the definition of other tobacco products to include new tobacco and tobacco driven products, like e-cigarettes.
Schoepf says three components are needed to prevent people from taking up smoking.
“Price, tobacco free environments, and education. North Dakota’s doing great on two of those but we’re missing that third leg and that’s diluting those other A plus efforts,” says Schoepf.
“Having one of the lowest tobacco taxes in the nation is not something that we should be proud of. It’s time to raise the tobacco tax for the health of our state and to help protect our youth from a lifelong addiction to nicotine and the deadly consequences of tobacco,” Kristie Wolff, Program Manager, American Lung Assoc. ND.
Not everyone agrees with raising the tobacco tax however.
Mike Rud, President of the North Dakota Retailers Association says North Dakota’s economy is strong and is the last state that needs a business tax increase of any kind.
“Increasing the excise tax could hurt legitimate retailers when adult smokers shift purchases across state lines or to other outlets and as you heard today, at two dollars a pack, we would now be higher than South Dakota and Montana,” says Mike Rud, President, ND Retailers Assoc.
For Carol Two Eagle, tobacco is a part of her daily spiritual life.
“When you tax tobacco, you’re taxing something that’s essential for our religious practice and that’s unconstitutional. I am not sure how you’re going to get around this. but it needs to be addressed because we are the only group in North America, traditional indians, who require this material. Tobacco in our way is holy,” Carol Two Eagle.
Over a dozen people shared their viewpoint with legislators – some for the bill, and some against…
Sponsoring senators say the bill would save an estimated one billion dollars in healthcare costs over the next 10 years.
If passed, the new tobacco tax revenue would be deposited in a state general fund and legislators would decide how the revenue is to be spent.
The bill would exclude FDA approved cessation products like patches and lozenges.
To read more or watch video: http://www.kxnet.com/story/28027041/senators-hear-tobacco-tax-bill

Opinion: Raise tobacco tax

By: REBEKAH HARTMAN, Mandan
It is time for North Dakota to raise the tobacco tax. I know firsthand that raising the price is an effective way to help people quit smoking.
I am personally affected by our state’s low rate of tobacco taxes as my husband is in a constant struggle to battle his addiction to tobacco. When we lived in Minnesota, the price of cigarettes was high enough that buying a pack forced him to stop and think about what — exactly — the money was going for and if there was a better way to spend the dollars. Now that we’re in North Dakota, where the cigarette prices are shockingly low, there is little pause when deciding to buy a pack.
I’m urging our state legislators to support the proposals before them to increase the state tobacco taxes. Our elected officials should seize the opportunity to increase taxes on all tobacco products as it would reduce smoking rates, support countless people who are desperately trying to break their addiction, and ultimately lower health care costs for all North Dakotans.
http://bismarcktribune.com/news/opinion/mailbag/raise-tobacco-tax/article_7d15ce12-df00-50f2-a0e2-47a0658cfa34.html

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

Smoking not 'lesser evil' in mental health treatment settings

By: Maiken Scott, Newsworks
Picture an AA meeting, and a gigantic coffee urn and a cloud of smoke come to mind.
In fact, the two men who started AA, Dr. Bob and Bill W. both died from tobacco-related illnesses.
Public health experts say smoking is still pervasive among people living with addiction and mental illness, and it’s often not seen as a priority in treatment settings.
For example, smoking rates in Philadelphia have dropped significantly over 10 years, but haven’t budged among people with mental illnesses and substance-abuse issues.
Smoking is often seen as a “lesser evil” in mental health and addiction treatment settings, explained Ryan Coffman, tobacco policy manager for Philadelphia’s Department of Public Health. It’s not a priority, and some providers assume it helps their clients cope.
Research shows the opposite to be true, says Coffman. “Individuals living with mental illness and substance-abuse disorders who smoke have more severe symptoms, poorer well-being and functioning, they have more hospitalizations, and are at a greater risk for suicide,” he said.
Research also shows that people who quit smoking along with quitting other drugs have better recovery outcomes.
Philadelphia is increasing efforts to train mental health providers on tobacco-cessation programs, and to provide them with the most up-to-date resources available to their clients, Coffman said.
But for these efforts to really take root, a major cultural shift will have to occur, said University of Pennsylvania psychiatrist Robert Schnoll, who studies tobacco cessation.
“Research indicates that upwards of 25 percent of mental health care facilities still permit smoking on the grounds and on the premises,” he explained. “There’s pervasive use of cigarettes, or cigarette breaks, as a reward for pro-social behavior, so that’s certainly one of the issues we need to address going forward.”
Some providers think their clients don’t care about tobacco cessation, he said, or don’t understand the benefits. Some also simply don’t see it as their responsibility.
Research also indicates that smoking rates are high among people who work in mental health treatment settings, Schnoll said.
http://www.newsworks.org/index.php/homepage-feature/item/75483-smoking-not-lesser-evil-in-mental-health-treatment-settings?linktype=hp_impact

