If Maryland is going to tax cigarette smokers and say it's for their health, isn't the state obligated to spend some minimum amount to help them quit or prevent others from starting the habit in the first place? That was the argument heard in the State House a decade ago when the tax on cigarettes was raised to $1 a pack and lawmakers set a relatively modest mandate for anti-smoking programs.
Now, Gov. Martin O'Malley is looking to cut the state's $21 million minimum for tobacco prevention and cessation programs to a mere $7 million a year. In the midst of a recession, it's not hard to understand why - the governor wants more flexibility on where money goes when tax revenues have fallen so sharply.
Yet it's not as if smokers aren't paying. Between the now-$2-a-pack state tax on cigarettes and the state's share of the Cigarette Restitution Fund (the money from legal settlements with tobacco companies), Maryland will collect more than $1 billion next year.
The restitution money represents a refund for tobacco-related health care costs of the past. But while some of the $1 billion benefits smokers now (in terms of health care and cancer research, for instance), much of it winds up helping the state balance its budget.
Two years ago, the federal Centers for Disease Control and Prevention estimated how much Maryland should be spending on tobacco control. The minimum amount was $46.8 million. The governor's budget proposal would reduce it to less than one-sixth that; the cut would probably mean the loss of a toll-free "quitline," which provides counseling and referrals to smokers, and an end to school-based prevention programs.
Although it's certainly reasonable to reduce funding for various health programs in times of financial emergencies, it seems morally wrong for the state to set one of the nation's highest tobacco taxes and then choose to permanently reduce spending on cessation. Such a move might be interpreted by the cynical as an effort to keep smokers smoking - and paying taxes.
For all the taxes they pay, smokers create a real hardship on the health care system. Smoking costs about $2.2 billion each year in cancer and disease treatment, and about half that cost is usually billed to taxpayers. That makes spending an adequate amount on stop-smoking campaigns one of the smarter government investments around.