Nice post. The only problem is that its wrong. Smoking rates have greatly decreased since the 1998 agreement was implemented:
Smoking rates drop 20 percent following tobacco settlement
Marc Kaufman / Washington Post
WASHINGTON -- Americans smoked fewer cigarettes last year than at any time since 1951, and the nation's per capita consumption of tobacco fell to levels not seen since the early 1930s, the association of state attorneys general reported Wednesday.
Based on data gathered by the federal government when it collects taxes on cigarette sales, the group found a 4.2 percent decline in 2005 and a drop of more than 20 percent since tobacco companies reached a national settlement with the states in 1998.
http://www.detnews.com/apps/pbcs.../603090432/
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Why did smoking rates decrease? Answer : price of cigarettes:
The drop was a result, they said, of factors including the sharply higher cost of cigarettes, restrictions on cigarette advertising, and a shift in public perceptions as the dangers of smoking are more aggressively and widely publicized.
A 20 percent smoking rate decrease is good for public health.
Why shouldn't tobacco companies have to pay for health care costs that they have caused and for anti-smoking program?
The MSA was not perfect but certainly better than nothing. That's why tobacco companies are attacking the MSA as well as pro-smoking groups.
http://www.detnews.com/apps/pbcs.../603090432/
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By the way, here's what the money is being spent on in Utah:
The MSA is no golden goose, and the state should carefully consider its options if a downward adjustment in the settlement agreement is awarded. For obvious reasons, the state wants to be able to fund prevention programs, the Children's Health Insurance Program, the trust fund formed when the settlement was reached as well as cancer research at the University of Utah.
http://www.detnews.com/apps/pbcs.../603090432/
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That's a good use of funds.
If smokers simply switched brands of cigarettes they could screw the tobacco companies up who have sold them out via the MSA and simultaneously damage the AG's financial need of the MSA payments to prop up the states who are fiscally challenged.So cost is not a major factor to the dedicated smoker.An even cheaper option is RYO.If smokers use the excuse of price to stop and it helps them to succeed then great,if it doesn't then it means coercion and intimidation have failed.
The claim of a 20% drop in smokes consumption is from the attorneys general, not exactly a neutral source of information, i would say. Apart from that, the article self-contradicts itself and contradicts even what Erik says:
Erik: "That's why tobacco companies are attacking the MSA as well as pro-smoking groups."
Article: "Michael Neese, spokesman for Philip Morris USA, said the company has always expected the settlement would bring about "meaningful change.""
Erik, one might ask: what have you smoked lately?
The anonymous above was me.
Here's why I think Erik is wrong. First of all, the question here is not whether the MSA was better than doing nothing, as Erik poses. The valid question is whether settling the 46 state lawsuits against the tobacco companies (i.e., the MSA) produced a better public health outcome than allowing these 46 lawsuits to be pursued, as I feel was in the best interests of the citizens who the AGs are supposed to represent.
Had these 46 lawsuits been allowed to continue, there is no question in my mind that we would have a far better outcome than with the MSA. If you look at the 4 states which settled their suits outside of the MSA, they got far better arrangements than the MSA states. In Florida, reductions in youth smoking due to the state's settlement were far greater than anything we have observed nationally due to the price increases associated with the MSA. And imagine what would have happened if similar programs had been implemented in many states. Even if the suits were not successful, they would have been settled on far more favorable terms (to public health) had they been allowed to continue.
But let's even go with Erik's hypothetical question of whether the MSA was better than simply doing nothing. I contend that it would have been far better for the public's health to do nothing.
Here's why:
There's little question in my mind, that if the states had refused to settle their cases against Big Tobacco, the companies would have been forced into bankruptcy. That wouldn't have ended the companies, but it certainly would have required far greater price increases, and resulted in far greater smoking reductions, than we have seen with the MSA.
The only reasons why the companies were not forced into bankruptcy and will not be forced into bankruptcy are that:
(1) Florida settled its lawsuit, which made Florida dependent on cigarette revenue, and forced the state legislature to dissolve the requirement for Big Tobacco to pay a $160 billion bond in the Engle case; and
(2) the state settlements and the MSA provided the cigarette companies with immunity from punitive damages (as we saw yesterday in Georgia and as the Florida Appeals Court decided previously) and with at least an argument that this is the case in every state. As a result, these settlements resulted in the overturning of the $145 billion Engle verdict, the failure of Illinois to require Philip Morris to pay a $12 billion appeal bond, and what will most likely be the upholding of the overturning of the Engle verdict. Even if the Engle verdict is upheld, the MSA has now provided a reason why the Supreme Court will hear the appeal of this case, which it might not have done otherwise.
Thus, without the state settlements (including the MSA), the tobacco industry would have been forced to pay a lump-sum $160 billion or $145 billion bond or punitive damage payment.
