The Value of a $1.50 Tobacco Tax Increase in Kentucky

Erica Palmer Smith
By Erica Palmer Smith
Kentucky government relations director
American Cancer Society Cancer Action Network
Nov. 4, 2016

When my best friend, a high school English teacher, and I meet for dinner or a movie, we occasionally run into one of her students. She’s always glad to see them but if one of them is smoking, she’s left feeling heartbroken and worried.

In Kentucky, 17 percent of high schoolers smoke, third highest in the nation. Our kids buy or smoke an astonishing 11.4 million packs of cigarettes each year. Youthful experimentation frequently develops into regular smoking because of nicotine, a highly addictive drug to which still growing and developing teens are particularly vulnerable. As a result, almost all people who become lifetime tobacco users begin before graduating high school.

This year in Kentucky, an estimated 3,200 kids under the age of 18 will become new daily smokers. As the aunt of four high schoolers myself, I care deeply about stopping teens from smoking and one of the best ways to accomplish that is to raise the cost of tobacco products. Evidence proves, however, that the price increase must be large enough to deter kids from buying cigarettes or smokeless tobacco.

Why? When tobacco tax increases are less than a dollar per pack, the tobacco industry has proven they can absorb those price differences and offer discounts to shield smokers and young people from having to pay the increased cost, thus reducing the public health impact. Because of this, the American Cancer Society Cancer Action Network in Kentucky is calling for an increase of $1.50 per pack of cigarettes and an equivalent amount on all other tobacco products.

In the first full year following an increase in the tax by $1.50 per pack, it’s estimated that youth smoking would be reduced by about 17 percent and nearly 38,000 kids would never become adult smokers because most would never light up that first cigarette or tuck that first pinch of snuff between their lip and gum.

A tax increase of this size would also convince approximately 45,000 current adult smokers to quit, generate more than $327 million in new revenue and save an estimated $9.28 million in Medicaid costs over a five-year period.

For those who believe taxes like this are unfair to the poor, they have it backwards: it is the harms from smoking that are regressive. Because Kentuckians with lower incomes smoke at a higher rate, they suffer more from the cost of smoking-caused disease, disability and death.

So, by reducing smoking-related illnesses, they and their families are helped physically, emotionally and financially. And, new revenues from tobacco tax increases can be used to fund tobacco prevention and cessation programs that benefit low-income communities.

The sad reality is that tobacco remains the number one cause of preventable death in Kentucky. And, almost nobody tries smoking for the first time after the age of 18. The best way to reduce death and disease caused by tobacco use is to keep kids from ever starting to smoke in the first place.

Kentucky’s current tobacco tax, which hasn’t been raised since 2009, ranks 43rd and stands 275 percent below the national average, creating real price incentives for Kentucky youth to start a lifetime of addiction. This has to change if we want to make a difference.

Let’s do our part and raise the tobacco tax by $1.50 per pack. That way, the next time I am out with my friend, we won’t be forced to watch another heart-breaking sequel involving Kentucky’s high school students.

The writer can be reached at 859-260-8284 or

Hopkinsville paper calls for smoking ban to save money

Kentucky New Era, Jan. 6, 2016

A new poll about attitudes toward smoke-free legislation in Kentucky confirms what has been clear for at least a few years now. Most adults — 66 percent, according to the Kentucky Health Impact Poll released Monday — support a statewide ban on smoking for indoor public places.

Unfortunately, some state lawmakers have stubbornly resisted public opinion, along with overwhelming health and financial considerations, in the debate over passing legislation to protect Kentuckians from secondhand smoke in restaurants, stores and offices.

As the General Assembly convenes this week in Frankfort, there ought to be some hope that 2016 will be the year Kentucky breaks this deadlock.

The key to winning passage could start with a recognition of the economic toll smoking takes on state governmentand Kentucky businesses. Medical costs related to tobacco use exceed $1.9 billion annually, and nearly $500 million of that is covered by Medicaid, according to Smoke-Free Kentucky.

Reducing these expenses would make a great deal of sense as Gov. Matt Bevin formulates plans for changing his predecessor’s Medicaid expansion under Obamacare. Given the poll results about support for a statewide smoking ban, Bevin wouldn’t risk any political capital with Kentuckians if he encourages the Republican Senate to pass the legislation. His support would be grounded in fiscal responsibility.

The Republican Senate has been the last obstacle for a smoke-free bill. A year ago, the House narrowly passed a statewide ban but the Senate failed to advance the bill out of committee.

For two straight years, Republican leaders have assigned the legislation to a committee chaired by a lawmaker they knew would let the bill die in committee. In 2014, it was the Judiciary Committee chaired by Sen. Whitney Westerfield, R-Hopkinsville. Last year, it was assigned to the Veterans, Military Affairs and Public Protection Committee, headed by Sen. Albert Robinson, R-London.

The proper assignment would be the Senate Health and Welfare Committee, chaired by Sen. Julie Raque Adams, R-Louisville. She supports the measure and would ensure it gets a fair hearing.

