Friday 26 October 2007

Tobacco & Health, v1: Tax Policy

As some of you know I am involved with a course run through the Ontario Tobacco Research Unit. Discussions in this class cover a pretty decent snapshot of the tobacco cessation debate from genetics, farming, engineering, pharmacology, policy, marketing, and organized crime. While it is an elective for me, I am enjoying the class and am learning new things every week. In this Tobacco & Health series of notes, I'll be putting out random statements on different elements of the debate which I've found particuarely interesting.

Would love to hear any thoughts or experiences ya'll might have on the subject!
Now to the subject matter at hand ...

In the past decade we have seen gradual increases to cigarette taxes, which is a trend that will likely continue for some time. Increases in the purchase price of cigarettes in Ontario has been fundamental to recent tobacco control efforts, as well as a key factor in preventing more and more young people from developing smoking habits in the first place. But while the benefits of such policies have been widespread for the general public, certain marginalized subsets of the population have been adversely affected.

One such group of individuals are those with mental health comorbidities - that is, people living with a mental health illness who are also addicted to cigarettes. While price increases have lead to reductions in the amount purchased by the average smoker, it has been documented that this has not only not been the case with mental health consumers - but that many of them are willing to spend higher and higher percentages of their incomes on cigarette purchases. The resulting effect is that higher cigarette taxes without additional supports puts far too many of these individuals deeper into poverty and leads to greater dependence on the system.

In public policy, there is no perfect legislation. Even the best policies that benefit the most will still work against the interests of some. In the tobacco context, while I am strongly in favour of raising the price tag on cigarettes to as high a level as we can go - I wouldn't think of doing it on its own without it happening alongside effective harm reduction programs that are easily accessible and appropriately targets those who will be most adversely affected by it.

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