Officials for a state campaign aimed at ending tobacco use among California’s children are supporting a tobacco tax increase initiative for the November ballot that will raise the price of cigarettes and vaping products but giant tobacco companies are doing everything they can to stop it, they said. The Campaign for Tobacco Free Kids says companies like Altria/ Phillip Morris have already begun a counter campaign against the initiative, Prop 56, spending nearly $17 million to stop the increase. It’s in their best interest, John Schacter, communications director for the campaign told the Sentinel during a recent interview, since their main targets— kids and low income residents— are the most price conscious groups.
“[Statistics show] that ninety five percent of adult smokers started before they were 21,” Schacter said.
“If we can get people to 21 without smoking, they almost certainly never will. It is critical for the tobacco companies for their own bottom line, for their own profit, to keep addicting kids.
“There are internal documents from tobacco companies from decades ago, which refer to kids as ‘replacement smokers.’ They know that their products kill a half a million people a year. When you lose that many people to death, you need to replace them.
“As for which kids, they obviously want everyone they can get. But they spend large amounts of money for product placement, signage, coupons, discounts. There are so many more tobacco shops in low income areas, it’s reflection of the fact that they are more focused on the people in those areas…”
According to a 2014 Surgeon General report, smoking is directly correlated with income level and years of education. Since the release of their first report on smoking in 1964, smoking has become increasingly more concentrated among populations with lower incomes and fewer years of education. In the past, the highest income Americans smoked at levels even greater than the poorest; now they smoke at almost half the rate of those with the lowest income.
“Tobacco is the leading cause of death in the United States, killing 480,000 Americans every year,” said TFK officials.
“Another 16 million Americans suffer from a smoking-caused disease, disability, or other serious health problem. Thanks to the tobacco industry’s targeted marketing efforts, lower-income and less educated populations are particularly burdened by tobacco use: low-income people smoke more, suffer more, spend more, and die more from tobacco use.
“The tobacco industry has gone to great lengths to target lower income and racial and ethnic groups. Through market research and aggressive promotions, the industry has successfully penetrated these communities, and the industry’s ‘investment’ in these communities has had a destructive impact…”
For instance, a 2002 study published by the British Medical Journal revealed that tobacco companies directly advertised mentholated products to blacks. Within poor environments that had a greater quantity of African Americans, there were more interior and exterior tobacco advertisements in retail outlets than in predominantly white and middle-to-upper class communities. These were mentholated cigarette advertisements. Tobacco companies pushed mentholated cigarettes to these “poor and minority neighborhoods “not because they’re African American”, but “because they like menthol cigarettes.” In the late 90s, Philip Morris began testing a new version of their best selling Marlboro menthol brand in hopes of attracting more African American customers.
Direct advertising of mentholated tobacco products has had detrimental effects on the usage of cigarettes within the African American community, according to the study.
In 2013, the U.S. Food and Drug Administration (FDA) released a report that found menthol cigarettes led to increased smoking initiation among youth and young adults, greater addiction, and decreased success in quitting smoking. The agency concluded that, “these findings, combined with the evidence indicating that menthol’s cooling and anesthetic properties can reduce the harshness of cigarette smoke and the evidence indicating that menthol cigarettes are marketed as a smoother alternative to non-menthol cigarettes, make it likely that menthol cigarettes pose a public health risk above that seen with non-menthol cigarettes.”
Consequently, while smoking rates among African Americans are lower than national levels, this ethnic group suffers disproportionately from smoking-caused chronic and preventable diseases. Each year, approximately 45,000 African Americans die from a smoking-caused illness. An estimated 1.6 million African Americans alive today, who are now under the age of 18, will become regular smokers; and about 500,000 of these will die prematurely from a tobacco-related disease.
And now, say proponents, the tobacco companies’ ad dollars are being spent on a “very dishonest campaign” against the tobacco tax.
Opponents of 56 are advertising it as a “special interest tax grab” and say, instead of helping people to quit smoking like it claims, most of the revenue generated from the interest will go directly to health insurance companies.
Not so, said officials from the Yes on 56 Campaign.
“California taxpayers spend $3.58 billion-per-year to treat tobacco-related illnesses through Medi-Cal,” they said.
“The money raised by Prop 56 will help to offset some of these costs. The Medi-Cal revenue generated by Prop 56 must go to patient care—if insurers or providers don’t provide coverage or care to Medi-Cal patients, they don’t get the money. Medi-Cal managed care plans are governed by federal and state laws requiring that Medi-Cal managed care plans strictly limit spending on administration and profit and ensuring that at least 85 percent goes directly to medical care. These laws also require reporting on timely access to care, network adequacy, provider directories, and more.
“Since the passage of the Affordable Care Act, over 4 million people have been added to the Medi-Cal rolls. Despite this historic increase, Medi-Cal funding has been cut by both the state and federal governments. At the same time, Medi-Cal’s provider reimbursement rates are among the lowest in the nation, meaning providers are limited in their ability to serve Medi-Cal patients, many of whom have to travel long distances for care…”
This article was produced as a project for the California Health Journalism Fellowship, a program of the Center for Health Journalism at the USC Annenberg School for Communication and Journalism.