As California cuts spending on anti-smoking programs and tobacco companies boost their marketing campaigns, young Californians are reaching for cigarettes in increasing numbers.
Smoking is up among young adults, reversing a trend that had lasted more than decade and troubling public health advocates who say the state is at risk of losing a marketing war to the tobacco industry.
“It is these pennywise foolish decisions that are going to cost lives, and really, they are going to cost the state money,” said Danny McGoldrick vice president of research at the Campaign for Tobacco-Free Kids, a non-profit which releases annual reports on prevention spending. “What the state put into these programs, it gets out of them.”
Historically, California has been a leader in tobacco prevention. In 1988, ten years before the tobacco settlements, in which major tobacco companies agreed to provide annual payments to compensate each state for the health costs caused by their products, Californians approved a 25-cent tax on cigarettes with Proposition 99. Five cents of the tax went to the California Tobacco Control and Prevention program. This program has supported anti-smoking campaigns, communities grants for tobacco prevention programs, and research.
In recent years, funding for the programs has declined, in part because people are smoking less. Tthe program has been a victim of its own success, since the fewer people who smoke, the less tax revenue the state collects to spend on anti-tobacco programs. The state spent $62.1 million in the past year on prevention programs, less than half of what it spent about a decade ago, at its peak.
Overall, the California Tobacco Control Program has proven to be a cost-saver for the state, studies say. From 1989 to 2008, the program cost the state $2.4 billion and saved the state $134 billion in health care costs, according to a study released by the University of California, San Francisco in February 2013. The study found that the amount spent on these programs per person affected cigarette use per person and overall smoking prevalence, which ultimately led to reduced health care costs. The study compared smoking and health costs in California to 38 other states, with smaller tobacco control programs or lower cigarette taxes.
Since the program began, smoking rates have fallen by almost half, from 22.1 percent in 1989 to 12.7 percent in 2012. While smoking rates have dropped across the country, California has had the second lowest smoking rates in the country for over a decade, second only to Utah. But in the past few years, the decline in smoking rates has slowed and the smoking rate has even gone up slightly in 2012, according to the department .
Young adults in particular have begun to defy this downward trend. Among those age 18-24, smoking rates went up from 12.3 percent in 2010 to 14.6 percent in 2011. In California, almost two-thirds of smokers start smoking by eighteen and 99 percent start by 26, according to the State Health Officer’s Report on Tobacco Use and Promotion in California, released in December 2012.
Young adults seem less affected by tobacco prevention programs and anti-smoking campaigns.
“Smoking is fun and it helps when I’m stressed out.” said Kai Ambrose in an interview outside a local cafe. Ambrose is a twenty-one year old Sacramento native who started smoking at nineteen in college. “I feel like most of the anti-smoking campaigns are really extreme and it’s easy to rationalize that it won’t happen to you. Plus, you don’t see them all that often, especially because people our age don’t really watch TV because we use laptops.” Ambrose doesn’t define himself as a chain-smoker but smokes almost every day.
The reduced effectiveness of tobacco prevention programs on young adults could partly be attributed to the reduced spending on the anti-smoking campaigns and programs. “Funding reductions have diminished program intensity and reach,” said Scott Sandow of the California Department of Public Health. When the program started, it funded 148 grant projects. Now it funds only 42. The statewide media campaign lasted only 15 weeks this past year, half the time of when it was first launched.
While young adults seem less affected by the anti-smoking campaigns, tobacco companies continue advertising efforts. In 2011, marketing spending by major tobacco companies increased for the first time in ten years, according to the cigarette report by the Federal Trade Commission. Overall, big tobacco companies spent $8.37 billion for cigarette advertising in 2011, up more than $300 million from 2010. Smokeless tobacco marketing also grew from $444.2 million in 2010 to $451.7 in 2011.
Most money for cigarette marketing is spent in retail stores for promotional ads, higher shelf visibility of their products and incentivized discounts. Young adults have been shown to be more sensitive to cigarette prices than other adults, according to the 2012 Surgeon General’s report Preventing Tobacco Use among Youth and Young Adults.
California’s relatively low tax on cigarettes might also explain the overall slowed decline in smoking rates and higher smoking rates in price-sensitive young adults. California ranks 33rd in the nation with a $0.87 tax per pack. “While California made progress in the past with lowering smoking rates, they should be doing more now,” said McGoldrick. “They would have a much bigger impact with higher taxes. Tax itself would increase cessation. But it would also be a huge revenue boom, so that they have money to put into these prevention programs.”
But recent efforts to raise California’s tobacco taxes have been unsuccessful. Anti-tobacco advocates introduced an initiative to tax cigarettes in 2012 but voters defeated the measure by less than a percent. A bill by Senator De Leon (D-Los Angeles), which would tax each pack of cigarettes two dollars, stalled in the Senate Appropriations Committee in July. The measure can be taken up again in January 2014, if the committee decides to do so. All of the money from the proposed two-dollar tax would be used for tobacco prevention and education, tobacco disease related heath care, and tobacco law enforcement.