But that's not even the core of the reason. The real reason is the addiction of the states to tobacco revenues. In the long-run (as well as the short-run, as I've argued above), that is going to do far more harm than any short-term gains from the MSA's price increases.
There is no question in my mind that the state settlements and the MSA have been the worst public health blunder of my lifetime.
"Why shouldn't tobacco companies have to pay for health care costs that they have caused and for anti-smoking programs?"
Erik, that statement should read: "Why shouldn't SMOKERS have to pay for health care costs that they have caused and for anti-smoking programs? Or do you think the settlement affected Big Tobacco's bottom line?
So let's cut the baloney. Smokers as a group already PAY for their health care costs. They pay in onerous taxes, and they pay by dying earlier (lowering health care costs; lowering the cost of time spent in nursing homes; lowering the burden on the social security trust fund and on private pension funds). Just what additional pound of flesh do you wish extracted from smokers?
And who do you think is paying for the anti-smoking programs? Big Tobacco? Or smokers themselves?
I'm just waiting for the day when a statue is finally erected outside of every Office of the Exchequer in the land: "To the Smoker. In Gratitude." But I'm not holding my breath.
While the AG's may claim this ridiculous drop in per capita consumption, note that smoking prevalence has not significantly changed. CDC says it was 24% in 1998.
http://www.cdc.gov/tobacco/
resea..._fact_sheet.htm
In 2005, the earliest estimates peg it at 22%.
http://www.cdc.gov/nchs/data/
nhi...lease200512.pdf
This is about an 8% drop, not 20%.
Note that in the 2005 document chart, you can almost draw a line right through the middle of all the 95% confidence interval brackets, meaning the decline could possibly be much less than they say.
There are some more issues as well:
1) Do the consumption figures also take into account non-MSA brand sales?
2) Do the consumption figures also take into account bootleg or grey market sales?
Even if per capita sales dropped by
20%, that means roughly 4 less cigarettes smoked by an average pack-a-day smoker.
It could be that smoking bans, which prevent the opportunity to smoke, as opposed to increased cost, actually account for the decline in per capita consumption, especially in light of the fact there is no corresponding 20% decrease in overall smoking prevalence.
Also, note that earlier in the document with the preliminary 2005 smoking prevalence figures, the overall number of Americans without health insurance is basically unchanged.
Now, that's a REAL tragedy, because it is my understanding that lack of access to basic health care results in higher health care costs (due to non-treatment) and is a better predictor than smoking for overall life expectancy.
Thus, without the state settlements (including the MSA), the tobacco industry would have been forced to pay a lump-sum $160 billion or $145 billion bond or punitive damage payment.
Maybe, but tobacco companies don't settle often and it is likely that very little money would have been paid.
However, a greater penalty and a finding for punitive damages would have certainly helped the effort.
It could be that smoking bans, which prevent the opportunity to smoke, as opposed to increased cost, actually account for the decline in per capita consumption, especially in light of the fact there is no corresponding 20% decrease in overall smoking prevalence.
That's a good argument for smoking bans. However, the main argument is to protect non-smokers.
bottom line, it doesn't matter WHO or WHAT the entity is or represents, the less we decide our own matters, the more compromised we are. and the more we follow blindly, the more we get dependent on whoever is leading rather than learning how to make our own way (and probably get bumped into a few walls for ha-ha's along the way!)
so doc, how's that study-study link coming? (blatant, unapologetic hint)
btw erik, i suggest that the main argument is to protect the non-smokers RIGHTS, which is just as important for us tobacco users to recognize as well. other's can keep their good intentions, i'll keep my handbasket, thankyouverymuch.
to paraphrase a saying i've been taught, "legislation in the name of Public Good is for people who fear hell; compromise in respecting everyone's rights is for people who've been there.
Erik writes: "It could be that smoking bans, which prevent the opportunity to smoke, as opposed to increased cost, actually account for the decline in per capita consumption ... That's a good argument for smoking bans."
That's a fascist, brown-shirt argument for smoking bans. You won't stop smoking, you addicted animal? Well, we'll devise new methods to stop you smoking!
Thank God I live in the Land of the Free and the Home of the Brave. But not for long, apparently.
"That's a good argument for smoking bans. However, the main argument is to protect non-smokers."
Well, it's a BETTER argument for smoking bans, in the sense at least it's more HONEST: the purpose of smoking bans are merely attempts to deny smokers the opportunity to smoke, that is, a form of punishment.
Mike Siegel wrote:
"The valid question is whether settling the 46 state lawsuits against the tobacco companies (i.e., the MSA) produced a better public health outcome than allowing these 46 lawsuits to be pursued, as I feel was in the best interests of the citizens who the AGs are supposed to represent."
