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In her post below, Amy asked for a rationalization that Measure 50 is “a tax on the poor,” wondering what it is about poor people, according to that argument, that makes them less able to quit smoking than higher income people.
Reader Chris Woo (an OHSU employee—and campaign volunteer for city council candidate Chris Smith) gave the answer that I’ve always heard, that access to health care largely determines one’s ability to quit once addicted:
The consensus from my colleagues in tobacco cessation research is that, as a whole, it is harder for lower income individuals to quit than those with higher incomes. It’s not because of any difference in physiology or intelligence, rather it is has more to do with things like access to health insurance, class and workplace differentiations, cultural image and differences in coping resources for stress, etc.Let’s not forget that we’re talking about an addiction — rational economic, cost/benefit decisions don’t always apply. Studies show that increased tobacco taxes do help prevent potential smokers from ever starting, but they are largely ineffective at getting current smokers to quit.
As a hopefully-soon-to-be-former smoker, I can confirm that access to medicines, cessation aids, and disapproving doctors is vital to quitting. Have any of you ever tried quitting on your own? It’s damn near impossible, and it’s easy to see why those who don’t have health care, and are under the stress of possibly multiple jobs with paltry paychecks might have more difficulty quitting.
That said, I paid $8.10 for a pack of Camel Lights this weekend in Chicago. I can personally guarantee that that cost alone would make me quit—even if I didn’t have insurance. Maybe the problem with Measure 50 is that the tax isn’t high enough.
The fact that RJ Reynolds has pumped over 12 million dollars into this campaign to try to defeat Measure 50 causes me to really want to support it. When have big tobacco companies ever supported anything positive? All they care about is keeping people smoking as much as possible and as long as possible. And they certainly don't mind if the price is low enough for kids to start smoking and get addicted.
Thanks, for "outting" me as an OHSU employee, Scott ;0) I won't advocate for either side of the M50 debate, but I will say that OHSU's decison to go tobacco-free this year took a hard look at how banning tobacco use at our facilities would affect our patients -- the majority of whom are at the lower end of the income spectrum. Anytime you do something that affects the use of tobacco in our communities - whether for good reasons or not-so-good reasons - it's the poor who will be most impacted. Very effective treatments for tobacco dependence are out there (both medication and behavioral), but communicating and connecting people with those resources is tricky. It's even harder when someone does not have the social support or financial means/insurance to access those treatments even if they know what they are.
If anyone is interested (Warning: shamless self-promotion ahead) in learning more about how we went about implementing the tobacco-free policy at OHSU, they can check out the websites below. The websites pertain to the internal projects/programs at OHSU, but there may also be some info of interest to the general public as well:
www.ohsue.edu/tobaccofree
www.ohsu.edu/smokingcessation
Setting up a whole list of things one needs to quit smoking (e.g. smoking cessation classes) is a good way to put it off indefinitely. At least that's what I did.
A big-ass bag of dum-dums costs about a buck fiddy. That and a whole bunch of willpower will do the trick.
But the purpose of measure 50 isn't to get people to quit smoking. It's to fund health care. It depends on people to keep and/or start smoking. I can't back this up with hard facts, but my thinking is that this very specific 84.5 cents per pack was very well-researched. Scott's correct: $8.10/pack and a lot of people quit. But nickel and dime smokers every couple of years and they'll continue to smoke, which I think is what the people behind M50 want.
What's often left out of this debate is what this tax is funding. Measure 50 is not about taxing cigarettes, it's about using that tax as a funding source for low-income families and children. A study of the tax (sorry, couldn't find the link right away) showed that low-income people, which include smokers, would receive a net benefit from Measure 50.
One trip to the emergency room without insurance can easily run $500 or more; let's not even talk about ambulance rides. That $.85 per pack all of a sudden doesn't seem like that much...
1-800-QUIT-NOW, The Oregon Quit Line, will offer you a starter kit of cessation products, and for those who qualify, free in-person counseling. Free over-the-phone counseling is available to anyone, anytime.
Jon is right. Progressive politics recognizes that any product tax -- gas, food, cigs, whatever -- takes the biggest bite out of the smallest paycheck. I smoke, don't intend to quit, and could easily afford $5+ cig prices, but I also feel that targeted and punitive vice taxes don't represent a progressive way forward towards a more socialized healthcare system. Willingness to share the burden, rather than pawn it off on a specific, powerless, and easily demonized group, is what the left should insist on at all times. I voted no on exactly this principle.
Can somebody tell me what the real purpose behind this tax is?
1. Encourage people to quit smoking and therefore save money in health care in the long run as the illnesses due to smoking will decline
2. Try to get immediate additional funding for health care as current system does not seem to work and lack funds for kids health program
#1 by itself could be a reasonable purpose. However it doesn't seem very realistic that a 85cent increase on a package price will make people quit smoking. It is not going to even reduce the number of people who will start smoking. We need to increase a pack price to $10/pack in order to make this work.
#2 by itself is not a reasonable purpose at all. If there is something wrong with the system we need to find the problem and try to solve it. Implementing new taxes, especially targeted on a specific product, is not an efficient way of solving the funding problem. This contradicts with the basics of the US economy and life style.
#1 + #2 combined is not going to work as they contradict to each other. Lets say we increase the pack price to $10 and help kids with the health care. What if everybody quits smoking in 10 years and there are no new smokers? Are we going to tell kids "sorry no more money, that was all we had"? Or maybe we can implement a trans fat tax to cover!
I don't think it is a surprise that tobacco companies invest to defeat the campaign. Any business would have to do it. If there was a measure in discussion to protect our privacy and prevent search engines from collecting personal information on the Internet, I am sure Google and Yahoo will start a "No" campaign against it. I am by no means defending tobacco companies (or funded by them :)) but this is not a black/white situation. They employ thousands of people who also have kids that need to eat and go to school...
I am not eligible to vote, just wanted to share my 2 cents...
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Scott,
My take on it is still that it's a proportion thing. My comment to Amy's post...
"The 'tax on the poor' argument is a proportion thing, since the tax isn't a percentage (say, like income taxes). For example, a rich dude and a poor dude may smoke the exact same amount, but the extra $.85 is gonna hit the poor dude harder simply because he makes much less money so that amount is a higher proportion of his overall money. It's the same argument used to say the state lottery is a tax on the poor... a ticket still costs $1, but it's a $1 irrelevant of purchaser's income, so proportionally, yes, it is most definitely a bigger hit on the poor. The issue of smoking and playing the lottery being a matter of choice, rather than a mandatory tax, is a whole other (valid) debate. The above comment is just the rationale behind the 'tax on the poor' argument."