This is how Georgia lawmakers are balancing public health and tax hikes on smokers
LISTEN: Georgia’s tax on tobacco has not increased since Sonny Perdue was governor, 20 years ago. But now state lawmakers could change that. GPB’s Ellen Eldridge reports.
The fact that smoking contributes to cancer, heart and lung diseases is undisputed.
A federal law has forced tobacco manufacturers to include a warning about hazardous health on each box of cigarettes since 1965. The only products that are exempt from this law do not contain tobacco or nicotine and are not made or derived from tobacco.
The Surgeon General’s Advisory Committee on Smoking and Health concluded in 1964 that smoking contributes to lung and laryngeal cancer, which often begins as chronic bronchitis.
SURGEON GENERAL'S WARNING: Smoking Causes Lung Cancer, Heart Disease, Emphysema, And May Complicate Pregnancy. Quitting Smoking Now Greatly Reduces Serious Risks to Your Health.
But Georgia is one of the cheapest states to buy hazardous nicotine products because its current tobacco tax is one of the lowest in the nation.
A new bill would raise the tax by 20 cents, making the total Georgia tobacco tax 57 cents per pack of cigarettes. The national average tobacco tax is about $2.
This excise tax is in addition to the state's sales tax on cigarettes.
Advocates of House Bill 191 argue higher tobacco taxes will reduce the number of smokers and save on health care costs, but other anti-smoking advocates say we need to do more to combat the physical, economical, and racist effects.
Despite passing a bill on the last day of the 2020 legislative session to tax vaping products for the first time, tobacco tax in Georgia has not increased since former Gov. Sonny Perdue raised it from 13 to 37 cents.
That was 20 years ago.
Over the past two decades, Georgia received more than $3 billion from its share of The Tobacco Master Settlement Agreement money related to lawsuits against the four largest tobacco companies.
The purpose of the settlement money is to reduce smoking, especially among young people, and the MSA recommends raising the price of cigarettes.
The state brought in $150 million in fiscal year 2019, but lawmakers that year used 80% of the settlement money to pay Medicaid for direct health care in the federal/state program, Georgia Health News reported.
Georgia owes Medicaid $650 million a year for health care costs directly related to smoking, Georgia Budget and Policy Institute analyst Danny Kanso said in 2020.
"We can get to an adequate level where right now we're only raising about $230 million a year from those 450 million packs of cigarettes that are sold," he said. "We could bump that number up significantly to at least cover the direct costs associated with smoking and to help fill part of that hole in our budget."
Medicaid costs are paid by all taxpayers in Georgia.
These are the people who inevitably end up as some of the sickest, Savannah Republican and pharmacist Rep. Ron Stephens said. He is the lead sponsor of HB 191 and HB 192.
Not raising the tax on cigarettes amounts to a tax on nonsmokers — Rep. Michelle Au
His bills separately propose tax increases on tobacco and vape products in Georgia.
Research shows smoking harms the entire body — not only the lungs. Georgians who use tobacco are also more vulnerable to stroke and vascular disease, said Dr. Michelle Au, who represents District 50 in the state House.
Last session, Au put together a committee to study the costs of smoking so the legislature would have data from its own body to consider.
"I wanted to do the homework to give the Legislature an unavoidable way to need to look at this problem, and an unavoidable solution that it needed to examine," Au said early in January.
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Despite these harms, the Campaign for Tobacco-Free Kids reported that the tobacco industry for decades has deliberately targeted the Black community with marketing for menthol cigarettes.
Anti-smoking advocates in Georgia continue to push for a full ban on menthol cigarettes and tobacco products by the U.S. Food and Drug Administration.
In 2019, there were more than 18.5 million current menthol cigarette smokers ages 12 and older in the U.S., with particularly high rates of use by young adults, the FDA reported.
Menthol cigarettes disproportionately contribute to preventable death among the Black community, Robert Wood Johnson Foundation’s Dr. Giridhar Mallya said.
“Menthol is the most popular cigarette among young people and the most popular cigarette among African Americans and other communities of color,” Mallya said.
Although Black Americans make up 12% of the U.S. population, a 2021 study found they represented 41% of the premature deaths due to menthol cigarettes from 1980 to 2018.
Lincoln Mondy is an Atlanta-based documentarian whose 2016 film "Black Lives / Black Lungs" investigated the tobacco industry’s successful infiltration into the Black community.
He said he forthcoming film focuses on the origins of Big Tobacco, which he said is steeped in colonization, capitalism and slavery.
"The FDA has had authority to regulate menthol since the 2009 Tobacco Control Act," Mondy said. "And it's beyond time to really, really focus on the health of Black Americans and make a final decisive action to bring victory for Black health."
The FDA issued draft regulations in April 2022 to ban menthol cigarettes and flavored cigars, and the department is expected to issue final regulations later this year.
While Senate Bill 47 proposes to restrict vaping, no currently filed bills propose to ban or restrict menthol tobacco products.
Not raising the tax on cigarettes amounts to a tax on nonsmokers, Au said.
"Taking care of the health care costs of patients who do smoke amounts to something like $900 per household," Au said. "So, this is money that we are paying because of our high smoking rates, and it basically amounts to a subsidy incentivizing bad health behaviors."
Au initially proposed a bill to raise Georgia’s tax on cigarettes from 37 cents to $1.91 a pack, but now supports a compromise to pass a 20-cent tax increase.
Advocates of House Bill 191 argue higher taxes will reduce the number of smokers, and save on health care costs.
During the first hearing before the Tax Revision Subcommittee on Feb. 22, Stephens again said smokers inevitably get sick, and it shouldn’t be up to nonsmokers to foot the bill.
"This is a user fee for Medicaid, if you will," he said. "This is probably the best way to explain it. There's no way to charge a user fee except with an excise tax."
Opponents of the tax increase include the Georgia Association of Convenience Stores, which represents about 2,200 stores in the state, argue the state will lose money if smokers buy their tobacco across state lines.
"If everybody quit smoking, then it don't generate any income; that's where I'm getting lost," Rep. Jason Ridley said. "How is it generating any income?"
He suggested that raising the tobacco tax is a "tax on the poor."
Andy Lord, who spoke on behalf of both Georgians for a Healthy Future and the Georgia Society of Clinical Oncology, argued there already exists a precedent among private insurance companies to charge smokers for their unhealthy choices.
“If you're the same age, height, weight, everything, but one's a smoker and one's a nonsmoker, the private sector model says we charge the smoker more, right? That's a business decision,” Lord said. “Higher risk behaviors result in higher premiums. That's ubiquitous across the insurance industry.”
Ridley also suggested the American Cancer Association had ulterior motives for its support of HB 191.
If a piece of legislation has not cleared at least one chamber of the Georgia General Assembly by Crossover Day, which is March 6, that bill is unlikely to pass this session.