Tobacco tax: For our children and grandchildren

Dear Editor:

Missouri's tobacco tax is 17 cents per pack, by far the lowest in the nation. The national average is $1.49 per pack. Proposition B on the November ballot adds a 73 cent tax to each pack of cigarettes. This new tax will generate more than $250 million, revenue specifically designated for elementary, high school and college education, as well as supporting tobacco prevention and cessation. Price increases at this level always lead to a reduction in cigarette smoking, together with spike in demand for smoking cessation programs.

But far more important is the enormous health benefit Proposition B will bring to our children for generations to come.

The key numbers to remember are 40,000, 1,800 and 3.

About 9 out of 10 lifetime smokers started smoking by age 18. Tobacco marketers spend more than a thousand advertising dollars for each child or adolescent smoker captured. Our children often become addicted before they have developed the mature judgment to understand the full implications of what they have done. There are 1.5 million children living in Missouri today, and about 300,000 of them are projected to become addicted smokers by age 18. However, conservative econometric estimates indicate that a 73 cent price increase will deter about 40,000 of today's Missouri children from becoming addicted smokers. And smoking, of course, would have affected their health for the rest of their lives. Early death occurs in half of all smokers, who will die an average of about 15 years ahead of their time.

Currently Missouri has one of the highest youth smoking rates in the country, leading to costly diseases: emphysema, chronic bronchitis, cancer, heart disease, asthma and stroke. Smoking also contributes to high blood pressure, erectile dysfunction and aging skin. Tobacco-related illnesses are estimated to cost every Missouri household $586 a year, which we pay through increased insurance premiums and taxes.

The damage to our grandchildren is every bit as worrisome. Our cigarette-smoking daughters will soon be having children of their own. Each year in Missouri, smoking causes about 1800 low birth weight and premature babies (450 preterm and 1350 underweight term births). Infants of mothers who smoke are also more likely to have school problems or mental retardation in later childhood. Based on Institute of Medicine estimates, the total lifetime medical and societal economic cost for 450 preterm infants in Missouri is more than $100 million each year.

How much will a cigarette smoker actually have to pay? A typical pack-a-day smoker spends about $1,600 per year for the habit, and the new tax will add another $267 per year. Proposition B opponents argue that 73 cents is an "outrageous 729 percent tax increase." However, the actual added cost is the same as just three cigarettes per day for the average smoker. Cut out three cigarettes and it costs nothing.

A "yes" vote on Proposition B in November is a vote for the health and well-being of both our children and our grandchildren, and it will improve education and lower health insurance costs for all. Rarely are we given such an opportunity to accomplish so much, so easily, for so many.

Michael Cooperstock, MD, MPH

Dr. Cooperstock is Professor of Pediatrics at Women's and Children's Hospital at the University of Missouri - Columbia. He writes as a representative of the Missouri Branch of the American Academy of Pediatrics. cooperstockm@missouri.edu