Although 24 communities have passed comprehensive bans, Smoke-Free Kentucky estimates 67 percent of the state’s residents live in an area without protection from secondhand smoke in public indoor places.

It’s time to provide protection to the entire state and to reduce the cost of treating tobacco-related illnesses. Kentucky can no longer afford this burden.

Ky. Rural Health Assn. calls for statewide smoking ban

By Tina McCormick
Executive director, Kentucky Rural Health Association,

Last year, we had many letters to the editor written urging Kentuckians to become engaged in the Smoke-Free Legislation. As the executive director of the Kentucky Rural Health Association, I am requesting all Kentuckians, to contact your elected state officials to support a strong, statewide, smoke-free workplace law during the 2015 Kentucky General Assembly session.

It’s time for Kentucky to join the growing number of states, counties, and cities that have enacted smoke-free laws that apply to all workplaces and public places, including restaurants and bars. Twenty-four states and nearly 500 municipalities have enacted such laws. Nearly half of the U.S. population now lives in areas with this important health protection.

Regrettably, many residents and workers in Kentucky do not yet have the right to breathe clean, smoke-free air. Too often when they enter a workplace or public establishment, Kentuckians are still exposed to harmful secondhand smoke, which contains more than 7,000 chemicals, including hundreds that are toxic and at least 70 that are proven to cause cancer. In addition to the danger to public health, secondhand smoke also harms Kentucky’s business image. That’s why the Kentucky Chamber of Commerce has joined hundreds of health and medical organizations and community groups in supporting a state law to make all indoor workplaces smoke-free.

The good news is that about 31% of Kentuckians are protected by comprehensive, smoke-free laws or regulations passed at the city or county level. These laws are an appropriate response from local leaders to the overwhelming scientific evidence that secondhand smoke is a serious health hazard that causes heart disease, lung cancer, and other serious illnesses. As smoke-free laws have spread, the evidence in Kentucky is that these laws protect health without harming business in bars, restaurants, and other hospitality venues.

As Kentucky legislators again prepare to consider smoke-free legislation, I want to share with you the evidence that secondhand smoke is hazardous to human health and that smoke-free laws protect health without harming business. I also want to share information about the Kentucky Rural Health Association, and other members of the Smoke-Free Kentucky coalition, advocating for a comprehensive, smoke-free law that applies to all workplaces and public places and is free of exemptions that would leave some people exposed.

Secondhand smoke is a serious health hazard

There is now overwhelming and irrefutable evidence that secondhand smoke harms human health. As the U.S. Surgeon General stated when releasing a landmark 2006 report on secondhand smoke, “The debate is over. The science is clear. Secondhand smoke is a serious health hazard that causes premature death and disease in children and non-smoking adults.” In 2010, the Surgeon General’s Report confirmed that even a little bit of tobacco smoke causes damage to DNA, blood vessels, and lung tissue. The Surgeon General’s conclusions from both reports include:
• Secondhand smoke is a toxic mix of more than 7,000 chemicals that attack every organ in the body.
• Secondhand smoke causes lung cancer and heart disease in non-smoking adults and respiratory and ear infections, more severe asthma attacks, sudden infant death syndrome, and low birth weight in children. According to the Centers for Disease Control and Prevention, nearly 50,000 Americans die each year from lung cancer and heart disease caused by secondhand smoke exposure.
• There is no safe level of exposure to secondhand smoke. Even brief exposure can trigger immediate, harmful changes in the cardiovascular system that increase risk of heart attack or stroke.
• The only way to protect non-smokers from secondhand smoke is to require smoke-free workplaces and public places. Other approaches, such as air ventilation systems and smoking and non-smoking sections, do not work.
These findings lead to one clear conclusion: no one should have to put up with the serious health risks of secondhand smoke in order to earn a living or enjoy an evening at a bar or restaurant.

Smoke-free laws protect health without harming business

As we debate smoke-free legislation, opponents continue to make the usual, unfounded arguments that smoke-free laws hurt business. These arguments are not supported by the facts. Dozens of scientific studies and the experience of the growing number of smoke-free states and cities all show the same thing: smoke-free laws at worst have no impact on the restaurant and bar business and even have a positive impact in some cases. This conclusion is based on comparisons of objective economic data, such as employment, sales, and profits, before and after smoke-free laws take effect. As the Surgeon General’s 2006 report concluded, “Evidence from peer-reviewed studies shows that smoke-free policies and regulations do not have an adverse economic impact on the hospitality industry.”

In Lexington, which went smoke-free in April 2004, a study concluded, “In general, selected key business indicators in Lexington restaurants, bars and hotels have not been affected by the smoke-free law.” The same was true of an economic study that examined the economic impact on northern Kentucky border counties when Ohio went smoke-free.

