Monday, April 08, 2013

President Obama Proposes Tying Pre-Kindergarten Education to Continued High Sales of Tobacco Products

Faced with a budget crisis and difficulty finding a way to fund pre-kindergarten education, President Obama has proposed to put the burden of funding pre-school education on the nation's smokers. His proposal would fund education programs for four year-olds from revenues derived from an increased tax on cigarettes and other tobacco products.

According to a Bloomberg article: "Obama’s 2014 budget proposal, to be released April 10, would finance a pre-kindergarten program for 4-year-olds with higher taxes on cigarettes and other tobacco products."

Also according to the article, anti-smoking groups are widely supporting the proposal:

"Anti-smoking organizations praised Obama’s proposal. “A significant tobacco-tax increase is a win-win-win for the country -- a health win that will reduce tobacco use and save lives, a financial win that will raise revenue to fund an important initiative and reduce tobacco-related health-care costs, and a political win that is popular with voters,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids in Washington."

The Campaign for Tobacco-Free Kids praised the proposal in its own press release, stating: "It is great news for our nation's health, and especially for the health of our children, that President Obama plans to propose an increase in the federal tobacco tax to pay for early childhood education initiatives."

In contrast, the cigarette companies are opposing the proposal:

"“It is unfair to single out adult tobacco consumers with another federal tobacco-tax increase to pay for a broad, new government-spending program,” said David Sutton, a spokesman for Richmond, Virginia-based tobacco-maker Altria Group Inc. (MO)."

The Rest of the Story

Ironically, I agree with Altria's statement and disagree with the Campaign for Tobacco-Free Kids' statement on this proposal.


For three major reasons:

1. The Tax Proposal is Unfair

First, it is unfair to put the burden of funding pre-school education on the nation's smokers, especially when they will pay the tax but will not benefit directly from it. Asking wealthier Americans or corporations to shoulder the burden of funding pre-school education is fair, but asking some of the poorest Americans to shoulder that burden is not.

Many smokers already spend 25% of their income on cigarettes and asking them to spend even more than that is not going to help their families or their children in any way.  We can blame the smokers all we want, but the reality is that all of us have various vices or unhealthy behaviors in which we engage. It is not fair to single out smokers every time we have a budget shortfall, unless the tax revenues will directly benefit smokers in some way (for example, by funding research and better treatment into smoking-related diseases).

David Sutton is right when he argues that it is not fair to single out smokers to pay for a "broad, new government-spending program." If this were a narrow program designed to address tobacco-related diseases specifically, then it would be fair. But since the revenues do not directly benefit smokers, it is an unfair proposal.

2. The Proposal Permanently Ties Pre-School Education to Continued High Rates of 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 smoking.

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.

3. The Proposal Undermines the Principle of Using Cigarette Tax Increases to Fund Comprehensive Anti-Smoking Campaigns that Directly Benefit Smokers

The gold standard in tobacco control is, or at least ought to be, the implementation of comprehensive anti-smoking campaigns which include programs that directly benefit smokers, such as providing encouragement or assistance with smoking cessation, improved screening and treatment for smoking-related diseases, and research into better treatments for these diseases. Such programs should implement best practices, such as providing "Pathways to Freedom" to all African American smokers who are trying to quit. They should implement anti-smoking media campaigns and should include support for specific tobacco control infrastructure and programs in communities of color. Cigarette taxes are an appropriate and fair way to fund these campaigns because although smokers shoulder the burden of funding the programs, they directly benefit from them. Also, the programs do not have perverse effects because there is no disincentive to reduce cigarette smoking. As smoking rates drop and revenue declines, the need for the revenue diminishes. Eventually, the goal of such programs is actually to put themselves "out of business."

By pushing this proposal, the anti-smoking groups - especially the Campaign for Tobacco-Free Kids - are continuing their erosion of the important principle that cigarette tax increases should only be supported if the revenue is used to directly benefit smokers. Cigarette tax increase proposals should include provisions that allocate the revenues specifically to smoking-related programs.

Stan Glantz has written two recent commentaries on his tobacco control blog that share my opinion that cigarette tax increases should only be supported by public health groups if the revenues are allocated to smoking-related purposes, including programs that will directly benefit smokers:

Commentary 1

Commentary 2

In the second commentary, Glantz summarizes his opinion, which accords with mine:

"I do, of course support increasing the tobacco tax. It is just that it has to be the right tobacco tax.
And what would a right tobacco tax look like?  All the money should go to pay for things related to smoking."

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