Prevention Matters

The old joke goes that two men were being chased by a bear when one of them shouted to the other one: "What are we gonna do? We can't outrun that bear!" The second man replied: "I don't have to outrun him, I just have to outrun YOU!"

That seems to have been big tobacco's philosophy earlier this week during the debate over a hike in federal tobacco taxes. Sen. Jim Webb, D-Va., offered an amendment to cut the 61-cent-a-pack tax hike to only 37 cents, and make up the difference with a new system of taxing the income of partners in hedge funds as ordinary income.

Could big tobacco have been betting that, in the current economic climate, hedge fund managers are more despised among the American public than they are? Considering that Webb withdrew the amendment due to a lack of support, was it a bad gamble? Who outran the bear?

Shortly after President Obama agreed to remove family planning funding from the economic stimulus package that's before Congress, various forces began pushing him to do the same thing with tobacco cessation programs. The Senate version of the package contains $75 million for telephone quitlines and other cessation programs, which critics are deriding as pork.

Partnership President Corinne G. Husten, MD, MPH, today urged Senators overseeing the health section of the package to retain this funding on the grounds that the funding is good fisal policy as well as good public health policy. She said the programs would create jobs and help rebuild the public health infrastructure.

"Funding additional quitlines and cessation programs will help provide more of the services needed to empower people to quit smoking," Husten said in a letter to Sens. Tom Harkin, D-Iowa, and Arlen Specter. "Doing so will produce jobs to staff and promote the quitlines and other cessation programs. Given that smoking is responsible for over 400,000 deaths each year in the United States and for $193 billion annually in healthcare costs and lost worker productivity, this is no small matter."

Husten said the funding is consistent with the Center for Disease Control and Prevention’s (CDC) Best Practices, which calls for increasing support for state quitlines so that they have the infrastructure to provide comprehensive treatment to at least 10% of all tobacco users each year. She said it was also consistent with a Call for ACTTION (Access to Cessation Treatment for Tobacco In Our Nation) by a coalition of major business, labor, insurance, health care, and government institutions. The call is a plan to provide every American with access to comprehensive tobacco cessation treatment services by the year 2020.

While Congress still needs to resolve differences between the House and Senate version of the State Children’s Health Insurance Program (SCHIP) expansion, the goal of prevention advocates to raise the Federal tobacco excise tax to $1 per pack now seems assured. Both House and Senate versions of the bill include a 61 cent increase in the Federal cigarette excise tax (current tax is 39 cents) with similar increases in the tax on other tobacco products. Tobacco control experts believe the increase, which will fully fund the SCHIP program expansion, will help an estimated 1 million adult smokers to quit and two million kids from starting.

One remaining issue of concern for Partnership is the difference in how the House version of the bill treats the tax increase on so-called little cigars. Partnership believes little cigars, which look and are packaged identical to cigarettes except for a brown tobacco wrapper, should be taxed at the same rate as cigarettes; a provision that is contained in the Senate version of the bill. Final action on the legislation is expected to be swift with Congress committed to presenting a final bill to President Obama before the scheduled congressional district work period that begins February 16.

Sen. Jim Webb (D-VA) this evening withdrew his amendment to reduce a proposed increase in the federal tobacco tax from 61 cents to 37 cents. He sought to attach the amendment to a bill that would expand the State Children’s Health Insurance Program (SCHIP). Webb had proposed replacing that tobacco tax revenue with a new system of taxing the income of partners in investment management services firms (e.g., hedge funds) as ordinary income.

Thanks to all of you who contacted your senators and urged them to oppose this amendment.

By Diane Canova,
Managing Senior Fellow for Tobacco
Partnership for Prevention
dcanova@prevent.org

We have just learned that the Senate is expected to vote today on an amendment by Sen. Jim Webb (D-VA) to the State Children’s Health Insurance Program (SCHIP) bill that would only increase the federal tobacco tax by 37 cents, instead of the proposed 61 cents. This amendment would dramatically reduce the new federal tobacco product tax rates to fund expansion of the SCHIP legislation, substituting a new system of taxing the income of partners in investment management services firms (e.g., hedge funds) as ordinary income.

Tobacco taxes are not only a good way to raise revenue, but they are a proven deterrent to tobacco use. This increase combines good fiscal policy with good public health policy.

Please call your senators' offices today expressing your support of the full 61 cent cigarette tax and opposing the Webb amendment to lower the tax. Let us know if you have any questions or need more info.

Is individual, patient-based medical care the best way to improve health? Dr.Jonathan E. Fielding, chairman of the US Task Force on Community Prevention Services, says it's not. Dr. Fielding - who is also Director of the Los Angeles County Department of Public Health and Chairman of Partnership for Prevention's Board of Directors - discusses health reform on our first "Prevention Matters" podcast. Listen by clicking on the headphones to the right.

by Corinne G. Husten, MD, MPH, Partnership Prevention Interim President

When it comes to public health funding, President Obama’s economic stimulus package is exactly what the doctor ordered. It would provide the largest single increase in public health funding in the nation’s history. These critical appropriations will establish a community prevention infrastructure that will go far to help the nation reduce the leading drivers of chronic disease: poor nutrition, physical inactivity and tobacco use.

The plan, which is now before Congress, will result in an increase from nearly 100 prevention programs to as many as 800 programs in urban and rural communities across the nation. A Senate subcommittee has approved a version of the plan that would fund $5.8 billion for state and local programs, while the full House of representatives is slated to vote Wednesday on a version that would provide $3 billion.

This infusion of Federal funding will help implement the recommendations of the Task Force on Community Preventive Services and its nationally recognized Community Guide. The Task Force represents the nation’s only independent body dedicated to the evaluation of community prevention strategies based on systematic review of high quality research. More funding will enable the Task Force to eliminate its current backlog of research evaluations and establish a first class process for widely disseminating their findings to State and local stakeholders.

The Task Force on Community Preventive Services will play an essential role in helping communities identify priorities and select interventions that are the most effective interventions and provide the biggest health benefit. The success of community prevention will depend on the application of effective, research-based programs.