The numbers are just numbers – unless, of course, you’ve ever had to watch a loved one die a smoker’s death from cancer or any of the many other diseases caused by tobacco addiction.
But the fight to save the smokers of tomorrow from the early deaths that surely await some of them is one that comes down ultimately to dollars and cents.
Consider, first, the good news. In the almost 50 years since the U.S. Surgeon General’s report that definitively linked smoking with cancer and other life-threatening diseases, the number of people who smoke has been cut by more than half.
The bad news, as a coalition of public health groups noted in a report released this week, is that tobacco use remains the number one cause of preventable death and disease in the United States. Tobacco is responsible for 443,000 deaths per year, the report says, more than AIDS, alcohol, car accidents, illegal drugs, murders and suicides combined.
Some 24 percent of us in Indiana still smoke – including 18.1 percent of all high school students – which leads to 9,700 deaths a year, adds $2.08 billion to Indiana’s healthcare costs and increases each Hoosier household’s state and federal tax burden by $559, according to the new report, Broken Promises to Our Children: The 1998 State Tobacco Settlement 15 Years Later, by the American Lung Association, the American Heart Association, the American Cancer Society and several other organizations.
With those grim statistics and more, the coalition poses a simple question. Why is it that Indiana and most other states are failing to use more than a small fraction of the money they recover from tobacco companies to finance anti-smoking campaigns?
In the ’90s, all 50 states demanded compensation from the major tobacco companies for the enormous strain tobacco-related health costs had placed on health care. A November 1998 agreement negotiated on behalf of 46 states, including Indiana, provided for payments from the tobacco companies of approximately $246 billion over the next 25 years. Even more money flowed to the states through taxes on tobacco sales.
At first, the states dedicated much of that money to programs to fight smoking. But as the pressure on public treasuries has increased over the last 15 years, funds that were used for anti-smoking campaigns have dwindled in most of the settlement states. Next year, less than 2 percent of the $25 billion in settlement revenue nationwide will be targeted at prevention of tobacco use.
The few states that invest more of their tobacco-related funds in smoking-cessation programs see results. Florida, for instance, is spending a full 15 percent of its settlement funds on tobacco education, $65.9 million for 2014. High school smoking there has dropped to an incredible 8.6 percent.
The amount Indiana is spending on those programs has plummeted, from $35 million a year in the early 2000s to an estimated $5.8 million in 2014. In their continuing efforts to recruit new smokers, tobacco companies will spend more than 47 times that – $271 million – in advertising in Indiana next year.
The coalition’s report ranks Indiana 31st among the states involved in the settlement. That ranking, for what it’s worth, may be squishy: Our state and a handful of others are tied up in a dispute over how much of the settlement we should receive. Next year’s settlement payment may be reduced from $131 million to $68 million, and the state may lose even more of the funding.
But Indiana still could target more of its tobacco money to fight smoking. The settlement funds aside, the state will take in an estimated $453.8 million in tobacco-tax revenue next year, according to the coalition’s report. Dedicating some of those tax funds to prevention in years to comewould save many lives and have a tremendous positive impact on Indiana’s healthcare costs.