HJBR Nov/Dec 2019

Q&A 28 NOV / DEC 2019 I  Healthcare Journal of BATON ROUGE   them harder to purchase through cigarette taxes and increasing the legal age to pur- chase them. There is good evidence sup- porting the notion that these actions, if they are put into place, may decrease the overall smoking prevalence in Louisiana. I can cite two examples; first, the U.S. Institute of Medicine estimates that moving from 18 to 21 years of age for the legal age to smoke will decrease the smoking preva- lence by 12 percent over time. Second, rais- ing tobacco taxes is known to decrease the smoking prevalence by 2 percent for adult smokers, and 3.5 percent for youth smok- ers for every 10 percent increase in the retail cost of a pack of cigarettes. Louisiana’s cur- rent tobacco tax of $1.08 per pack ranks Louisiana as 36th among the U.S. states and the District of Columbia. The District of Columbia, at $4.50 per pack, is the highest among the 51 jurisdictions in the U.S., while the State of New York was a close second at $4.35 per pack. Missouri has the lowest tobacco tax of all states at $0.17 per pack. If Louisiana were to increase its tobacco tax from $1.08 to the average for the 50 states ($1.73/pack), the results would be between a 12 percent and a 21 percent decrease in the smoking prevalence. A 12 percent drop in the adult prevalence from 23.1 percent to 20.3 percent would improve the quality of life for about 126,000 Louisiana residents that today suffer the ill-effects of smoking. As for vaping/e-cigarettes, the Smoking Cessation Trust’s court order dictates that Trust benefits are available only to Loui- siana residents who started smoking cig- arettes before 09/01/1988. However, if an approved Trust member needs help, the specific cessation benefits provided by the Trust are recommended as a remedy for nicotine addiction, no matter which deliv- ery method was used. Therefore, if a Trust member (by definition, a nicotine-addicted individual) is vaping and smoking, then they can receive treatment to help them quit smoking that should work equally well to relieve them of the need to vape. Addition- ally, the Louisiana state quit-line (Quit with Us: 800-784-8669) is available to all Loui- siana citizens seeking help to stop smoking/ vaping. We at the Trust are deeply concerned that this migration to vaping/e-cigs via Juul and similar e-cig products, will create a whole new generation of cigarette smokers, per- haps re-igniting smoking in former smokers who quit some time ago, but who may still have nicotine-driven cravings. Vaping has the potential to undo the great work that has been accomplished over the past 10–15 years to reduce the smoking prevalence to near or below 15 percent nationally, and fall- ing—a tragedy by anyone’s measure. As we say at the Trust, “Don’t switch; quit!” Many states seem to be moving toward Tobacco 21 legislation. Do you think Louisi- ana will raise its tobacco purchase age to 21? A pretty good effort to make such a change was attempted in the Louisiana legislature this year. A form of Tobacco 21, the movement to pass new laws forbidding the sale or use of cigarettes/tobacco/e-cigs/ vaping (i.e., nicotine) to youths under the age of 21 years of age is now law in 18 states, and counting, and over 500 localities across the United States. It was introduced as House Bill 38 by Representative Frank Hoffmann, District 15, Monroe, in our 2019 session, and was approved by the House Health andWel- fare Committee, but was defeated on the House floor. It was officially supported by the Orleans ParishMedical Society, the Jef- ferson Parish Medical Society, the Smok- ing Cessation Trust, and many of the largest hospital providers across our state. Oddly, it was even supported by the tobacco industry itself, leaving many to wonder how it could have failed on the House floor. The Smoking Cessation Trust strongly encourages the citizens of Louisiana to join us in putting pressure on the state legisla- ture to make the needs of our youth a pri- ority. If this coalition of support continues to grow this year, and into the spring 2020 legislative session, we could possibly see our representatives do the right thing and pass Tobacco 21. How much is smoking costing Louisiana tax- payers and employers? It is time for the Louisiana public to get serious about the impact of smoking and other health-impacting lifestyle issues— what the CDC calls social determinants of health. “We at the Trust are deeply concerned that this migration to vaping/e-cigs via Juul and similar e-cig products, will cre- ate a whole new generation of cigarette smokers, perhaps re-igniting smoking in for- mer smokers who quit some time ago, but who may still have nicotine- driven cravings.”