Wrong. That hasn't been a valid question since 1998-1999, when the MSA achieved Final Approval.
In retrospect, many other options could have or should have been done instead of what actually occurred.
But that train left the station a long time ago.
>In retrospect, many other options (other than the MSA) could have or should have been done instead of what actually occurred.
Yes, however, at the time, no plaintiff had been successful bringing an action for injury against the tobacco companies, or a least not a large case.
Many AGS and private attorneys were relunctant to take the cases as the prior litigation had been so difficult.
Yet, could the public had benefitted had the terms of the MSA been better? Yes certainly. However, no one gets their wish list in a settlement.
At this point, it is history. The important thing for public health is for Siegel and others to encourage more indoor smoking bans to protect the public.
One has to wonder, with so many states dependant on the MSA money, just what vested interest do they have to do something to make smoker's quit? If it were actually to help people quit smoking, then the states would get less money. Most of the MSA money doesn't even go for what it's supposed to anyhow. It goes to other interests that are not at all related to smokers and their health.
Also, as someone that has worked in hospitals, I've only seen 2 people in for what could be construed as a smoking related illness. Neither of those two people had any kind of public health care. One is 80 and still going...However, I've seen tons of non-smoking 80 year olds with similar troubles (COPD). Where are all these sick smokers taking up the public health money that the MSA is supposed to be paying for?
At this point, it is history. The important thing for public health is for Siegel and others to encourage more indoor smoking bans to protect the public.
Erik
Ok, but let's not be hypocrites here. I expect to see just as serious efforts for car exhaust bans, industrial plant bans, campfire bans, barbeque bans, and fireplace bans.
I expect to see just as serious efforts for car exhaust bans
Yes, if they tried to run a car in a restaurant.
"Yes, if they tried to run a car in a restaurant."
It's been done before.
Jales inquired:
"One has to wonder, with so many states dependant on the MSA money, just what vested interest do they have to do something to make smoker's quit?"
In fact, the MSA financially rewards states that aggressively reduce cigarette consumption (as compared to other states) because annyual MSA payments to all 46 states are based upon nationwide cigarette consumption, not on consumption within the state.
"Yes, if they tried to run a car in a restaurant."
You don't have to go into a smoky restaurant, but there is no way to escape car exhausts, they are outdoors AND indoors (where else would the indoor air come from?)
"Yes, if they tried to run a car in a restaurant."
Ah, but the question is no longer about restaurants is it? It's about outside, in your own home, in your own car, in your own business where maybe yourself is the only employee. I would definitely say that consistent exposure to car exhaust fumes, plant fumes, etc would have health effects that far outweigh the 3 second pass through cigarette smoke on a sidewalk....or sitting on a beach where the smoke may not even be blowing your direction AND you have the option of stepping 5 feet in any direction to get it out of your face...
"Yes, if they tried to run a car in a restaurant."
It's been done before.
Yes, isn't that called suicide?
"In fact, the MSA financially rewards states that aggressively reduce cigarette consumption (as compared to other states) because annyual MSA payments to all 46 states are based upon nationwide cigarette consumption, not on consumption within the state."
hmmmmm. interesting. the more aggresive a state is with it's anti-smoking policy, the more money it gets.
so, let's see. first let's tax the hell out of everyone, then tax the smokers to one of the darker, more fiery pits [tx for the lite], make it look like we really care about the 'public good' by yoking the public with ever greater restraints on their lives, and a little extra tax on sins that haven't gotten as much corporate cash behind it (yet) and let's just watch all the money flow in!
oh yeah. i wanna live in your world bill - NOT.
"Yes, if they tried to run a car in a restaurant."
It's been done before.
"Yes, isn't that called suicide?"
No, it's called ventilation.
LOLOLOLOLOL!
And I would add to the auto exhaust argument...a study needs to be done! What about all those children that go to NASCAR races now? Outside, the exhaust fumes, the chemical release of tires meeting the track and breaking down of that rubber compound, outside....with the "vortex" winds that can push away bad weather as DW likes to say. What about the children that go to the Indy 500 and favorite saying- Nothing like the smell of methane in the morning!!!
I go to these races...with the understanding that there are particulates in the air that I am breathing. I would think the parents of the CHILDREN would be up in arms...
Go and talk to NASCAR (who are now supported by nicorette, Depends, Scotts Miracle Grow, and on and on)...which is why I am no longer going to ANY NASCAR race again-they have turned it into the great anti race business. And I have communicated with many of them regarding that.
I am going to Indy 500-because they have communicated that that race and track are not in the Ban area. I do support any race function that allows any advertising-not just the politically correct ads. CART Indy Cars and local small tracks/racing.
So, we know that cars exhaust can be hazardous to someone/somehow.
