In a destructive move that will have negative repercussions for future funding of tobacco control programs, the Campaign for Tobacco-Free Kids has turned its back on the state-of-the-art in tobacco control and instead, is pushing for a cigarette tax increase that will further reduce incentives for the government to reduce cigarette use.
In a letter to the editor published in the New York Times, the Campaign for Tobacco-Free Kids supports President Obama's proposal to increase the federal cigarette excise tax by 94 cents in order to fund early childhood education programs. The revenues would be used to help expand pre-school programs. None of this money would be allocated for tobacco control or even other health-related programs.
The Rest of the Story
The state-of-the-art in tobacco control is the use of cigarette tax increases to fund comprehensive tobacco control programs. This is precisely what California did in 1989, and this is specifically why California has been so successful in reducing smoking prevalence. Unfortunately, this model is not being used any more, largely because the Campaign for Tobacco-Free Kids turned its back on this model. Instead, the Campaign decided to, in knee-jerk reflex fashion, support any and all cigarette tax increases, regardless of their underlying purpose or the use of the resulting revenue.
Why is it that so few states are funding their anti-smoking programs at
adequate levels? Part of the answer, believe it or not, is the actions
of the Campaign for Tobacco-Free Kids.
In the late 1990s, the Campaign made a decision to support increasing state cigarette taxes without
tying those tax increases to smoking-related spending. The Campaign
initiated campaigns throughout the country to increase cigarette taxes,
but did not insist that the revenues be allocated for treatment of
smoking-related diseases, research to prevent or cure smoking-related
diseases, or anti-smoking education and prevention programs.
As a result, numerous tax increases were enacted with no tie to
smoking-related programs. Thus, the public learned to dissociate the
two. The public also learned to distrust policy makers because they
failed to see the tobacco revenues being used for smoking-related
purposes. They saw the revenues simply being plopped into the general
Largely because of this, it is now very difficult to pass any cigarette
tax increase as the public trust is not there. Moreover, the idea of
using cigarette taxes for smoking programs has all but disappeared.
It is my belief that in no small way, the Campaign for Tobacco-Free Kids
is responsible for the devastation of statewide tobacco control in the
United States. The low allocation of state budget resources - especially
cigarette tax revenues - for anti-smoking programs is very much the
Campaign for Tobacco-Free Kids' doing.
In addition to undermining funding for tobacco control programs, this policy has the disastrous effect of permanently tying the provision of pre-school education to continued high rates of cigarette smoking.
In the future, what would happen if smoking rates dramatically drop? The
answer is that pre-school education programs would have to be cut
because of declines in cigarette tax revenue. Thus, the President's
proposal creates a situation in which the maintenance of pre-school
education becomes dependent on continued high rates of cigarette
This has several perverse effects. One is that it takes away any
incentive for the federal government to substantially cut cigarette
smoking. Doing so would result in de-funding pre-school education and
who would want to do that? A second effect is that it creates a
government dependence on cigarette smoking for one of the most critical
services that the government provides: pre-school education.
Essentially, this proposal would allow smokers to boast that it is
thanks to them that our nation's 4 year-olds are being educated. Can you
imagine bumper stickers like: "Support Pre-School Education: Smoke
Early and Often," or "I Support Kids: I Smoke."
This is how perverse the effects of the proposed tax would be.
Should the Congress increase the cigarette tax? Well, it depends on the purpose of the tax increase. If the money is used to fund pre-school education, then no. It makes no sense, it makes this essential program dependent on continued high rates of smoking, it removes the incentive for the government to substantially reduce smoking rates, it undermines the principle of spending tobacco revenues on tobacco control, and it is unfair to smokers to have to shoulder the burden of funding pre-kindergarten education programs.
But if the money were to be used specifically for anti-smoking programs, then it would truly become a win-win situation. The tax would not only decrease cigarette consumption but would provide much-needed funding for tobacco control. It would be fair to smokers, because much of the revenue would be used to directly benefit smokers, such as finding more effective treatments for smoking-related diseases and providing specific services to smokers. Moreover, if the revenues decline over time, the program needs less money because there are fewer smokers.
This is what the Campaign for Tobacco-Free Kids should be supporting, not balancing our federal budget on the backs of smokers.