Ready to quit smoking? Here's what works best

Kim Painter, Special for USA TODAY
It’s always a good time to quit smoking. But if smoking cessation has a season, it’s about to begin.
Thursday is the American Cancer Society’s Great American Smokeout, a day on which all smokers will be encouraged to abstain or start making a plan to quit. In coming weeks, even more people will make resolutions to quit as New Year’s Day approaches.
Sadly – with smoking causing 480,000 deaths each year in the United States – most will not succeed, at least this time.
One reason: most people try to do it alone, and just 4% to 7% of those people manage to quit on any given attempt, according to the cancer society. Getting help can raise quitting rates to 25% or more, at least in studies, the society says.
But what kind of help?
“We have a gold standard, and it’s a combination of counseling and medication,” says Yvonne Hunt, a program director at the National Cancer Institute’s tobacco control research branch. But just 4% of potential quitters use such combinations, according to the federal Centers for Disease Control and Prevention.
There are several methods to choose among, Hunt says: “People can mix and match and find a combination that works best for them.”
Among the proven methods:
• Counseling. One way to start planning a quit attempt is to call 1-800-QUIT-NOW (1-800-784-8669) to reach counselors on your state’s quit line. In-person counseling is available through many clinics and hospitals. Increasingly, counseling also is available through text messages (such as the cancer institute’s SmokefreeTXT program). Some websites and apps offer advice too, but quality varies.
• Varenicline (Chantix). This prescription pill is the most effective smoking-cessation drug in studies. It can ease withdrawal symptoms and make smoking less satisfying by blocking the effects of nicotine. The pills carry warning labels – which a Food and Drug Administration panel recently voted to keep – saying they have been linked to mood swings, depression and suicidal thoughts. But those side effects are rare “and generally it’s accepted as a safe medication,” says Lee Westmaas, director of tobacco control research at the cancer society.
• Bupropion SR (Wellbutrin, Zyban). This is another prescription pill. It is best known as an antidepressant but it also can decrease cravings and withdrawal symptoms in those quitting smoking. Common side effects are dry mouth and difficulty sleeping.
• Nicotine-replacement therapies.
Nicotine from a patch, gum, spray, inhaler or lozenge can ease withdrawal symptoms and cravings in the first weeks and months without cigarettes. Some require a prescription and all are considered medications. They can be combined with non-nicotine medications. They have various side effects. For example, patches can cause skin irritation and nicotine gum can cause mouth sores.
Not on the list of proven methods: hypnosis, acupuncture and laser therapy. “You will certainly find people who swear by these methods, but they do not have a solid evidence base behind them,” Hunt says.
Some smokers also may be surprised that electronic cigarettes – e-cigarettes – are not listed as quit-smoking aids by groups such as the cancer society or the National Cancer Institute. The increasingly popular devices contain nicotine, but unlike nicotine-replacement therapies, they are not regulated and have not been thoroughly studied as quitting aids.
“The sale of e-cigarettes is going 100 miles an hour and the science is going five miles an hour,” says Jonathan Bricker, a psychologist specializing in smoking cessation at Fred Hutchinson Cancer Research Center, Seattle.
Bricker’s own research focuses on improving counseling methods. It is clear smokers need more and better help than is available now, he says: “We are not helping 65% to 75% who want to quit.”
But it’s also important for smokers who fail one — or many — quit attempts to keep trying, Westmaas says. “Each attempt gives them more information about what to do differently next time.”
More information on quitting is at the federal government’s smokefree.gov site and the cancer society’s cancer.org site.
Benefits of quitting:
For those who need reminders about why they should quit, here – according to the cancer society – are some benefits after:
20 minutes: heart rate and blood pressure drop
12 hours: carbon monoxide levels in blood drop to normal
2 weeks to 3 months: circulation and lung function improve
1 year: excess coronary heart disease risk cut in half
5 years: risk of mouth, throat and bladder cancer cut in half
10 years: risk of dying of lung cancer cut in half
15 years: risk of coronary heart disease same as non-smokers’
http://www.usatoday.com/story/news/nation/2014/11/16/quit-smoking-what-works/18812269/