I would demand a study if I thought it would be scientific...Not in this day and age though.
Annette wrote:
"hmmmmm. interesting. the more aggresive a state is with it's anti-smoking policy, the more money it gets."
No. Every year, each of the 46 states (and several territorities) receive a preagreed upon percentage of the MSA funds, which comes to about $.40/pack and is based upon national cigarette sales.
As such, as state that dramatically reduces smoking will receive the same amount it would have if smoking had increased in the state.
But by reducing smoking sharply, states save money they would have otherwise spent on Medicaid and other state funded and subsidized healthcare services attributable to smoking diseases.
so, the statement:
"In fact, the MSA financially rewards states that aggressively reduce cigarette consumption (as compared to other states)"
is true or false?
your words, bill, remember them?
bon appétit
Bill Godshall hypothesizes that, "by reducing smoking sharply, states save money they would have otherwise spent on Medicaid and other state funded and subsidized healthcare services attributable to smoking diseases."
Maybe so, but I would like to see how the numbers really add up. Since 1998, when the costs of the MSA were added to a pack of cigarettes produced by the participatory companies and with New York's subsequent excise tax hikes, the numbers of total Medicaid eligibles increased from 2,805,788 to 4,050,562 in 2004 for a 44% increase.
The big jump actually started in 2002. The terrorist attacks of 9/11 undoubtedly contributed to the effect. However, NYS also raised the state excise tax on cigarettes in April of 2002 to become the highest in nation at that time. Then Bloomberg approved raising NY City's tax from $0.08 to $1.50 per pack in June. So the combined "take" by NYS and NYC was $3.00 in excise taxes, $0.40 in MSA payments passed on by the tobacco companies, and approximately $0.31 per pack in state and city sales taxes added in for good measure.
The problem with these type of tax increases is that they hurt small businesses, consumers, and taxpayers alike. Contrary to typical anti-smokers' claims, the problem is that smokers didn't just quit, they merely changed their point of sale whenever and wherever possible to out of state sources. More affluent NYC residents and commuting smokers from NJ and CT coming into the city merely planned their buying habits to avoid having to purchase smokes while in the city. That effects more than just cigarette sales for small businesses and convenience outlets. Excise taxes are regressive, effecting lower income families more by taking a bigger bite out of their paycheck and putting more lower income families on the Medicaid qualification role. It's quite plausible that NY's aggressive approach to try to sharply reduce smoking is one reason why more people in NY are now qualifying for Medicaid than before the war on smokers ignited.
Here's 2 Studies that I have found.
Cardiovascular effects in patrol officers are associated with fine particulate matter from brake wear and engine emissions
Conclusion
PM2.5 originating from speed-changing traffic modulates the autonomic control of the heart rhythm, increases the frequency of premature supraventricular beats and elicits pro-inflammatory and pro-thrombotic responses in healthy young men.
http://www.particleandfibretoxic...m/content/1/1/
2
Traffic Air Pollution and Mortality Rate Advancement Periods
Chronic exposure to air pollution is associated with increased mortality rates. The impact of air pollution relative to other causes of death in a population is of public health importance and has not been well established. In this study, the rate advancement periods associated with traffic pollution exposures were estimated. Study subjects underwent pulmonary function testing at a clinic in Hamilton, Ontario, Canada, between 1985 and 1999. Cox regression was used to model mortality from all natural causes during 1992–2001 in relation to lung function, body mass index, a diagnosis of chronic pulmonary disease, chronic ischemic heart disease, or diabetes mellitus, household income, and residence within 50 m of a major urban road or within 100 m of a highway. Subjects living close to a major road had an increased risk of mortality (relative risk = 1.18, 95% confidence interval: 1.02, 1.38 ). The mortality rate advancement period associated with residence near a major road was 2.5 years (95% confidence interval: 0.2, 4.8 ). By comparison, the rate advancement periods attributable to chronic pulmonary disease, chronic ischemic heart disease, and diabetes were 3.4 years, 3.1 years, and 4.4 years, respectively.
http://aje.oxfordjournals.org/cg.../full/160/2/
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Erik--
Sure, raising the price of cigarettes may reduce consumption.
So what? The government of a nation of free individuals has no business interfering in our lives that way.
You think so? The majority thinks so? Again, so what? Neither you nor any majority has the right to do so. They may arrogate to themselves the power to do so, but that is no right. Rights inhere to individuals, not groups.
Bill seems to think the states spend no money on non-smokers' medical costs.
I'm not buying the argument that smokers cost socialized medicine more than non-smokers. Most of us get sick and die in hospitals. That's very expensive in a modern nation, and it balances out between those who smoke and those who don't
Whenever I hear this argument, I know I'm dealing with either an unserious or dishonest mentality.
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