BY: DR. ROBERT CRITTENDEN, M.D., M.P.H., AND BECKY KAVOUSSI, M.P.P.
Washington is hurtling toward an economic crisis, but it may not be the one you know about. Our youth are becoming addicted to cigarettes at an alarming clip, spelling chronic illness and premature death for thousands. At the same time, over 750,000 of our friends and neighbors are without health insurance and the numbers are growing. These are festering problems just waiting to erupt. And when they do, Washington will be faced with avoidable health care costs exceeding $1 billion each year.
Initiative 773, which will appear on Washingtonians’ ballots on Nov. 6, gives us the opportunity to dramatically improve the health and health care of the people in our state through a 60 cents increase per pack of cigarettes. The Office of Financial Management estimates that I-773 will generate over $155 million each year for Washington state. This new revenue will go to expand Basic Health Plan coverage to 50,000 additional people, fully fund the state’s Tobacco Prevention and Control Program, and finance low-income disease prevention programs.
Higher cigarette prices and a strong tobacco prevention program will quickly translate into fewer kids addicted to cigarettes and fewer cigarettes smoked throughout the state. Every single state that has raised tobacco taxes has generated millions in additional revenues while watching smoking rates plummet.
Kids are less willing and less able to pay higher prices for cigarettes, making price hikes exceptionally effective in deterring youth from taking up regular smoking. This is exactly why the tobacco industry will pour money into the campaign against I-773 and why those who care about the health of children and families like the American Heart Association, the American Lung Association and the American Cancer Society, all support I-773.
After Oregon raised the cost of a pack of cigarettes, youth smoking dropped by 41 percent. When California took similar steps, smoking rates among kids decreased 43 percent. In fact, in every state where the tobacco tax was increased in recent years, the result was the same — youth smoking rates declined every time. Bottom line: I-773 will reduce the number of kids addicted to tobacco.
Ninety percent of adult smokers start before the age of 18. The tobacco industry sees today’s kids as tomorrow’s pack-a-day smokers, spending over $150 million on persuasive advertising in Washington each and every year, or almost 10 times the current state budget for tobacco prevention! Tobacco marketing is the single most influential factor in getting kids to smoke — stronger than parental influence or peer pressure.
Kids are receiving a steady diet of tobacco advertising with no alternative messages because deep legislative cuts forced the elimination of school programs for grades K-4 and 10-12 from the state’s tobacco prevention and control program. The positive effects of comprehensive tobacco prevention programs have been documented in hundreds of studies. I-773 will fully fund Washington’s Tobacco Prevention and Control program to stop tobacco addiction before it starts.
The final gain for health in Washington will come from expansion of the Basic Health Plan, which is available in every county. Washington’s uninsured rate is now 16 percent, a rate higher than that for Arkansas, Alabama, and Kentucky, and higher than the national average as well. Seven of 10 uninsured individuals come from working families. Low-income workers are far less likely to have access to health care through work, but they often make too much money to qualify for Medicaid.
For these families, the Basic Health Plan is their only option, but funding shortages and program caps keep 400,000 eligible individuals shut out of the program. I-773 will extend no-frills Basic Health Plan insurance to 50,000 additional low-income adults who otherwise couldn’t afford preventative care or needed medical services like eyeglasses.
Both smoking and lack of health insurance are extremely costly. Smoking-related medical costs alone add up to over a billion dollars every single year in Washington. Without intervention today, we face a problem of much larger dimension tomorrow.
I-773 will expand access to health care to low-income people throughout the state, while simultaneously slashing youth addiction and tobacco-related health care costs. Rarely do we get the opportunity to save lives and money at the same time. We’ll be a healthier state if we take the chance while we still have it.
Dr. Robert Crittenden is the President of the Washington Academy of Family Physicians and Chief of Family Medicine Service at Harborview Medical Center. Becky Kavoussi is the Health Care Policy Associate at the Economic Opportunity Institute.
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