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

CVS stops selling tobacco, offers quit-smoking programs

Jayne O’Donnell and Laura Ungar, USA TODAY

CVS Caremark plans to stop selling tobacco products in all of its stores starting Wednesday — a move health experts hope will be followed by other major drugstore chains.

CVS announced in February that it planned to drop tobacco by Oct. 1 as the sales conflicted with its health care mission. To bolster its image as a health care company, CVS will announce a corporate name change to CVS Health. Retail stores will still be called CVS/Pharmacy.

CVS, which has 7,700 retail locations, is the second-largest drugstore chain in the USA, behind Walgreens. It manages the pharmacy benefits for 65 million members and has 900 walk-in medical clinics.

The American Pharmacists Association called on drugstores to stop selling tobacco in March 2010 and several small, independent chains have done so, APA spokeswoman Michelle Spinnler says. CVS is the first large chain to stop tobacco sales.

“CVS’ announcement to stop selling tobacco products fully a month early sends a resounding message to the entire retail industry and to its customers that pharmacies should not be in the business of selling tobacco,” said Matthew Myers, president of the Washington-based Campaign for Tobacco-Free Kids. “This is truly an example of a corporation leading and setting a new standard.”

CVS is also launching a smoking-cessation campaign that will include an assessment of the smoker’s “readiness to quit,” education, medication support to help curb the desire to use tobacco and coaching to help people stay motivated and avoid relapses.

CVS says research shows its decision will have a big impact. A study the company is releasing Wednesday in the journal Health Affairs shows bans at pharmacies in Boston and San Francisco led to more than 13% fewer purchasers. Smokers didn’t just switch where they bought cigarettes and other tobacco products, some stopped buying them altogether. About 900 households in the two cities recorded everything they bought after the bans went into effect.

Troyen Brennan, CVS’ chief medical officer, says if the results were extrapolated for pharmacies across the USA, it would lead to 65,000 fewer deaths a year.

Ellen Hahn of the Tobacco Policy Research Program at the University of Kentucky says one chain not selling tobacco will have a limited effect, and other tobacco control strategies, such as price and tax increases and smoking bans, have been shown to be more effective.

Still, she said, “every little bit helps because they are such a large chain. If every pharmacy would follow suit, that would be best. But this sends a clear message that pharmacies should not be selling tobacco.”

Audrey Silk, founder of Citizens Lobbying Against Smoker Harassment, or CLASH, a national smokers’ rights group based in New York City, says CVS has every right to change what it sells, but she believes the company is falling for the anti-smoking “crusade.”

Pharmacies no longer sell just medicines, she said, “they have turned into grocery stores. They sell candy. They sell beer. CVS Health? It’s a perception war. … Tobacco is legal. They’re engaging in public coercion by not selling cigarettes.”

CVS says its tobacco sales total about $2 billion a year.

The U.S. Centers for Disease Control and Prevention calls tobacco “the single most preventable cause of disease, disability and death in the United States,” saying 443,000 people die from smoking or exposure to secondhand smoke each year.
Tobacco deaths are very personal to two top CVS executives. CEO Larry Merlo’s father died of tobacco-related cancer at age 57 and the mother of CVS/Pharmacy President Helene Foulkes died five years ago of lung cancer from smoking.
After its announcement in February, Foulkes says CVS was deluged with personal stories from customers who had quit smoking. Many said it was the “hardest thing they had ever done,” she says. The company is determined to make it easier for them, she says, because it simply makes sense.
“The contradiction of selling tobacco was becoming a growing obstacle to playing a bigger role in health care delivery,” Merlo says.
http://www.usatoday.com/story/news/nation/2014/09/03/cvs-steps-selling-tobacco-changes-name/14967821/

Letter: Tobacco taxes should be raised

“Hey! I have a great idea! Let’s raise a tax on something,” said no North Dakota legislator ever.

