Pass the 70 cent tax increase on cigarettes in Kentucky
Michael Bousamra, II, M.D.
Head of Thoracic Surgery, James Graham Brown Cancer Center
Director of Lung Transplantation, Jewish Hospital
Our state legislators in Frankfort are debating a 70 cent tax increase on cigarettes in the face of a large budget deficit relative to current expenditures. A reflex prohibition against this tax revenue will jeopardize recently gained, and long overdue improvements in education and compromise already substandard health care for thousands of Kentuckians. The simple cry of “no new taxes” rings hollow when we consider the justification for this measure. Allow me to present my perspective as a physician and thoracic surgeon who regularly treats the end results of smoking.
First the facts. Over the past decade at least fifty thousand Kentuckians have died an early death from smoking. Half of these deaths are due to lung cancer. Emphysema, and chronic bronchitis comprise about 15% of the total. Heart disease, stroke and other cancers throughout the body make up the remainder. Smoking cuts life short by an average of ten years and costs us hundreds of millions of dollars in health care expenditures annually. The common perception is that only older individuals are affected, but that view is mistaken. Because our youth start smoking at a young age, our citizens die much earlier. Kentucky lung cancer death rates for individuals 40 to 55 years are almost double the national average. The point is driven home by what I call the 90-90-90 rule. Ninety percent of lung cancer is caused by smoking. Ninety percent of lung cancer patients ultimately die of their disease, and most abhorrently, 90% started smoking before they were 21. In turn, we should do all we can to dissuade our youth from smoking.
Over the past fifteen years I have operated on and cared for hundreds of patients with lung cancer and have performed scores of lung transplants on patients with end stage lung disease. I love caring for these men and women who face life threatening diseases with courage and faith. Almost everyone wishes they had never started smoking when they were very young. Many wished they could have quit smoking long ago. Few scenarios bring more pain to patient and family than a fifty year old husband and father in whom the surgeon has biopsied unresectable, incurable lung cancer. With head hung low, bad news is delivered. In searching for reasons, the questions “why?” and “how did this happen?” are asked. The raw, blood stained truth is smoking--smoking since the early teen years. And family members who smoke are at particular risk of developing the same disease. This is a recurring scene in medicine and surgery. Because it is so negative it is not emphasized enough, but it is the rude reality. Given our limitations to cure these diseases, it is the responsibility of physicians and the community to do all we can to alter the root cause of these problems.
It is well known and beyond dispute that increasing the cost of smoking is the most effective measure to get at this “root cause” because it will reduce smoking especially among adolescents, teens and pregnant women. Public health experts estimate that thousands of young Kentuckians will not take up this fatal habit if a 70 cent tax hike is instituted. Lesser measures will be much less effective because a significant cost threshold is not met with a 25 cent increase. Since we have the highest smoking rates for adults and youths in America, this measure is long overdue.
The general health of Kentuckians is among the lowest in America and this predicament is almost solely due to smoking. The disease mechanism should pay for itself with a tax commensurate with the health burden it inflicts. Although unpopular to say so, smokers don’t pay their own way with respect to health care. It is not uncommon for me to evaluate a patient with lung cancer, who has already undergone a heart bypass, a carotid “clean out”, and who takes five medicines for lung disease-- and they are still smoking! A large proportion of smokers utilize subsidized health care, and few people, regardless of income, actually pay enough in health insurance to fully compensate for such expenses. A significant cigarette tax is a fair way for smokers to pay for their consumption of community health resources.
I hope the Kentucky Assembly, the Governor and all involved in this important decision will pass the full tax increase of 70 cents. We can and must improve our State’s welfare.
This is no time for backsliding on health and education; no time to “wallow in the mire” of petty politics. Regardless of political affiliation, the argument for the greater good takes precedence. It lies in the undisputed fact that a 70 cent increase in the cigarette tax will result in fewer young smokers and tremendous health benefits to our Commonwealth. It is just. It is time. Let’s have the courage and foresight do what is right for Kentucky.
