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87TH LEGISLATIVE 87TH LEGISLATIVE
SESSION SESSION

“Sin” Taxes on Tobacco Should

Match State Expenditure Table Two.
2019 Cigarette and Tobacco Taxes vs Costs in Texas

By John J. Seidenfeld, MD

The Texas Public Health Coalition (TPHC), made up of thirty-
one health care organizations in the state including the Texas Medical
Association and BCMS, is in favor of 1) banning all characterizing
flavors including menthol in E-cigarettes, which younger users favor,
2) increasing taxes on conventional cigarettes as well as imposing an

excise tax on E-cigarettes, and 3) strengthening enforcement measures
We are aware of the terrible toll of disease, disability, and death from 4
on retailers.
the use, combustion, and inhalation of tobacco and byproducts such
What is the broader purpose of raising funds through excise, Pigou-
as nicotine and countless hydrocarbons. Illnesses caused include ath- 5
vian, and sales taxes on tobacco and related products? Our duty as
erosclerosis affecting all organs, not the least of which the heart and
health care professionals is to help prioritize recommendations to pol-
brain; chronic obstructive pulmonary diseases; and cancers of many
How do we deter- icy proponents such as the TPHC, lobbyists, and legislators.
1
organs in addition to the lungs and oral cavity. Recently, vaping of to-
mine taxes for the
bacco products has added to the disease burden which many predict
significant expen-
will be equal or worse than that caused by cigarettes. In Texas there The major areas to support are:
ditures that smok-
are some three million cigarette and vape users. • Prevention of tobacco product use disorders, helping youth make
ers incur? Texas
The societal and budgetary costs attributable to smoking are high. sound healthy judgements, and immunizing to prevent further in-
taxes cigarettes, ac-
The costs show a significant state shortfall in terms of work missed, fections of the lungs and affected organs
cording to the comptroller, $1.41/package as excise tax and $0.34 as
healthcare costs and opportunity costs. The individual costs over a life-
sales tax. Vape products have no current excise tax and only sales tax. • Education of health care students and workers, counselors,
2
time and per year for Texas smokers are shown in Table One. It will and youth
In addition, the Federal government adds $1-2 depending on the size
be a few decades before we have data for vaping, but many pulmonolo-
of the cigarettes. On average, a package of cigarettes costs $5.78 in
gists predict similar adverse effects over time. 3 • Enforcement of tobacco use, vaping, age limitations, and
Texas. In Australia, the cost of a pack of cigarettes is $27 USD and in tax regulations
Mexico $3 USD. Texas legislators voted down an attempt to add an
Table One. • Research into use disorders and tobacco related health
excise tax for vaping in 2019, and as of today these products still are
Societal Costs Related to Smoking in Texas and State Rank consequences
not assessed an excise tax. Overall, tobacco use costs over 90 times the
amount that we tax on • Treatment of tobacco and vaping related disorders

smoking in Texas (Table
2), adding to the yearly Prudent citizens and health care professionals advise and advocate References and links
subsidy we get from big for a) additional taxes as compensation for the state’s expenditures on 1) https://www.cdc.gov/tobacco/data_statistics/fact_sheets/
tobacco after the lawsuit at the costs of tobacco and vape use and abuse, b) protection of youth 2) https://wallethub.com/edu/the-financial-cost-of-smoking-by-
the end of the last decade, from marketing directed actions that lead to a lifetime of tobacco or state/9520
and we still have a huge nicotine use disorder, and c) leaders who are guided by fiscal and sci- 3) https://comptroller.texas.gov/about/media-center/news/2019/
3a
shortfall. entific guidelines in future taxation legislation. 190904-sales-tax.php
3a) https://www.dshs.texas.gov/tobaccosettlement/pay2020.aspx
*Data from Wallethub.com 2020, US dollars, from CDC and US Bureau of Statistics
** Lowest numeric rank means lower income, lower opportunity cost, and lower health John J. Seidenfeld, MD is the Chair of the BCMS Publica- 4) https://static1.squarespace.com/static/
care spending by Medicare and Medicaid tions Committee. 5) https://www.taxfoundation.org

20 SAN ANTONIO MEDICINE • March 2021 Visit us at www.bcms.org 21