I Want You to Keep Smoking (Part 1).



Few things smell worse to me than the stank of a cigarette while trying to trying to load up on cholesterol via awesome blossom.  Perhaps one such thing is the beguiling tale of what perverse fate has befallen the gobs of cash money rewarded to state governments  from Big Tobacco. 

This seemingly righteous pursuit was fought by brave attorneys general of 46 various states to regain money we dished out to pay the costs of Medicaid patients who, due to tobacco use, found themselves in various state of wheeziness and/or infarction.  So naturally you’re asking  “why then did these same states  more recently try to help Big T in getting a recent settlement against it reduced?”  Good question.  Read on. . .

Background:  Smoking i s estimated to kill 440,000 people per year in the U.S.  To put this into perspective that’s the equivalent of ; (for Indians)  110,000 auto-rickshaws, (for white people) 440,000 full size suv’s, (for illegal immigrants)  44,000 windowless cargo vans, (for northern liberals) 5 New York giants’ stadiums worth of Celine Dion concerts). 

So it was only natural that we cheered our fair heroes as they pursued the feral beast that was (is) big tobacco to compensate us for the damage they had done to our Medicaid purses, oops I mean patients. And lo they were successful! Our public defenders brought home the bacon in the form of 206 billion to be paid out annually from the year 2000 to 2025 to the states. “Don’t worry!” they told us. The money would be used to pay for Medicaid expenses and for tobacco cessation programs. 

And that was important, because as we have seen from a study in NEJM looking at spending on smoking cessation in California, money spent on tobacco cessation directly affects smoking rates. Thus investment in smoking cessation programs directly reduces the amount of money spent on taking care of those whose health declines as a result of smoking. However, spending on smoking cessation has another unintended consequence: it reduces tobacco  and tobacco tax revenue. As that study suggested, when spending on tobacco cessation decreased in California, tobacco revenues increased a by a massive 1.4 billion over the period of study. The resulting increase in the number of deaths, due to cuts in tobacco cessation funding, could be quantified to the tune of an extra 8300 people dying in California alone.

So when does the government care more about helping Big Tobacco than preserving the lives of its own citizens? More in the next post. . .