Oregon Study Suggests that Tobacco Tax Initiatives and Anti-Smoking Programs May Be Harming, Not Helping Lower-Income Populations

Although Oregon enacted a substantial cigarette tax increase in 1996, a new report shows that there has been no decrease in smoking prevalence among lower-income Oregonians, which remained steady at about 35% from 1996 through 2007.

The report found substantial declines in smoking prevalence among all adults and a striking decline in smoking among youth, but no significant change in smoking prevalence among adults earning less than $15,000 a year. Although the number of cigarettes sold in Oregon fell by 46% between 1996 and 2007, this doesn't translate into any reduction in smoking prevalence among the lowest-income Oregonians.

According to the Statesman Journal article, while lower-income individuals apparently did not benefit from the tax initiative and resulting programs, their families did suffer an economic burden, paying out a greater proportion of their income for cigarettes: "The report notes the economic impact of smoking hits lower-income families harder."Tobacco is so addictive that some Oregon families reduce the amount of money spent on food to buy cigarettes," it said."

The Rest of the Story

This report should serve as a cautionary note to anti-smoking groups which continue to indiscriminately support cigarette tax increases to fund state budget shortfalls. While reducing cigarette smoking is a public health priority, so is reducing income-based health disparities. The evidence from Oregon suggests that current anti-smoking strategies may actually be harming the poorest groups and increasing health disparities. These groups may end up spending more of their income on cigarettes, making it harder to buy food. At the same time, they appear not to benefit from the tax increase and programs, as smoking prevalence was unchanged among this group over a ten-year period.

It may be that addiction to cigarettes is higher among lower-income smokers and that these smokers are less sensitive to changes in cigarette prices, in contrast to the conventional wisdom, which holds the exact opposite. It also appears that for some reason, anti-smoking interventions are either not reaching or are not effective among lower-income populations in Oregon.

Clearly, anti-smoking programs need to altered so that they focus specifically on reaching and effectively impacting lower-income populations. In addition, anti-smoking groups need to consider the potential impact of cigarette tax increases on low-income families and not jump to support cigarette taxes as a means of funding every government program under the sun, especially if revenues are not specifically earmarked for anti-smoking programs, services, or treatment that focus on aiding low-income populations.