Saving lives through tax policy.

Increasingly, public policymakers have turned to taxing tobacco products as a method of raising revenue and saving lives. Last year, the American Heart Association (AHA), American Cancer Society, and American Lung Association, united as the Coalition on Smoking OR Health, embarked on what at the time appeared to be a long-shot public policy initiativeseeking to raise the cigarette tax by as much as $2 per pack, with corresponding increases for smokeless tobacco products, including chewing tobacco and snuff. However, since a Capitol Hill announcement of coalition plans at a January 1993 news conference, it has become increasingly likely that a significant excise tax increase will be enacted. Editorial boards at the nation's leading newspapers quickly lined up in support of the dual purpose of the increase. U.SA. Today wrote, "President Clinton says he's considering a big, new tax on tobacco to pay for health-care reform. And well he should. The idea is overdue. The tax could raise money and save thousands of lives a year .... What fairer way to get money than to tax behavior that adds billions of dollars to the USA's health-care burden?" An editorial in The Washington Post stated, "Taxing tobacco more heavilyas President Clinton suggested the other day-is a thoroughly good idea. It's a twofer. The tax not only would raise substantial amounts of money for a government that desperately needs it but would exercise greater pressure on people to cut down their smoking." A Post article headlined, "Monster Cigarette Tax of Up to $2 a Pack Is Said to Gain Support." During the past 10 years, our neighbors in Canada have used tax policy to secure great advances in the field of tobacco control. According to a June 1993 report from the Canadian Department of Finance, from 1980 through 1991, federal excise levies have increased by more than 550%, whereas provincial taxes have risen by more than 500%. From 1981 through 1989, the percentage of smokers (15 years of age and older) decreased from 40% to 32%. Tax increases have had an even greater effect on youth. In 1981, 45% of male teenagers smoked compared with 22% in 1989, a more than 50% decrease in consumption. From 1981 to 1991, overall Canadian tobacco consumption decreased by 36%. At the same time, tax revenue increased from $2 billion to $7.1 billion. According to the European Bureau for Action on Smoking Prevention, the First European Conference on Tobacco Policy (Madrid, November 1988), organized by the World Health Organization and the Commission of