I recently was in one of my favorite cities, Nashville, Tennessee, when something that has struck me on previous visits struck me again. In so many places that my family and I walked, cigarette smoke filled the air.
While walking through a new arts district we passed smoker after smoker. As I sat on a bench outside a store on a chilly morning, a man smoked two feet from me. And each time we made the walk from our hotel to the parking lot we had to walk by a long line of smoky Joes.
Our son wasn’t accustomed to the smell and covered his nose as we made our way past the fumes. I took that as a good sign and I said to my wife at one point that when it comes to smoking, Indiana at least is doing better than Tennessee. That’s not surprising, as Tennessee is one of the nation’s top five tobacco-producing states.
In reality, though, Indiana is not achieving much when it comes to attacking or even addressing its dreadful smoking rate. And when I came home and checked the latest federal studies, I was disappointed to see that Indiana is not doing much better than Tennessee. Our state’s 21.1 percent smoking rate is barely one percentage point lower that Tennessee’s, and it’s the 10th highest in the country.
Worse, the smoking rate among pregnant women is 15.7 percent, according to the state Department of Health, and that’s nearly double the national rate.
Then there is this reality: Despite these depressing statistics, despite its great economic costs, and despite a state report that noted smoking “is the most preventable cause of death and disease,” our state government leaders continue to do little about it.
Bills to increase the cigarette tax die routinely at the Statehouse, as did a bill earlier this year to raise the age at which young people can buy cigarettes. This, even as the state found that cigarette-related health matters cost Indiana $3 billion annually in health care expenses alone, nearly $600 million of which is covered by Medicaid.
Indiana’s rate of smoking is “consistently higher than the U.S. median smoking (rate),” a document on the Department of Health’s website reads.
That gave me an idea. What if our state set a goal of reducing Indiana’s smoking rate to the national average of 17.1 percent? Doing that would cut our smoking rate by about 20 percent, equal to more than 200,000 people. When you think of how many people want to quit, and who would be boosted by a push, achieving this goal looks doable.
Many groups have pushed hard to get the state to act, but they’ve hit frustrating roadblocks. The Indiana Chamber of Commerce worked hard this year to get the legislature to increase the age at which Hoosiers can buy cigarettes from 18 to 21. The Richard M. Fairbanks Foundation has championed a call to aggressively attack what it rightly labels one of the state’s top public health crises, and a host of health advocates have made the case.
Still, little changes.
This is one of those situations where low-hanging fruit and years of inaction give Indiana a chance to make significant improvements with relative ease. Here are four easy steps we should take.
First, raise the cigarette tax, now one of the nation’s lowest, by a dollar. A Congressional Budget Office report notes that cigarette tax increases encourage people to both quit smoking and to smoke less. The greatest impact, its report found, was on young people. This increase has been proposed time and again, with support from members of both parties, but the legislature has so far refused to act.
Second, increase the age at which Hoosiers can buy cigarettes. House Republicans killed this idea earlier this year, pointing to what they said would be $14 million in lost revenue to the state. That’s lost revenue we should welcome, as it represents fewer young people buying cigarettes. The longterm savings would be tremendous.
Third, the state should reverse years of low spending on smoking-cessation programs. The last two-year budget increased spending from $5 million to $7.5 million a year, but that’s far below the CDC’s recommended level of spending on programs that are generally carried out at the local level.
Fourth, state lawmakers should stop accepting campaign contributions from cigarette companies. Over the past five years, Republican and Democratic state politicians and parties have taken in $185,000, collectively, from the nation’s top two cigarette companies. It’s legal. But why take their money? On this critical health issue, why do anything that makes it harder to make decisions that are in the best interests of Indiana?
More than anything, Indiana needs a leader willing to stand up and boldly declare that the reduction of our smoking rate is now a top goal of state policy. It could be the governor, the Speaker of the House or the next Senate leader.
So far, Indiana doesn’t have that leader. It’s a shame, because great improvements are waiting to be had, and apathy and inaction on this issue is costing Hoosiers greatly.