Head of Thoracic Surgery, James Graham Brown Cancer Center
Director of Lung Transplantation, Jewish Hospital
Our state legislators in Frankfort are debating a 70 cent tax increase on cigarettes in the face of a large budget deficit relative to current expenditures. A reflex prohibition against this tax revenue will jeopardize recently gained, and long overdue improvements in education and compromise already substandard health care for thousands of Kentuckians. The simple cry of “no new taxes” rings hollow when we consider the justification for this measure. Allow me to present my perspective as a physician and thoracic surgeon who regularly treats the end results of smoking.
First the facts. Over the past decade at least fifty thousand Kentuckians have died an early death from smoking. Half of these deaths are due to lung cancer. Emphysema, and chronic bronchitis comprise about 15% of the total. Heart disease, stroke and other cancers throughout the body make up the remainder. Smoking cuts life short by an average of ten years and costs us hundreds of millions of dollars in health care expenditures annually. The common perception is that only older individuals are affected, but that view is mistaken. Because our youth start smoking at a young age, our citizens die much earlier. Kentucky lung cancer death rates for individuals 40 to 55 years are almost double the national average. The point is driven home by what I call the 90-90-90 rule. Ninety percent of lung cancer is caused by smoking. Ninety percent of lung cancer patients ultimately die of their disease, and most abhorrently, 90% started smoking before they were 21. In turn, we should do all we can to dissuade our youth from smoking.
Over the past fifteen years I have operated on and cared for hundreds of patients with lung cancer and have performed scores of lung transplants on patients with end stage lung disease. I love caring for these men and women who face life threatening diseases with courage and faith. Almost everyone wishes they had never started smoking when they were very young. Many wished they could have quit smoking long ago. Few scenarios bring more pain to patient and family than a fifty year old husband and father in whom the surgeon has biopsied unresectable, incurable lung cancer. With head hung low, bad news is delivered. In searching for reasons, the questions “why?” and “how did this happen?” are asked. The raw, blood stained truth is smoking--smoking since the early teen years. And family members who smoke are at particular risk of developing the same disease. This is a recurring scene in medicine and surgery. Because it is so negative it is not emphasized enough, but it is the rude reality. Given our limitations to cure these diseases, it is the responsibility of physicians and the community to do all we can to alter the root cause of these problems.
It is well known and beyond dispute that increasing the cost of smoking is the most effective measure to get at this “root cause” because it will reduce smoking especially among adolescents, teens and pregnant women. Public health experts estimate that thousands of young Kentuckians will not take up this fatal habit if a 70 cent tax hike is instituted. Lesser measures will be much less effective because a significant cost threshold is not met with a 25 cent increase. Since we have the highest smoking rates for adults and youths in America, this measure is long overdue.
The general health of Kentuckians is among the lowest in America and this predicament is almost solely due to smoking. The disease mechanism should pay for itself with a tax commensurate with the health burden it inflicts. Although unpopular to say so, smokers don’t pay their own way with respect to health care. It is not uncommon for me to evaluate a patient with lung cancer, who has already undergone a heart bypass, a carotid “clean out”, and who takes five medicines for lung disease-- and they are still smoking! A large proportion of smokers utilize subsidized health care, and few people, regardless of income, actually pay enough in health insurance to fully compensate for such expenses. A significant cigarette tax is a fair way for smokers to pay for their consumption of community health resources.
I hope the Kentucky Assembly, the Governor and all involved in this important decision will pass the full tax increase of 70 cents. We can and must improve our State’s welfare.
This is no time for backsliding on health and education; no time to “wallow in the mire” of petty politics. Regardless of political affiliation, the argument for the greater good takes precedence. It lies in the undisputed fact that a 70 cent increase in the cigarette tax will result in fewer young smokers and tremendous health benefits to our Commonwealth. It is just. It is time. Let’s have the courage and foresight do what is right for Kentucky.
posted by Dr. Michael Bousamra at
8:08 AM
<< Home