Health Care Groups Join to Push Cigarette Tax Hike

SACRAMENTO —  A coalition of health care groups, hoping to discourage teen-agers from smoking, is organizing a campaign to triple the state’s tax on cigarettes.

In a burst of political activism, the American Lung Assn., the American Cancer Society, the California Medical Assn. and the American Heart Assn. have joined to back legislation and, if necessary, a statewide initiative to raise the cigarette tax from 10 cents a pack to 30 cents or more.

Money raised from the tax hike, estimated at more than $500 million annually, would be devoted under the coalition’s plan to tobacco-related programs, including cancer research, medical care and anti-smoking educational programs.

“The principal reason is not to raise money. The principal reason is to stop smoking,” said Jay D. Michael, a lobbyist for the medical association. “If a tax were imposed and it raised nothing, we would be delighted--that would mean nobody would be buying cigarettes.”

Last Raised in 1967

California’s cigarette tax was last increased in 1967 when the Legislature raised it from seven to 10 cents a pack. According to the coalition, only six states have lower cigarette taxes and four of those are tobacco-growing states. A jump of 20 cents would put California near the top, just behind Washington state, which has a tax of 31 cents a pack.

The tax-hike plan is based on the idea that smoking costs the taxpayers billions of dollars annually in medical care and lost productivity due to smoking-related illnesses--far more than taxes on tobacco take in.

The coalition is counting on winning support from a public that is increasingly opposed to smoking and concerned about the effects of second-hand smoke.

But the proposal is likely to pit anti-smoking activists and the health care community against politicians who oppose raising taxes, including Gov. George Deukmejian, who won reelection last year on an anti-tax hike platform.

And it is certain to arouse the opposition of the tobacco industry, which has donated substantial sums to California legislators and spent millions of dollars to defeat anti-smoking initiatives.

Tobacco Lobby Vows Fight

Brennan Moran, a spokeswoman for the Tobacco Institute in Washington, said the industry will fight any attempt--either in the Legislature or at the ballot box--to increase excise taxes on cigarettes, which already are one of the nation’s more heavily taxed products.

“Smokers pay more than their fair share of taxes,” she said.

During 1985 and 1986, the Tobacco Institute gave more than $133,000 in campaign contributions to Deukmejian and 73 of the state’s 120 legislators. In 1978 and 1980, the tobacco industry spent more than $8.7 million to defeat two initiatives that would have created smoking and nonsmoking areas in public places.

As a first step in pushing for the tax increase, Assemblyman Lloyd G. Connelly (D-Sacramento) plans to introduce legislation this month embodying the coalition’s proposal. Several issues must be worked out, Connelly said, including whether the proposed tax hike would be 20 or 25 cents a pack and how the new revenues would be divvied up among various programs.

Backers of the measure acknowledge that they have little chance of winning passage of the bill over the opposition of the tobacco industry and anti-tax-hike lawmakers. But the supporters believe that even if the Legislature rejects the idea, California voters would approve a statewide ballot measure to raise cigarette taxes.

The hope is that legislative debate on Connelly’s bill could help build popular support for the idea.

“It is our hope the Legislature would approve it,” Connelly said. “The history of such bills, however, is that it is unlikely the Legislature would do so. Believing that, it is our intention to go to an initiative and go directly to the people in 1988.”

In the short run, Connelly said, the tax hike would save more lives than would cleaning up all of the state’s toxic wastes or requiring motorists to wear seat belts.

Advocates of raising the tax in California point to studies showing that a 10% jump in the price of a pack of cigarettes would result in a 4% decrease in the number of smokers. The price of a pack of cigarettes now ranges from about 90 cents to $1.50.

The deterrent effect is even more pronounced among teen-agers, the study showed, with a 10% price hike resulting in a 14% decline in smoking. This is particularly important, health care representatives pointed out, because most people who smoke start the habit while they are teen-agers.

Half Start Before 13

“Ninety percent of smokers take up smoking before they reach age 20,” said Tim Shannon, a lobbyist for the California Medical Assn. “Fifty percent start before the age of 13.”

In California, the coalition estimates that an increase of 10 cents a pack would induce 300,000 Californians to quit smoking. Since one out of four smokers die of tobacco-related diseases such as emphysema, lung cancer and heart disease, a 10-cent tax hike could prevent 75,000 premature deaths, said Curt Mekemson, a spokesman for the American Lung Assn. The coalition had no estimates on the effect of a tax increase of 20 cents or more.