These findings are not surprising given the strong public support for smoke-free laws and strong preference for smoke-free establishments. A 2014 poll found that Kentucky voters support a statewide smoke-free law by a 65% to 29% margin. The Zagat Survey, the authoritative survey of restaurant dining trends, has consistently found that consumers strongly prefer smoke-free restaurants. The 2008 Zagat Survey of 132,000 Americans showed 77% of diners said they'd eat out less if smoking were permitted in local restaurants, and only 2% saying they'd dine out more.

Smoke-free laws that are comprehensive are also the most effective

Kentucky can learn from other states that passed partial, smoke-free laws in the past. Many were challenged in the courts, often because they exempted certain businesses, forcing states to fund costly legal battles. When exemptions have not been overturned, states often have a difficult time with enforcement due to confusion over which businesses are covered and which have been granted an exemption. They often have costly and complicated systems for approving exemptions and conducting compliance checks. When all indoor workplaces are covered, the law is easily understood and the public and business owners are often required to do little more than ask smokers to step outside.

In summary, smoke-free laws have been unmitigated and popular successes here in Kentucky at the local level and virtually everywhere they have been implemented. Comprehensive laws protect everyone equally, achieve nearly universal compliance, and improve air quality and the health of workers almost immediately. Finally, the hospitality industry thrives – despite claims to the contrary – and the public appreciates smoke-free laws.

To contact your elected state officials and let them know that you support the smoke-free initiative, visit or call 1-800-372-7181.
Governor's focus on health deserves another round of applause in an unhealthy state
By Jane Chiles
Friedell Committee for Health System Transformation
The headliners in Gov. Steve Beshear’s State of the Commonwealth speech Tuesday were all worth the ink they received in the next day’s newspapers
. Casinos. Pensions. Tax reform.
They were also familiar. This was the governor’s seventh such speech and the seventh round of gubernatorial attention for most of these issues.
But tucked into the 2014 speech was something different. It was this urgent observation that our state’s “collective health stubbornly remains among the worst in the nation.” Lest anyone miss the point, he made it again: “Kentucky ranks among the worst, if not the worst, in almost every major health category, from smoking to cancer deaths, preventable hospitalizations, cardiovascular and cardiac heart disease and diabetes."
It was blunt assessment of what former University of Kentucky President Lee Todd once labeled the Kentucky uglies – a sobriquet he explained like this: “In my mind, the uglies are the things that have held us back for years but that we didn't want to talk about. Things like being the leader in lung cancer, obesity, diabetes...."
It mattered. His university began to think of  strategies to erase them. It is no accident that UK, in the heart of tobacco country, became a statewide leader in smoking abatement, guiding communities that wanted to pass smoking bans in the interest of public health.
It will matter as much – perhaps more – that Gov. Beshear has been frank with us about the health deficiencies that we know exist but pretend do not. Within a day of his speech, he  announced a $1.7 million federal grant to go after the leading uglies – obesity, diabetes, stroke, heart disease and high blood pressure – to " support our goal of improving our dismal health statistics."
Dismal indeed.
We were the 45th least healthy state in the 2013 edition of America’s Health Rankings, the bible of state health statistics. That same report lists Kentucky as first among the states for smoking, a deathly status that we can’t shake even as we watch our friends and family suffer through the horrors smoking’s other fatal consequences.
Thank God, for Mississippi – that faint praise with which we so often soothe ourselves –  soothes in only some categories of health. At 50th, Mississippi is worse overall. But when it comes to cancer rates, the Magnolia State (49th) can thank the deity for the Bluegrass State (50th). Worse yet is drug deaths. Mississippi is 18th to our 47th.
What to do about the uglies? The Friedell Committee for Health has been convening health professionals and laymen over the past year to ask that question. The solutions will require resources and time. We need a commitment in Frankfort. But we also need a community commitment.
Here’s the good news: We have an existing infrastructure for a state and community collaboration. We have a health department in each of our 120 counties. Their mission, guided by state statute and a state Department for Public Health, has been transformed in recent years. They still combat communicable diseases, provide health screenings and services and protect us with restaurant and other inspections. But the best of our health departments have also taken on the enormous task of keeping communities healthy by influencing the social, environmental and economic conditions affecting population health.
We need more of that.
Why bother? Isn’t health an individual thing. You want to smoke? Smoke. You want to supersize your soda? It’s a free country. But here’s the thing: Improved population health links directly to improved education and vice versa. Likewise, for economic vitality. If we want a prosperous, smarter Kentucky ready to compete with the world, we need a healthy Kentucky.
Here is how America’s Health Rankings put that: “In Kentucky, 47.1 percent of adults aged 25 years and older with at least a high school education report their health is very good or excellent compared to only 17.9 percent with less than a high school education, resulting in a gap of 29.2 percent.”
Healthy, wealthy and wise. Inseparable. Tuesday, Gov. Beshear gave this the attention it deserves. Robust applause followed his closing call to action, “We need to take bold, decisive action to build a healthier, more educated and better trained population. And together, I believe we can.”
That, friends, deserves a second round of applause.

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