Testimony before the Illinois Senate Public Health Committee

Published February 5, 2019

Testimony before the Illinois Senate Public Health Committee
Lindsey Stroud, State Government Relations Manager
The Heartland Institute
February 5, 2019

Chairwoman Van Pelt and members of the Committee, thank you for taking the time today to discuss the issue of raising the age to purchase and possess tobacco and vaping products. The Heartland Institute is a 34-year-old independent, national, nonprofit organization whose mission is to discover, develop, and promote free-market solutions to social and economic problems. Heartland is headquartered in Illinois and focuses on providing national, state, and local elected officials with reliable and timely research and analyses on important policy issues. Heartland would like to submit the following testimony.

Many states have proposed legislation to raise the age required to purchase tobacco products. Often, this legislation classifies e-cigarettes and vaping devices, also called tobacco harm reduction products, in a manner similar or identical to products that contain tobacco.

Such proposals limit individual freedom, fail to curb consumption, ignore potential health gains, and cost millions of dollars in lost revenue. Rather than restricting adults’ choices, legislators should make use of revenues already received through tobacco taxes and settlements to promote cessation efforts.

Increasing the age required to smoke and purchase tobacco and vaping products limits individual freedom and grossly undermines the responsibility governments place upon individuals aged 18. 18-year-olds can serve in war; are tried as adults in courts; and can amass tremendous amounts of debt in contractual loans, such as student loans, which averaged around $30,000 in 2016.[i] Why then should lawmakers require so much responsibility from these individuals, but are intent on banning 18 to 20-year-olds from purchasing tobacco or vaping products?

Although one can make a reasonable argument that adults shouldn’t use tobacco products, raising the age for consumption of cigarettes does not necessarily provide the public health benefits officials aim for. For instance, in the 2018 Monitoring the Future Study: Trends in Prevalence of Various Drugs, the National Institute on Drug Abuse noted more than 53 percent of 12th graders and more than 37 percent of 10th graders reported consuming alcohol in the past year.[ii]

The legal age for possession and consumption of alcohol in Illinois is 21 years of age, and state law permits a “3-month suspension of driving privileges for court supervision,” with increased lengths of suspensions for subsequent violations.[iii] The current legislation, while making it illegal for persons under 21 years old to purchase tobacco products, removes the penalties for persons under 21 in possession of tobacco products. Should policymakers in Illinois want to truly deter youth tobacco consumption, persons under 21 years of age should face harsher penalties to discourage youth possession.

Even more troubling with the proposed legislation is the fact that Illinois currently uses very little funding from tobacco settlement payments and taxes on tobacco control programs. Of the $1.129 billion the state received in fiscal year 2018, Illinois “allocated $7.3 million in state funds to tobacco prevention in fiscal year 2018, just 5.3 percent of the Centers for Disease Control and Prevention’s (CDC) annual spending target.”[iv] Illinois has brazenly used tobacco funding for other programs such as tax relief. In 2000, Illinois used tobacco settlement revenue to “fund one-time property tax rebates,” with nearly $350 million earmarked for tax relief. In the same year, the state allocated only “29 million for smoking prevention programs.”[v] In 2017, Gov. Bruce Rauner “announced a 36 percent cut to fiscal year 2018 tobacco control programs.”[vi] For fiscal year 2019, Illinois will spend $9.1 million on state tobacco control programs, or 6.7 percent of the CDC’s recommended target.[vii]

Illinois’ effort to deter tobacco use included a tax hike in 2012 that increased the cigarette tax from 98 cents to $1.98. Policymakers expected “the tax hike would raise an additional $350 million for the state.”[viii] Although Illinois experienced marginal increases in revenue from 2013 to 2015, cigarette tax revenues “began plummeting in fiscal year 2016.” More pointedly, it is unclear if the tax had an effect on smoking rates. In 2012, 18.6 percent of Illinois adults smoked and the number “decreased to 15.1 percent by 2015.” The national smoking rate, however, “decreased to 15 percent from 18 percent in the same period, meaning the Illinois smoking rate decreased just a half percentage point more than the national average.”[ix]

It’s no surprise that Illinois relies on revenue from tobacco settlement payments and cigarette taxes to fund programs other than cessation. Of the $1.129 billion the state received in 2018, less than one percent is dedicated to tobacco control programs. What is interesting is that policymakers would put forth legislation that further decreases the revenue generated by cigarettes. In similar legislation introduced last year, cigarette tax receipts were expected to decrease by $35 million and sales tax receipts by $6 million. Therefore, it can be expected that should Illinois raise the tobacco age to 21, the state’s total receipts from cigarette taxes will decrease “by $41 million to $48 million.”[x]

Most troublesome with this legislation is the inclusion of electronic cigarettes and vaping devices, or tobacco harm reduction (THR) products. Data continues to indicate that THR products are significantly less harmful than combustible cigarettes. Legislation that classifies these products as tobacco products does a disservice to the public health gains e-cigarettes provide for adult smokers.

