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OTPC executive committee is comprised of volunteers representing various community sectors within Oklahoma. The Oklahoma Turning Point Council champions the Turning Point philosophy by supporting community partnerships through advocacy, sharing opportunities and resources, and promoting local efforts to improve the health of all Oklahomans. 2
The OTPC provides guidance and receives feedback from community partnerships on local and state policy issues that may impact health improvement efforts. This is achieved through the development of recommendations on local and state policy changes and by collaborating with other organizations in taking action on policy issues that may impact the health of all Oklahomans. In August 2017, Policy Day was held in Norman, where OTPC and community partners participated in a facilitated conversation and consensus workshop. Three primary policy objectives were selected for 2018 and 2019.. Educate the public and advocate for effective strategies to reduce deaths from opioid overdose and misuse Educate the public and advocate for policies and programs to support paid family and caregiver leave Educate the public and advocate for increased price of tobacco products 3
The current cigarette sales tax in Oklahoma is $1.03 and the average state cigarette tax in the nation is $1.71 per pack. 4 4
Approximately 19.6% of Oklahomans are smokers, which is above the national average of 17%. 1 14% of Oklahoma s adult population reported smoking every day compared to 12.3% of the adult population in the United States. 1 Smoking is responsible for approximately 7,500 deaths in Oklahoma each year. 4 Not only does smoking cause cancer of the esophagus, lungs, bladder, kidney, liver and other organs, it also damages blood vessels doubling the risk of stroke and coronary heart disease. 5 In Oklahoma, 31.1% of cancer deaths are attributable to smoking. 6 Research explicitly indicates increasing the price of cigarettes is the single most effective way to reduce smoking rates. 7 5
According to the U.S. Surgeon General, there is no safe level of exposure to cigarette smoke. 8 Secondhand smoke has been linked with several illnesses in children, including breathing problems, ear infections, bronchitis and pneumonia. In adults, it has been linked with heart disease and lung cancer (Tanner, 2016, para 4). Approximately 1 in 4 non-smokers report daily exposure to secondhand smoke. 8 In Oklahoma, 1 in 5 children are exposed to secondhand smoke at home. 11 6
Research shows that smokers cost three times as much as non-smokers. 13 Smoking caused-productivity losses cost businesses $2.1 billion. 13 Productivity losses includes health care costs, absenteeism, time employees spend on smoke breaks during work hours, higher life insurance premiums, greater risk of occupational injuries, and increased disability costs. 14 Including the $264 million covered by the state Medicaid program, Oklahoma spends $1.62 billion each year on health care costs directly caused by smoking; this cost does not include smokeless tobacco, cigar smoking or secondhand smoke exposure. 13 The cost of smoking is passed onto Oklahomans in the form of additional state and federal taxes. 12 7
Most of the habits and practices established in adolescence are carried over into adulthood and maintained throughout the life span. In 2015, 13.1% of Oklahoma high school students used cigarettes compared to 10.8% of high school students in the United States. 4 Among the 13.1% of Oklahoma high school students who smoked cigarettes, 47.7% did not try to quit within the last year of the survey. 16 8
If one can reach adulthood without smoking the probability of smoking onset is greatly reduced (Bader, Boisclair & Ferrence, 2011, p 4210). It is imperative to reduce youth smoking rates, not only due to the detrimental health effects on developing bodies, but also because youth smokers become adult smokers. 17 Young people who use tobacco are typically more responsive to increases in cigarette taxes and prices compared to older individuals. 18 Research suggests this is because younger smokers are more likely spend more of their disposable income on cigarettes than older smokers, younger smokers may consider the short-term costs of smoking (e.g., price increase) more sensitively than the long-term costs of smoking, younger smokers may have shorter histories of smoking and therefore they might be less addicted to cigarettes, and lastly younger people are highly influenced by their peers. 19-20 9
This chart comes from data given by the Campaign for Tobacco Free Kids, American Cancer Society Cancer Action Network, and the Tobacconomics Program. Increasing the price of cigarettes by $1.50 per pack will 21 : Motivate 30,400 adult smokers to quit in the first year Keep 28,200 youth from becoming adult smokers Prevent 16,700 premature smoking caused deaths Reduce smoking-complicated pregnancies and births by 4,900 in 5 years 5 year Medicaid program savings 3.92 million The public health benefits are compounded with a $2.00 per pack increase. 21 The projected new annual revenue from increasing the cigarette tax by $1.50 per pack is over $183 million. 21 10
