Indiana should raise the legal age for smoking from 18 to 21 and increase the state tax on cigarettes by as much as $3 a pack, says a new study that warns the tobacco epidemic is costing the state nearly $7 billion a year in health care and lost productivity.
The recommendations, released Thursday, were part of a study commissioned by the locally based Richard M. Fairbanks Foundation, which awards grants in the areas of health, education and toward the “vitality of Indianapolis.” The foundation has given out more than $150 million in grants over the past 10 years.
The study said more than 11,000 Hoosiers die prematurely each year from smoking and another 1,400 die as a result of second-hand smoke. Twenty-three percent of Indiana adults smoke, higher than the U.S. median of 18 percent.
The report also examined Indiana’s opioid epidemic, which it said costs Indiana more than $1.4 billion a year in medical costs and lost lifetime earnings for victims.
Drug overdose fatalities in Indiana claimed 1,152 lives in 2014. The two categories of opioids—prescription pain relievers and heroin—are the second- and third-highest leading causes of Indiana’s overdose fatalities, respectively, behind only “other and unspecified drugs.”
The figures were tallied by the Indiana University Richard M. Fairbanks School of Public Health.
“The prevalence of opioid and tobacco addiction in Indiana should sound alarm bells for state and civic leaders, health care providers, employers and everyday Hoosiers, all of whom bear the cost of these challenges,” said Claire Fiddian-Green, president and CEO of the Fairbanks Foundation, in a written statement.
The recommendation to raise the cigarette tax comes just months after the Indiana General Assembly flirted with the idea of raising taxes on cigarettes and gasoline to fund road repairs. The plan was seen primarily as a way to raise millions of dollars for roads, but in the end, the state decided to tap budget reserves to fund $800 million worth of road repairs.
The new report also follows a move to discourage cigarette smoking in general. Four years ago, then-Gov. Mitch Daniels signed a law outlawing smoking in work places and enclosed public places, such as restaurants, shopping malls and auditoriums.
The study does not make a recommendation for a specific increase in the state cigarette tax, but outlines a range of $1.53 to $3 a pack for the “best chance of passage.”
Indiana currently charges tax of 99.5 cents on a pack of cigarettes, ranking the state 34th nationally and below the tax charged by the nearby states of Illinois ($1.98), Michigan ($2), Ohio ($1.60) and Wisconsin ($2.52). The only surrounding state with a lower tax is Kentucky, at 60 cents per pack.
The average state tax is $1.59 a pack, which is in addition to a federal tax of $1.01 a pack.
“An increase of at least $1.53 would raise the tax from its current level … to $2.525 per pack, placing Indiana in the top 10, just above Wisconsin, which is currently in 10th place, and above all of Indiana’s neighboring states,” the report said.
The study also recommends raising the legal age for smoking from 18 to 21, as a growing number of cities and states have done, including New York City, Kansas City, Hawaii and California.
“Raising the legal age for purchase of tobacco products is an idea whose time has come,” the report said.
It pointed out that the Institute of Medicine found that 90 percent of daily smokers first used cigarettes before the age of 19, and that a legal age of 21 would “likely prevent or delay initiation of tobacco use by adolescents and young adults. It estimated that smoking rates would fall to 12 percent if the legal age was raised to 21.
The reports recommend other solutions to the epidemics, such as increasing resources for substance-abuse prevention and cessation programs, and making the life-saving drug naloxone more accessible for treating drug overdoses.