Research on electronic cigarettes and vaping devices finds similar reduced harms. In 2015, Public Health England found e-cigarettes to be less harmful than combustible cigarettes, noting that “the current best estimate [shows] using e-cigarettes is around 95% safer than smoking.”[xi] A 2016 report from the Tobacco Advisory Group of the Royal College of Physicians concluded that hazards from e-cigarettes were “unlikely to exceed 5% of the harm from smoking tobacco,” and these products have created “a massive opportunity for a consumer – as well as healthcare – led revolution in the way nicotine is used in society.”[xii] In 2018, the National Academies of Sciences, Engineering, and Medicine released a report that found “substantial evidence that completely switching from regular use of combustible cigarettes to e-cigarettes results in reduced short-term adverse health outcomes in several organ systems.”[xiii]

Most importantly, public officials should recognize the public health gains these products provide. A 2015 policy analysis by State Budget Solutions examined electronic cigarettes’ effect on Medicaid spending. The author estimated Medicaid savings could have amounted to $48 billion in 2012 if e-cigarettes had been adopted in place of combustible cigarettes by all Medicaid recipients who currently consume tobacco products.[xiv] A 2017 study by the R Street Institute examined the financial impact to Medicaid costs, should a number of current Medicaid recipients switch from combustible cigarettes to e-cigarettes and vaping devices. The author used a sample size of “1% of smokers [within] demographic groups permanently” switching. In this analysis, the author estimates that Medicaid savings “will be approximately $2.8 billion per 1 percent of enrollees,” over the next 25 years.[xv]

Rather than limiting the personal choices of adults, lawmakers in Illinois should reform how they are currently using tobacco funds and direct more resources towards cessation and education efforts. Policymakers should also understand the role of THR products, and recognize the potential health gains these products provide. Legislation that regulates these products should be done on a continuum of harm that reflects the risks associated with each tobacco product.

For more information about The Heartland Institute’s work, please visit our website at www.heartland.org, or contact Lindsey Stroud by phone at 757/354-8170 or by email at [email protected].

[i] “Student Debt and the Class of 2016,” TICAS, The Institute for College Access & Success, September, 2017, https://ticas.org/sites/default/files/pub_files/classof2016.pdf

[ii] “Monitoring the Future Study: Trends in Prevalence of Drugs,” Drug Abuse, National Institute on Drug Abuse, 2018, https://www.drugabuse.gov/trends-statistics/monitoring-future/monitoring-future-study-trends-in-prevalence-various-drugs.

[iii] “Laws and Penalties for Underage Drinking,” Illinois Liquor Control Commission, 2019, https://www2.illinois.gov/ilcc/Education/pages/under21laws.aspx.

[iv] “Tobacco Use in Illinois,” Truth Initiative, June 2018, https://truthinitiative.org/tobacco-use-illinois.

[v] Ray Long and Christie Parsons, “ILLINOIS 1 OF 2 STATES TO USE TOBACCO FUND FOR TAX RELIEF,” Chicago Tribune, July 18, 2000, https://www.chicagotribune.com/news/ct-xpm-2000-07-18-0007180139-story.html.

[vii] Laura Bach, “Key State-Specific Tobacco-Related Data & Rankings,” Campaign for Tobacco-Free Kids, December 21, 2018, https://www.tobaccofreekids.org/assets/factsheets/0176.pdf.

[viii] Vincent Caruso, “Thank You for Smoking: Illinois Cigarette Taxes Fourth-Highest in the Midwest,” Illinois Policy Institute, January 29, 2018, https://www.illinoispolicy.org/thank-you-for-smoking-illinois-cigarette-taxes-fourth-highest-in-the-midwest/.

[ix] John Kristof, “Illinois Cigarette Tax Money Goes Up in Smoke,” Illinois Policy Institute, July 26, 2017, https://www.illinoispolicy.org/illinois-cigarette-tax-money-goes-up-in-smoke/.

[x] SB2332, “Tobacco Products – Under 21,” Illinois General Assembly, 100th General Assembly, 2018, http://ilga.gov/legislation/billstatus.asp?DocNum=2332&GAID=14&GA=100&DocTypeID=SB&LegID=108817&SessionID=91

[xi] A. McNeill, L.S. Brose, R. Calder, S.C. Hitchman, P. Hajek, and H. McRobbie, “E-cigarettes an evidence update,” Public Health England, August, 2015, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/457102/Ecigarettes_an_evidence_update_A_report_commissioned_by_Public_Health_England_FINAL.pdf.

[xii] Royal College of Physicians, Nicotine without Smoke: Tobacco Harm Reduction, April, 2016, https://www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction-0.

[xiii] Committee on the Review of the Health Effects of Electronic Nicotine Delivery Systems, “Public Health Consequences of E-Cigarettes,” The National Academies of Science, Engineering, and Medicine, 2018, https://www.nap.edu/catalog/24952/public-health-consequences-of-e-cigarettes.

[xiv] J. Scott Moody, “E-Cigarettes Poised to Save Medicaid Billions,” State Budget Solutions, March 31, 2015, https://heartland.org/wp-content/uploads/documents/20150331_sbsmediciadecigarettes033115.pdf.

[xv] Edward Anselm, “Tobacco Harm Reduction Potential for ‘Heat Not Burn,'” R Street Institute, February 2017, https://www.rstreet.org/wp-content/uploads/2017/02/85.