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Editorial: Tobacco tax increase in California is long overdue

Proposition 56, increasing the tobacco tax in California by $2 a pack, is the most important health care measure on the November ballot. By passing it, voters can save thousands of lives, substantially reduce the state’s health care costs and increase its atrociously low reimbursement rates for doctors who treat poor patients.

California spends $9 billion a year on tobacco-related medical care, and taxpayers pay about one-third of it. Most of the $1.6 billion the tax will generate will go to anti-smoking programs and to increase the Medi-Cal reimbursement rates. The rates now are so low that many doctors can’t afford to accept the thousands of new patients suddenly insured under Covered California, making health insurance a false promise.

Smoking kills 40,000 Californians every year. It’s the state’s No. 1 cause of preventable death.

Polls show voters strongly support a tobacco tax increase — but don’t underestimate the tobacco industry’s influence. A 2006 measure to raise the tax by $2.60 a pack went down by a 52 to 48 percent tally after Big Tobacco spent $66 million to defeat it.

For a state that purports to value health, California has an abysmally low tobacco tax: just 87 cents a pack, the 33rd highest in the country, and it hasn’t been raised since 1993. The national average is $1.63 a pack. New York charges $4.35. Even Texas charges $1.41.

The industry fights tax increases so aggressively for a simple reason. Taxes and the programs they fund are amazingly effective at reducing smoking.

When California increased the cigarette tax in 1988 by 25 cents a pack to pay for a smoking prevention program, the smoking rate for adults was 23 percent. In 2011 it was 12 percent. This has saved tens of thousands of lives and reduced health care costs by billions.

Virtually every major medical organization supports Proposition 56, including the California Medical Association, American Heart Association, American Cancer Society, American Lung Association and California Dental Association.

The need is urgent: e-cigarettes have increased teen smoking at an alarming rate. The Centers for Disease Control reported last year that vaping by middle- and high-school students tripled from 4.5 percent in 2013 to 13.4 percent in 2014. It’s an easy slip from there to tobacco, and the harm is similar.

The proposition raises the tax on e-cigarettes, as well as on other tobacco products, at levels equivalent to the per-pack cigarette hike.

It’s way past time for California to do this. Voters should resoundingly approve Proposition 56.

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