Are Kentucky Cigarette Prices to Blame for Smoking Rates?

Ten months after completing a smoking cessation class, Terrence Silver started smoking cigarettes again. It was his first attempt at quitting after smoking for 40 years. His biggest motivation to quit: cost.

“That was the primary reason I was going to quit, the money,” Silver said. “It wasn’t health, wasn’t that I didn’t like it. It was the money.”

Silver lives across the river in Jeffersonville, Indiana, where the tax on cigarettes is 99 cents per pack. So he comes to Kentucky to buy his cigarettes, where the tax is 60 cents.

Silver said when he took the smoking cessation class in April of 2015 — offered through the Metro Department of Public Health — he learned about his triggers: every time he gets in his car, he reaches for a cigarette.

In February of this year, he started smoking again. Silver said he’s now back to smoking a pack a day.

“I don’t know what it was,” he said. “I let my guard down; ‘maybe I’ll have one.’ And I got knocked out.”

The Cost of Smoking

Silver, now 60, has smoked since he was 20 years old. He said it hasn’t started affecting his health yet – he said he got a clean bill of health at his last physical.

But across Kentucky, 8,900 people die every year from causes directly tied to smoking. In 2014, Medicaid and other insurers paid almost $2 billion in claims related to smoking. 

Ellen Hahn, director of Kentucky Center for Smoke-free Policy at the University of Kentucky College of Nursing, said there’s been an effort in previous years by some state lawmakers to increase Kentucky’s cigarette tax.

“We know the price of a product does affect whether a person will use it or not,” she said. “The higher the price the less likely a person will use it.

Generally, a 10 percent increase in the price of a pack of cigarettes could result in a 2.5 to 5 percent decline in overall smoking, according to a policy brief last month in the journal, Health Affairs.

That means increasing the tax even by 6 cents could potentially mean 220,000 Kentuckians would stop smoking.

Kentucky collected $282.9 million in 2012 from the tobacco tax. Meanwhile, the state spent $39.2 million in 2014 on tobacco control programs like the toll-free hotline, cessation classes and anti-smoking marketing. That’s almost $20 million less than the Centers for Disease Control recommends the state spend.

“We’re severely underfunded in tobacco control, and that’s one of the reasons we have weak policies and high smoking rates,” Hahn said.

In 2014, 27 percent of Kentuckians were cigarette smokers. Robertson County – just south of Cincinnati – had the highest rate of smokers in the state at 42 percent.

Pushback

The Kentucky Farm Bureau is a main opponent of increasing the state cigarette tax. KFB argues that increasing the tax would mean less revenues for Kentucky because smokers might go to neighboring states to buy cheaper cigarettes.

Jeff Harper, director of public affairs at the KFB, said people like Terrence Silver generate more tax dollars for the state. And if the tax is increased and inches closer to the Indiana tax, people like Silver might start buying cigarettes in there.

“There’s a tipping point,” Harper said. “One could argue that if the tax goes up too high you’ll have the reverse effect, and the folks coming in from border states, and Kentucky residents, could pay Ohio and Indiana taxes.”

Neighboring Missouri has the lowest cigarette tax in the U.S. at 17 cents per pack. Virginia’s tax is the second lowest at 30 cents. Thirty-four states have a cigarette tax of $1 or more, including West Virginia, Ohio and Illinois.

Meanwhile, cigars, pipe tobacco, e-cigarettes and roll-your-own tobacco are not taxed. Harper said these products should be taxed just the same as cigarettes.

‘Just keep at it’

As for Terrence Silver, he said he’s going to give the smoking cessation program another try.

“Honestly, I want to go through the class again and give it all I got,” he said. “It was a good class, and I’ve heard a lot of people have to go through it more than once. I do think I can succeed if I just keep at it.”