FRANKFORT, Ky. — As Kentucky continues to lead the nation in cigarette smoking – as well as in cancer rates and tobacco-related deaths – health advocates are launching an effort to boost the state’s cigarette tax by at least $1 a pack, a move they say is proven to reduce smoking.
“We are the cancer capital of the country,” said Ben Chandler, chairman of a group called “Smoke Free Tomorrow,” a coalition of nearly 150 health, business and advocacy groups. “We need to cut the smoking rate. We need to cut the cancer rate.”
Chandler said he believes Kentuckians would be shocked to realize tobacco, containing the highly addictive drug nicotine, takes a greater toll in Kentucky than opioid addiction.
While about 1,400 people died from drug overdoses in 2016, tobacco causes about 8,900 deaths each year in Kentucky, where a quarter of the population smokes, he said.
“You hear so much about the opioid crisis – and it is a crisis – but you hear far less about the crisis of tobacco,” Chandler said.
Meanwhile, advocates say they are stepping up efforts to convince local communities to adopt smoke-free laws; the legislature has repeatedly rejected a statewide law banning smoking in public places such as offices, stores, restaurants and bars.
The cigarette tax hike may not be as hard a sell to state lawmakers.
The Senate Health and Welfare Committee last week voted to recommend an increase of at least $1 in the state cigarette tax after hearing testimony about the toll of smoking in Kentucky. The vote was symbolic since no bill was before the committee.
Among those at the hearing was Sen. Stephen Meredith, a Leitchfield Republican and former hospital executive who said he’s sick of talk about Kentucky’s cancer and smoking problems.
“I’ve been hearing this for over 40 years,” said Meredith, who has filed a bill proposing a $1 a pack health care “assessment” on cigarettes with some proceeds going toward smoking cessation programs in Kentucky. “It’s time to stop having this conversation and start action.”
Meredith’s comments came after Kentucky’s two top cancer doctors testified at the committee last Wednesday in support of raising the cigarette tax by at least $1.
Dr. Jason Chesney, director of the James Graham Brown Cancer Center at the University of Louisville, and Dr. Mark Evers, director of the Markey Cancer Center at the University of Kentucky, told lawmakers such an increase could dramatically reduce death and disease in Kentucky caused by tobacco.
“It’s a cycle of death we need to stop,” Chesney said.
Evers said such a tax should be applied to all tobacco products, including E-cigarettes, to discourage youths from smoking.
“Raising the tobacco tax by at least $1 may be the most important policy action you can take,” Evers told the panel.
Joining the physicians in support of the measure was a representative of the Kentucky Chamber of Commerce, who said a majority of its members support the proposal.
“The state’s largest business association is asking you to raise the cigarette tax by at least $1,” said Ashli Watts, the chamber’s senior vice-president for public affairs.
Watts said the chamber believes it would cut health costs, improve worker health and productivity and make the state more attractive to prospective employers wary of the state’s high smoking rate and high rates of cancer and other diseases.
“We still have the most unhealthy workforce in the nation and that is an economic development issue,” Watts said.
The committee appeared to agree. Acting on a motion by Sen. Alice Forgy Kerr, a Lexington Republican, members endorsed the idea of raising the state cigarette tax by at least $1,
“I know that we’ve talked it to death,” Kerr said.
Kentucky’s cigarette tax is now 60 cents, one of the lowest in the nation. A $1 a pack increase would bring in an additional $266 million a year in revenue at a time when the state desperately needs it, Chandler said.
But more importantly a tax of at least $1 would encourage thousands of Kentuckians to quit smoking and prevent others, mainly youths, from starting to smoke through a significant increase in price, said Chandler, the executive director of Foundation for a Healthy Kentucky, a non-profit health advocacy organization that is helping finance the Smoke Free Tomorrow campaign.
About 25 percent of Kentuckians smoke with staggering health and medical costs to the state, advocates say.
The two cancer center doctors who testified last week said current health costs in Kentucky related to smoking total nearly $2 billion a year, about $600 million of that in the state’s Medicaid program.
Research shows that a $1 a pack price increase on cigarettes could cause about 29,400 Kentuckians to quit smoking and 23,400 youths from starting, the advocates said. It would mean thousands fewer premature deaths from smoking per year.
And, over five years, it would save $31.6 million in medical costs.
That’s not lost on Meredith, sponsor of Senate Bill 29 for the $1 per pack assessment. The bill would direct the majority of proceeds to the state’s Medicaid program for tobacco-related illnesses and the rest to smoking cessation programs by county health departments.
“I regret deeply that we’ve got to spend $600 million for our Medicaid population when we can’t find money for schools,” Meredith said.
Chandler said his foundation is seeking to expand the growing number of Kentucky communities with smoke-free laws rather than seek a statewide law after such an effort failed in 2015.
Chandler, a former Kentucky attorney general and U.S. representative from the state’s 6th Congressional district, is using his familiarity with the state to make personal visits to all 120 counties to convince local officials of the merits of comprehensive smoke-free laws adopted by 26 communities including Louisville and Lexington.
“I visited 70 counties in 2017,” Chandler said. “I plan to get to get the rest of them done this year.”
But the immediate push is in Frankfort, where health advocates hope to convince lawmakers of the need for a significant hike in the cigarette tax. Chandler said he thinks the best chance would be to include it in any tax reform measure considered either in the current legislative session or a special session devoted to the subject.
Chandler said tobacco companies will lobby for lower increases, trying to convince lawmakers its represents a “compromise” between the health advocates and tobacco industry. But he said it takes a boost of at least $1 to reduce smoking.
“They will not oppose a cigarette tax but they will try to keep it low,” Chandler said. “We understand that is the playbook of the tobacco companies.”
A spokesperson for Richmond, Virginia-based Altria Group, the parent company for Philip Morris USA and U.S. Smokeless Tobacco Company, said its “tobacco companies oppose additional excise tax increases, which are unfair to adult consumers and can lead to less stability in state finances. Also, tax increases often result in unintended consequences, including creating additional incentives for illicit trade and harming retailers, wholesalers and tobacco growers.”
Altria employs several legislative lobbyists in Kentucky, according to the Kentucky Legislative Ethics Commission.
Chandler said his foundation, formed in 2001, has identified smoking and tobacco use as Kentucky’s overriding health problem and is targeting significant resources toward increasing the cigarette tax and expanding smoke-free laws.
It expects to spend around $573,000 in the current legislative session promoting those issues, Chandler said.
While the legislature has approved smaller cigarette tax increases in the past, Chandler said he believe this year could be different.
“This ought to be a no-brainer,” he added.