After years of decline, smoking is on the rise in New York City. While pointing to reductions in state and city spending on anti-smoking campaigns, advocates hope this Thursday, November 20, will be a turning point as smokers in New York and elsewhere are encouraged to decline lighting up for American Cancer Society's Great American Smokeout.
Anti-smoking groups hope smokers will keep their resolve going after Thursday and bring down New York City's smoking rate, which crept up from 14 percent in 2010 to 16 percent in 2013 despite bans on smoking in bars, restaurants and other places, and one of the highest taxes on a pack of cigarettes in any municipality.
To blame, some say, is the reduction in funding toward tobacco control programs in the state. This has led to a drop in airing graphic anti-smoking commercials, which anti-smoking groups say were effective in bringing the smoking rate down last decade.
Ads show a man coughing violently while blood drips in a sink, a woman discussing her various amputations, and photos of Terrie as a pretty young cheerleader who is now shown putting on her voice box and adjusting her wig. A postscript at the end of the commercial tells viewers she died at age 53.
"They are very effective," said Michael Burgess, director of government relations in New York for the Cancer Action Network of the American Cancer Society. "Most people want to quit smoking. The more that you bring people face to face with it, that brings them to the point where they think, 'I better do something about this.'"
Just a few years ago, the anti-smoking commercials were blitzing the airwaves. "You're seeing them less often because the state, as well as the city tobacco program, have cut their funding dramatically over the last 5 years," said Kevin O'Flaherty Northeast region advocacy director for the Campaign for Smoke-Free Kids. Five years ago, the state allocation for tobacco control programs was $85 million. This year, the amount dropped to $39.3 million. The amount for 2015 has not been released.
In New York City, the Department of Health has seen its budget cut incrementally in the last five years, from $13.5 million in 2009 to just over half that amount at $7.1 million for this fiscal year.
Fewer airings of the anti-smoking commercials also result in fewer calls to the New York State Smokers' Quitline. Data from the Quitline for 2009 to 2012 show that calls from the Bronx dropped 23 percent and calls from Queens saw a 21 percent reduction. Overall in the city, there was a 22 percent decline in the number of calls.
Taxes and the tobacco industry
Ironically, the tobacco industry funds New York's and most other states' tobacco prevention programs. In 1998, the Attorneys General of 46 states reached an agreement with the four largest U.S. tobacco companies (Philip Morris, R.J. Reynolds, Brown & Williamson, and Lorillard), as well as the industry's trade associations and PR firms, to settle lawsuits against the tobacco industry regarding the medical costs associated with treating tobacco-related illnesses.
The Tobacco Master Settlement Agreement left the tobacco industry immune from future state and federal suits and required the participating tobacco companies to pay approximately $200 billion to the states over the next 25 years to help cover healthcare costs associated with smoking. But much to the chagrin of anti-smoking advocates, the agreement did not place any restrictions on how states spent the funds.
"In 1998 when the master tobacco settlement agreement was signed, all the states acted like they were going to take the lion's share of this money, if not all of it, and dedicate it to tobacco prevention," said O'Flaherty. "And almost immediately they started spending it on anything but prevention.
They take the check and put it in the general fund. There's really no way to say what of this money is going toward prevention and what is going for golf courses or pot holes or anything else that the state, in its infinite wisdom, has decided to spend money on over the last 15 years."
Smokers also fund anti-smoking programs through the state tax of $4.35 and New York City tax of $1.50 per pack of cigarettes. City residents paid the highest state and city taxes in the country until the Chicago City Council approved a city tax hike on cigarettes last fall, making their combined state and city tobacco taxes $6.16, the highest in the nation.
According to the Council of State Governments, New York State collected $1.632 billion in cigarette tax revenue in 2013. However, the funds are not all earmarked toward tobacco control programs. With the last state tax increase on cigarettes in 2010, $440 million was allocated toward healthcare programs, including subsidies for AIDS drugs, money for tobacco cessation programs, and $71.6 million for the state cancer research center in Buffalo.
"Research shows that if the State were spending more money on smoking cessation activities, not only would we have a lower smoking rate, but the State would be saving more in terms of what it spends in long-term health costs," said O'Flaherty. "These programs literally do pay for themselves and they do it in a way that morally make sense."
Higher tobacco prices should also bring down smoking rates. According to The Centers for Disease Control and Prevention, a 10 percent increase in the price of cigarettes reduces consumption by 3 to 5 percent and deters youth from picking up the smoking habit. Last November, former Mayor Michael Bloomberg signed what became known as local law 97, which created higher prices for cigarette and tobacco products in New York City and required age restriction signs stating that some tobacco products cannot be sold to people under the age of 18, and for some, 21.
But increasing the price of cigarettes (to about $14 a pack) can also backfire with smokers who may seek out other ways to get cheaper smokes. According to a 2013 report by Pew Charitable Trusts, states with high tobacco taxes lost about $5 billion in 2010 revenue because of cigarette smuggling. The report notes that most of the black market in cigarettes occurs when smugglers purchase cigarettes in a low-tax state and transport them to a high-tax state. They then sell them at a discount to smokers, pocketing a healthy profit. The loss of revenue due to smuggling also affects the monies states receive from the Master Settlement Agreement since the amount is based on legal consumption figures.
To combat the loss of revenue from cigarette smuggling, local law 97 defines a retail dealer as any person who possesses or transports more than 400 cigarettes, prohibits the sale of cigarette or tobacco products for less than the listed price and from anyone other than a manufacturer or licensed dealer, and requires retailers to post a sign stating that all cigarettes sold in New York City must be in packages bearing valid New York City and State tax stamps.
Some smokers have also responded to the higher prices by smoking fewer cigarettes per day. The Department of Health reports that while there has been a decrease in the proportion of heavy smokers, there has been an uptick in the numbers of non-daily and light smokers who smoke 10 or fewer cigarettes per day. That group now makes up 76 percent of the New York City smoking population, compared with 64 percent in 2002.
Non-daily smokers are now the target of the Health Department's new media campaign, Imagine for Life, which was produced at a cost of $835,700.
"There is no acceptable level of smoking," cautioned Burgess. "Even if you consider yourself a social smoker, there are health risks and your level of smoking can increase."
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by Hayley Camacho for Gotham Gazette
@GothamGazette