Wow! Raising a tax on anything, with North Dakota being so flush from oil money, just doesn’t make any sense at all.

And yet, taxes (or fees if you want a more politically correct term) do continue to inch up here and there.

During the 2013 legislative session, North Dakota lawmakers passed a bill that increased fees for many hunting and fishing licenses.

A tax is generally imposed to gain funds to pay for specific services or products: “It is a compulsory contribution to state revenue, levied by the government on workers’ income and business profits or added to the cost of some goods, services, and transactions.”

As said, to raise a tax in North Dakota today just doesn’t seem to make any sense, unless it’s a tax to protect the health of our residents, prevent disease and thwart kids from starting a path of extremely unhealthy behavior.

OK, I’ve beat around the bush long enough. I have read a lot about the idea of increasing the tobacco tax in North Dakota, and I am totally in favor of such an action. Here’s why:

The tobacco tax in North Dakota is one of the lowest in the nation (we are 46th at 44 cents per pack of 20 cigarettes), the lower-than-us states include: Missouri at 17 cents; Louisiana at 36 cents; Georgia at 37 cents and Alabama at 42 cents.

Our tobacco tax hasn’t increased since 1993.

The effects of North Dakotans’ tobacco use also affects the wallets of those who don’t use tobacco. North Dakota’s annual health care costs directly caused by smoking are $326 million. The portion covered by state Medicaid is $47 million.

But the most important reason is that a higher tobacco tax encourages people to quit and discourages younger folks from starting. According to the Tobacco Free Kids organization, “tobacco tax increases are one of the most effective ways to reduce smoking and other tobacco use, especially among kids. Every 10 percent increase in cigarette prices reduces youth smoking by about seven percent and total cigarette consumption by about four percent.”

For all the work being done by public health and health advocacy organizations, raising the tobacco tax is win-win.

I think it’s about time the North Dakota legislators started having a serious talk about this rather serious idea.

http://www.westfargopioneer.com/content/letter-tobacco-taxes-should-be-raised

Taxes on cigarettes help reduce number of smokers

By Matthew L. Myers, president of the Campaign for Tobacco-Free Kids
The Hill
Science and experience have demonstrated conclusively that cigarette tax increases are highly effective at reducing smoking, especially among kids. Thus, the conclusions in a Gallup poll The Hill recently wrote about (“High cigarette prices aren’t stopping smokers,” July 18) are inconsistent with what happens in the real world every time cigarette taxes are increased.

The most recent surgeon general’s report on tobacco concludes that “raising prices on cigarettes is one of the most effective tobacco control interventions.” The report called for additional cigarette tax increases “to prevent youth from starting smoking and encouraging smokers to quit.” The Congressional Budget Office has also reviewed the evidence and concluded that an increase in the federal cigarette tax would significantly reduce the number of adult smokers.

In the year after a 62-cent increase in the federal cigarette tax in 2009, cigarette sales declined by a historic 11.1 percent. Adult and youth smoking rates also declined. “This single legislative act — increasing the price of cigarettes — is projected to have reduced the number of middle and high school students who smoke by over 220,000 and the number using smokeless tobacco products by over 135,000,” the surgeon general’s report noted.

Even the poll The Hill wrote about reported that more than a quarter of adult smokers surveyed said they smoked less due to tax increases. As there are 42 million smokers in the United States, this translates into millions of smokers whose behavior is affected by cigarette tax increases. And this survey of current smokers would not have included former smokers who have already quit due to increased tobacco taxes.
Tobacco tax increases don’t have to cause every smoker or even a majority of smokers to quit or cut back in order to have a big impact on public health. As the scientific evidence and even the new Gallup poll show, such tax increases will impact the behavior of large numbers of smokers, saving many from a premature death.
From Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, Washington, D.C.

Read more: http://thehill.com/opinion/letters/213571-taxes-on-cigarettes-help-reduce-number-of-smokers#ixzz38sdK91IE
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