Higher cigarette prices provide a strong fiscal disincentive to all current and potential new smokers. 22 11
The most effective approach leading to smoking cessation is a combination of efforts aimed at all levels of a socio-ecological model, which explains how behavior is interrelated with a person s social context and environment. 23 We are most effective at influencing behavior change if we have a presence in each of these different levels. For example, research shows that young people are more likely to use tobacco products if it seems acceptable among their peers, especially males 24-25 : A cigarette tax increase could influence the individual, interpersonal, and policy level of the socio-ecological model simultaneously. Research found that adolescent boys were significantly affected by cigarette prices but adolescent girls were not, instead adolescent girls were influenced by weight-related factors. Picture found at: https://www.researchgate.net/figure/294108643_fig1_figure-1- One-variant-of-the-socio-ecological-framework-of-health-promotion- Uncredited 12
Opponents to an increased cigarette price often claim high cigarette taxes disproportionately burden the poor. While most smokers tend to be middle or low income, it is true individuals from low socioeconomic backgrounds are most sensitive to changes in price. However, these individuals are typically on some form of public assistance and they contribute to the rising cost of health care. Each year the Oklahoma State Medicaid Program spends $264 million on health care costs directly caused by smoking. 26 By increasing the cigarette tax, Oklahoma will save the state Medicaid program $3.33 million in five years. 21 13
Opponents to an increased cigarette price often claim cigarette tax revenues are unpredictable and therefore not a reliable source of state income. 22 State cigarette revenues are more predictable than most other state revenue income sources such as personal income or corporate taxes. 26 14
This chart comes from the research conducted at University of Illinois with the Tobacconomics program. Oklahoma has enjoyed substantial revenue increases each time it raised the cigarette tax rate, followed by years of steady revenue levels. 26 As you can see, when Oklahoma last increased its cigarette tax rate in January 2005, revenues increased sharply and have stayed relatively high since then. 26 15
Others opposed to an increased cigarette price claim that as the cigarette prices increase, the decline in consumption will not yield revenue gains. 26 However, this is untrue. In fact, some declines in cost, such as those resulting from smoking during pregnancy, will be seen almost immediately. 26 Research has shown that increasing the cigarette tax in states increases their revenue, even when smoking rates decline. For example, the last cigarette tax increase in Oklahoma occurred in 2005 increasing the tax from by $0.80 to $1.03. The state saw a reduction in total packs of cigarettes sold by 47.4 million over the next two years while Oklahoma s state revenue increased from $55.2 million to $197 million (Orzechowski & Walker, 2014). 16
This chart shows what the Campaign for Tobacco-Free Kids, the American Cancer Society Cancer Action Network and the Tobacconomics Program projects that a $1.50 per pack increase would generate in new tax revenues over each of the next 5 years. 26 17
While there may be some tax avoidance and evasion in response to increases in cigarette price, the tax increase will generate significant public health and revenue gains. 26 18
This chart comes from research conducted by the Tobacconomics program at the University of Illinois in Chicago. 26 Following the 2005 increase, with the exception of Colorado who also increased cigarette tax at the same time, no other state surrounding Oklahoma (AR, KS, MO, NM, TX) experienced significant gains in revenue. 26 19
Some opponents argue higher cigarette prices will harm convenience stores, however research shows a positive correlation between state cigarette tax and the number of convenience stores. As price increases, customers begin substitute spending on cigarettes to other products. 21 $1.00 tax increase is associated with an increase of 1 store(s) per million population. 21 20
Increased cigarette prices are essential in the control and reduction of smoking. A 2015 poll indicated 62% of registered voters in Oklahoma support a cigarette tax increase and 74% support increasing the cigarette tax to fund health care costs. 27 21
Oklahoma health organizations share their support for a cigarette tax increase. 28 Terry Bailey hopes that the tax increase will reduce the amount of youth who try cigarettes and who begin to smoke cigarettes. 28 22
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