To address youth smoking, Massachusetts should raise taxes on tobacco products and ban flavored tobacco products, according to advocates and legislators.
“The data is there,” Rep. Marjorie Decker said. “When you increase taxes on tobacco you lower the rates of new smokers who are coming in. It works.”
The American Cancer Society Cancer Action Network and The 84 Movement have each held events in recent weeks to push for more laws to combat youth smoking, especially vaping, an industry that picked up a new ally this week when former Attorney General Martha Coakley joined the lobbying team at JUUL, where she was a consultant.
The Cancer Action Network held a lobby day last week to push for bills calling for more transparency in health care and programs that assist residents in quitting smoking.
The group’s main priority is to adjust taxes on tobacco products, raising the cigarette tax by $1 per pack, creating a 75 percent wholesale excise tax on e-cigarettes and increasing the cigar tax to 80 percent of wholesale. The calls come as lawmakers and Gov. Charlie Baker are showing an openness toward tax hikes, with Baker having put his own plan on the table to tax vaping products.
Rep. Danielle Gregoire said she supports creating a tax for e-cigarettes because the products are not taxed at all right now, and the increased price is a major deterrent to youth.
“Our youth are getting sick and they have no idea what the consequences are, so it is time for us to put a stop to that here in Massachusetts and I’m looking forward to doing just that,” she said.
Decker also spoke in support for all of the tobacco tax increases, and plans on offering them as a budget amendment later this month, as well as sponsoring legislation that would create them independently.
“There is no excise tax on e-cigarettes and it doesn’t make sense that we don’t treat it the same way as cigarettes, cigars and other tobacco products,” Decker said.
She said nearby states have higher tax rates for tobacco than Massachusetts.
Currently the tax on a pack of 20 cigarettes is $3.51 in Massachusetts. According to The Campaign for Tobacco Free Kids, as of Dec. 21, 2018, the tax on a pack of cigarettes is $4.35 in New York and Connecticut, $4.50 in the District of Columbia and $4.25 in Rhode Island.
“We need revenue, but more importantly we need to continue saving lives,” Decker said.
Sen. John Keenan said he supports the tax increases, and has sponsored a bill that would ban all flavored tobacco products. Currently, 142 cities and towns across Massachusetts have some restrictions on flavored tobacco products, but there are no statewide rules.
“It’s time that we stand up and we say to the big tobacco industry, the big nicotine industry, and say you are not going to take another generation,” he said. “Together we are going to fight you every step of the way.”
It’s not just adults who are concerned about big tobacco targeting youth; teenagers have noticed as well. The 84 Movement, a statewide tobacco prevention program, gathered activists Wednesday for Kick Butts Day, a youth-led rally for teenagers to advocate for stronger tobacco restrictions.
Hayli Manning, a senior at Holbrook Middle High School, talked about watching her friends try flavored tobacco products from lemon-berry tart to menthol.
“For example, I’ve seen menthol not only in my community but on a much more personal level as well. I have friends who use mint flavored products,” Manning said. “One of them made a comment about mint vape being like gum for your lungs.”
Manning also said that of youth between the ages of 12-17 who do smoke traditional cigarettes, 54 percent of them smoke menthol cigarettes.
At the American Cancer Society event, Keenan spoke about visiting a school in his district, where he talked with students about the dangers of vaping and an eighth-grade boy said he worried not only about himself and his friends being attracted to vaping, but his younger brother too.
Rep. Sean Garballey sponsored Kick Butts’ Day and emphasized that tobacco companies target kids to get them addicted for life.
“Tobacco companies spend hundreds of millions of dollars each generation to try to get you hooked,” Garballey said. “They’re not spending it on 50-60 year olds. Why are they targeting you? Because if they get you hooked they have a customer for life.”
Lt. Gov. Karyn Polito attended the Kick Butts Day event, and said she was concerned about the perception that e-cigarettes are less bad than regular cigarettes.
“It feels to me like we’re not doing our job if we have out there this perception that this is a safe choice,” Polito said. “We’ve got to dispel that perception, make the facts a reality in people’s minds and impact cultural norms.”
Speakers at both events emphasized the importance of fighting youth smoking, and while the most recent data from Massachusetts in 2017 shows it on the decline, national data showed a jump in e-cigarette use in 2018. It’s that jump that advocates are concerned about, as in the past Massachusetts statistics have followed national trends.
In 2017, the Massachusetts Youth Risk Behavior Survey showed that 24.6 percent of high school students reported using any tobacco, including e-cigarettes, in the past 30 days, down from 29.3 percent in 2015. In addition, in 2015, 44.8 percent of students reported ever using “electronic vapor products,” and in 2017 that number decreased to 41.1 percent.
However, in February, 2019 the Center for Disease Control released a national report, “Vital Signs: Tobacco Product Use Among Middle and High School Students — United States, 2011–2018,” which showed a drastic jump in youth smoking.
E-cigarette use by high schoolers increased significantly from
11.7 percent in 2017 to 20.8 percent in 2018, adding up to approximately 1.5 million additional youths using e-cigarettes in 2018. This increase comes even as the report states that there were no significant changes in the use of any other tobacco products.
“However, current e-cigarette use increased by 77.8% among high school students and 48.5% among middle school students during 2017–2018, erasing the progress in reducing e-cigarette use, as well as any tobacco product use, that had occurred in prior years,” said the report.
Marc Hymovitz, the director of governmental relations for the American Cancer Society Cancer Action Network in Massachusetts, said the organization has also heard from teachers and employees that there has been a drastic increase in students caught vaping, something he blames on the marketing of flavored e-cigarettes to kids.
“We are mostly concerned because we know that big tobacco is targeting kids,” he said. “So that’s where we are trying to impact change.”
Last session, the Legislature and Baker agreed to a law raising the minimum age to buy tobacco from 18 to 21, which went into effect January.
The Cancer Action Network also advocated for bills to make health care plan choice easier.
A bill backed by Sen. Brendan Crighton and Rep. Jen Benson would make cost and utilization management information available to consumers when they choose health plans. This would mean that during open enrollment consumers can see the list of drugs covered under each plan and what the cost would be to them before purchasing the plan.
The process of choosing a health plan can be especially difficult when someone has cancer or other serious illnesses, when the costs of treatment are much higher and consumers don’t know exactly what medicines will be covered and how much it will cost them.
“While you are having the fight of your life against cancer, you shouldn’t be fighting the fine print, you shouldn’t have to roll the dice with uncertainty as you try to select a health care plan,” Crighton said.
Benson, who is the House chair of the Joint Committee on Health Care Financing, said the focus on health care reform should be on patients not cost.
“I can say moving forward this session we are focused on health,” she said. “Now, you’re going to hear a lot about cost. And we all worry about cost because if something is too expensive you’re not going to be able to access it. But we also understand that the way to reduce cost in the long term is keeping people healthy.”
Patti Morris, a volunteer from the American Cancer Society, spoke about her personal experience with cancer. Twenty-nine of her relatives have had cancer and several of them have passed away from cancer, including her mother, her sister-in-law and her mother-in-law. Morris was shocked when her grandson seemed interested in flavored e-cigarettes, telling her that juuls must be good because it “smells really good.”
“I want you guys to know how important our voices are and I have a voice, my mother doesn’t have one, my mother-in-law, my sister-in-law they don’t have those voices,” Morris said. “And I’ll be damned if my 9-year-old grandson ever picks up an e-cigarette.”