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The Journal Gazette

  • Courtesy Truth Initiative

Friday, October 13, 2017 1:00 am


State of alarm: Indiana smokers in unwelcome company

Tobacco and taxes


Cigarette excise taxes are lower in states with the highest prevalence of adult smokers

U.S. average: $1.89 per pack

Tobacco Nation average: 98 cents per pack

Indiana: 99.5 cents per pack

Ohio: $1.60 per pack

Kentucky: 60 cents per pack

Illinois: $1.98 per pack

Wisconsin: $2.52 per pack

An anti-tobacco group has come up with a dramatic way to illustrate the nation's smoking problem – and Indiana is part of that problem.

Truth Initiative, a nonprofit public health organization, mapped the 12 states with the highest prevalence of adult smokers and found they fit neatly into a collection it calls “Tobacco Nation.” It's not company Hoosiers should want to keep:

• Residents 18 years of age and older in Tobacco Nation are more likely to smoke than the average U.S. adult. Twenty-two percent of Tobacco Nation adults smoke, compared to 15 percent of adults in the rest of the U.S. Indiana's adult smoking rate is 20.6 percent; Allen County's rate is a shameful 23 percent.

• Youth in Tobacco Nation also smoke at higher rates – 12 percent versus 9 percent – compared with the U.S. overall. Twelve percent of Indiana high school students smoke.

If you compare Tobacco Nation with other countries, the distinction becomes even more troubling. Smoking rates in the member states are similar to the 10 low- and middle-income countries with the greatest number of smokers, including the Philippines, Bangladesh, Pakistan and Brazil.  

Non-smokers in Tobacco Nation, including those in Indiana, pay the costs. Average life expectancy is 76.6 years for residents in those states, compared with 79.3 years in the rest of the U.S.

“Tobacco Nation residents are far more likely to rely on hospital care, with 30 percent more preventable hospitalizations for ambulatory, care-sensitive conditions among Medicare enrollees in the region than the average number of residents in the rest of the U.S.,” according to the Truth Initiative report.

“The fact that Indiana is in the 'Tobacco Nation' is no accident,” wrote Nancy Cripe, executive director of Tobacco Free Allen County, in an email. “We know how to combat tobacco use effectively. Other states, like California, New York and North Dakota, are doing it very well. Indiana simply isn't putting the necessary shoulder to the wheel to get the job done. That we fall in the 'Tobacco Nation' should be a wake-up call to our legislators that we need to make fighting tobacco use one of our first priorities.” 

How can Indiana escape Tobacco Nation? A tax increase is a possible route. The state's 99.5 cents-per-pack excise tax is 14th lowest in the nation. A 2017 analysis found that tax hikes of 71 cents to $4.63 per pack could yield an 8 percent to 46 percent reduction in cigarette consumption, according to Truth Initiative. “This is, in part, because price increases, including tax increases, reduce initiation of tobacco use among young people and could make smoking more prohibitive for low-income smokers.”

Indiana also could spend more of the money it receives from the 1998 class-action lawsuit against cigarette companies. According to a November 2016 review by the Campaign for Tobacco-Free Kids, Indiana spends just 8 percent of the amount recommended by the Centers for Disease Control and Prevention on smoking prevention and cessation. Of the state's $579 million in total tobacco settlement revenue in fiscal year 2016, Indiana spent just $5.9 million to help smokers quit or prevent young people from smoking. That compares with an estimated $284.5 million spent by tobacco companies to advertise in Indiana. 

“It is not a mystery how to combat tobacco use effectively,” Cripe wrote. “High taxes on tobacco products work, limiting accessibility and encouraging smokers to quit. Policies that restrict candy-like flavors and packaging that appeal to youth work – they've proven effective in other states and across the world. Truly robust funding of prevention and cessation programs works.”

Indiana's political leaders boast of low tax rates, but they do Hoosiers a great disservice in ignoring our tobacco problem. Indiana's estimated annual health care costs directly linked to smoking total $2.93 billion and 11,100 lives, according to the Campaign for Tobacco-Free Kids. That's a steep tax for residents of Tobacco Nation.