Low Tech Health Care Reform: Stop Smoking!

uncle-sam2
Photo: sonofthesouth.net

I have a very simple way to save the government billions of dollars in health care costs, and make Americans healthier, almost immediately:

Outlaw tobacco.

Likely to happen? Not a chance.  The tobacco lobby is way too powerful, and the tobacco states will rally loudly and strongly against it, not to mention big pharma that will see a decrease in revenues as the use of patches, gums and pills goes down.

Okay, next option: tax the poo out of cigarettes.  Currently the average tax by state on a package of cigarettes is $1.19.  The state with the lowest?  Not surprising, South Carolina, where the tax is just $0.07.  The tobacco states  average is $0.33 per pack, while other states average is $1.30.  Pathetic, but it shows that there is a lot of room to increase the taxes, especially in the tobacco states.  There should be a HUGE federal tax on cigarettes.  Likely to happen?  See above r.e. tobacco lobby.

Next option: teach ‘em young.  The feds need to mandate a  ‘smoking is bad’ curriculum YEARLY kindergarten through 12th grade.

Last option: We docs keep plugging at our patients.  I’m not so optimistic on this accord, but I’ll keep trying.  Here was my must recent attempt to convince a patient to stop smoking.  I report a conversation I had with a 70ish year old gentleman, on his way to the OR to have his foot whacked off secondary to peripheral vascular disease.

Me:  (earnestly) Mr. Marlboro, what can I do to help you stop smoking? Would it be helpful to have the nicotine patch while you are in the hospital?

Mr. Marlboro: (just as earnestly)  No, I don’t need the patch.

Me: You know, while you are in the hospital, it’s a great time to quit, because you can’t smoke here.  Besides, cigarettes are so expensive.

Mr. Marlboro: Well, I don’t care about the expense.  I’d just spend the money on something else.  Besides, I’ve smoked all my life, and it’s never hurt me.

At this moment, the transport team arrives to take him to the operating room.

Me: (defeated) Oh.

Good luck out there.  Sounds like I need to brush up on my motivational stop smoking speech, as I’m not envisioning President Obama or Mr. Daschle following my suggestions.

2 Responses

  1. Unintended consequence of option #2: increased criminal activity.

    From the profits made by cigarette smuggling in NYC to the shootouts between the St Regis Indians and the NYS authorities and Canadian Mounties, criminal activity will increase as taxes on tobacco products increase. It’s happening now. Of course, you could look at history and take a look at the #1 & #2 failures in drug prohibition in US history in the 20th and 21st centuries. But then if you honestly looked at those two periods of history you couldn’t seriously bring up prohibition, or its little brother prohibitive taxation.

    Still wondering why you and your peers feel the need to belittle, castigate, embarrass, and shame people you enjoy legal substances. And then turn around and wonder why your patients loathe you.

  2. My patients don’t loathe me. Further more, this post was in no way meant to belittle, or castigate people. It is a fact that increased taxes has decreased tobacco consumption. The literature supports this.
    Furthermore, the story in the blog is sad, but true. And yes, I think tobacco should be illeagal. It is decimating to the health of America.

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