We're Smoking Mad at Politicos and Big Tobacco

It takes a lot to make us mad, but we're furious: Here we are with a brand-spanking-new healthcare law, yet for the first time since 1960, smoking rates are increasing. Why?

• Legislators are taking money AWAY from stop-smoking programs.
• 85% of health insurance policies do NOT cover tobacco cessation treatment.
• Big tobacco is still plenty rich: It spends $25 million a day on marketing to hook new smokers. And it's still influencing politicians everywhere.

The result? Sicker people and a sicker economy. Fewer jobs, lower productivity, and a bigger budget deficit. We can hear you saying, "Are the YOU Docs crazy? How could smoking increase unemployment or the national debt?" Two ways: First, smoking is a huge drain on worker productivity, thanks to all that sick time (not to mention cigarette breaks). Second, state and federal governments are spending billions treating the serious illnesses caused by tobacco. Just imagine what would happen if those billions were spent creating jobs and, hey, maybe even shrinking the national debt, too.

Don't let any politician tell you that tobacco taxes cover these huge losses. That's a joke even Leno wouldn't crack. You'd have to charge over $10 per pack just to break even! Likewise, laugh at the many governors who think spending their state's share of the 1998 tobacco settlement on job creation -- instead of quit-smoking programs -- is smart. This year, most states will receive an average of $162 million from the settlement fund, yet they will spend an average of $202 million on tobacco-related health costs for Medicaid patients alone. The cost? About $40 million per state, or $2 billion total. Simple arithmetic, but the politicos can't seem to manage it. So let's help legislators do the math:

• $22.5 billion -- the total collected each year in cigarette taxes and settlement money
• $96 billion -- the annual price tag we all pay (in addition to seeing good people succumb to miserable deaths) in health costs related to cigarettes alone, not pipes, cigars, or secondhand smoke
• $96.8 billion -- the annual productivity loss due to tobacco use

The bottom line: We're spending $170.3 billion more a year on tobacco damage than we're collecting in tobacco taxes. And that contributes mightily to our budget deficit. Still, can we really afford quitting programs in a recession? We can't afford not to fund them! They save lives and dollars. Proof:

• When Massachusetts covered the full cost to Medicaid of stop-smoking programs, quit rates tripled, and the number of smokers on Medicaid fell 26%. In just 2 years (2006 to 2008), emergency-room visits for asthma attacks fell 17%, and hospitalizations for heart attacks dropped 38%!


• When companies help employees quit, they save at least $542 per ex-smoker per year on health insurance premiums.


• When smoking was banned in Pueblo, Colorado, work places and public buildings, hospitalizations for heart attacks dropped 27%.

By the way, if you're in Indiana, Massachusetts, Minnesota, Nevada, Oregon, or Pennsylvania, do a happy dance. These six states fully fund Medicaid quit-smoking programs, and the payoffs are huge. Now, if the other states will just learn this simple life-saving, job-creating, debt-shrinking lesson! (In fairness, some are trying, like Kentucky, but there's a long way to go.)

Another by-the-way: Medicine now knows how to win the quitting fight, and it's not going cold turkey. It's using a combination of nicotine-replacement products, prescription drugs (like bupropion) to get you over the psychological hump, behavior modification, and counseling. It's what we do with our own patients. And it works in whole towns, not just our offices. Dr. Mike personally saw this happen in 2006 when the Cleveland Clinic offered free smoking cessation programs to an entire Ohio county. In just 6 months, 16,800 smokers quit.

The new law covers good quitting programs for pregnant women -- which will mean healthier babies and moms -- and it earmarks funds for future pilot programs. But 74% of smokers want to quit right now. They, like us and you, are ready to make America healthier AND wealthier. We're not big on begging, but we're begging you: Write, call, or e-mail your state and federal politicians, and tell them to get a grip. Our nation's health -- and our ability to compete for jobs with Europe and Asia -- is at stake.

Our quit plan is the most effective way we know how to stop smoking. Check it out.

Previously published May 2010