Underlying the tax-increase proposal is the belief that smokers ought to contribute a greater share of the cost society pays for their habit.

Smokers in California now pay taxes totaling more than 30 cents a pack--10 cents in state excise taxes, 16 cents in federal excise taxes and a 6% state sales tax.

According to a study by the Congressional Office of Technology Assessment, smoking costs the public $2.17 a pack when such factors as medical care, sick time and lost productivity due to tobacco-related illnesses are taken into account. “We all end up paying for the cost of smoking, whether you smoke or don’t smoke,” Mekemson said. “We pay for it in terms of higher taxes, higher product costs and in terms of insurance premiums.”

Cost Estimated

With 2.7 billion packs of cigarettes smoked in California a year, the social cost of smoking in the state is nearly $5.9 billion annually, said Mekemson, who recently worked on a successful campaign in Alaska to raise the cigarette tax from eight cents to 16 cents a pack.

Not surprisingly, the tobacco industry rejects the idea that smokers do not pay enough. Already, the nation’s smokers contribute $10 billion in taxes on tobacco, said Moran of the Tobacco Institute. “That’s $10 billion in taxes that goes into roads, schools and services that both smokers and nonsmokers enjoy,” she said.

Moran also questioned the assumptions used to calculate estimates of smoking’s cost to society, particularly the premise that smokers take more sick leave than nonsmokers. “I think that those economic assumptions should be looked at with a very skeptical eye,” she said.

The Tobacco Institute takes the position that the number of people who smoke would not substantially decline if the price of cigarettes were to go up. Nor would teen-agers be substantially affected by a tax increase, Moran said, since many youngsters obtain their cigarettes from adults instead of buying them for themselves.

“We don’t think a tax increase would lead to fewer smokers,” she said

Supporters Optimistic

Advocates of the tax hike proposal are optimistic that during an initiative campaign they could overcome the opposition of the tobacco industry. They believe that since 1980, when the last clean indoor air initiative was defeated, the public attitude toward smoking has changed.

During the last five years, more than 100 cities have enacted laws establishing smoking and non-smoking areas, said Betsy Hite, a spokeswoman for the American Cancer Society. Increasingly, businesses are acting on their own to restrict cigarette smoking in the workplace.

In addition, she said, nonsmokers’ concern over breathing second-hand smoke has increased with Surgeon General C. Everett Koop’s report in December that “involuntary smoking” can cause lung cancer even in those who do not smoke.

Hite’s view is bolstered by public opinion polls that show considerable support for raising the tax on both cigarettes and liquor. A nationwide Los Angeles Times Poll conducted in February, 1986, found that 81% of those surveyed would favor increasing taxes on tobacco and alcohol over raising other sources of government revenue.

“We really feel the time is right,” Hite said. “The costs to society are just too high for the revenue that’s brought in.”

See Major Support

If the cigarette tax proposal goes on the ballot in 1988, its backers believe that they can tap into major sources of support to counter the tobacco industry’s money.

The membership of the health care organizations involved in the coalition exceeds 4 million people, including many doctors and other health professionals. The coalition also includes environmental and consumer groups. And it may attract support from the insurance industry and other businesses concerned with the economic effects of cigarette smoking.

The tax hike sponsors hope to broaden their appeal by designating the expected revenue for programs that are popular with the public and specific constituencies likely to support the measure. This is a tactic used successfully in 1984 by sponsors of the California Lottery initiative, which gave the games’ proceeds partly to education.

All of the revenue from the tax increase would go for smoking-related programs, including medical care and cancer research, two items favored by the California Medical Assn. Another large portion would go to anti-smoking education programs, popular among other health-care groups in the coalition.

Broadening Appeal

Some money also could be designated for state park programs under the theory that cigarettes are responsible for starting many fires that destroy wilderness areas. This proposal would especially appeal to environmentalists.

Members of the coalition also said that the definition of smoking-related programs could be stretched to include care of the medically indigent, anti-drug education programs and aid to local governments, whose fire deparments fight house fires caused by cigarettes.

“We’ll have a very broad and very strong coalition,” Assemblyman Connelly said. “Everybody knows somebody that’s been killed by tobacco.”