Editorial: We Must Act Now to Combat Indiana’s ‘Forgotten’ Health Crisis

This editorial was originally published in The Indianapolis Star.

To learn more about the devastating toll of Indiana's tobacco use, read our reports released with the Fairbanks Foundation.

The still escalating opioid epidemic has devastated thousands of families across Indiana. Stopping its spread will require aggressive, sustained action from state and local governments, the public health sector and an array of nonprofit organizations.

Yet as bad as the opioid scourge continues to be in Indiana, it’s not the state’s worst public health crisis, or even it’s most deadly and costly substance abuse problem.

Tobacco claims that awful distinction, killing far more Hoosiers each year than heroin and all other illegal drugs combined.

As the Fairbanks Foundation and IUPUI’s Fairbanks School of Public Health recently documented in a pair of studies, tobacco also is a costly drain on public and private resources — consuming $6.8 billion a year in health care expenditures and lost productivity traced to smoking-related diseases. Opioid addictions, according to the studies, cost Indiana $1.4 billion in 2014 in health care services and in lost income.

Researchers also found that tobacco use killed more than 10,000 Hoosiers in 2014. Opioid overdoses took the lives of more than 1,000 people in the state that year.

The point is not to downplay the opioid epidemic. It has unleashed a horrific wave of suffering and grief across the state. Again, it requires a sustained effort to develop better treatment options and to reduce demand for the drugs.

But the level of commitment needed to further drive down rates of tobacco use in Indiana is often lacking, in part because there’s a failure to grasp the scale of devastation that smoking inflicts every year in our state.

What is left to be done after decades of warning people about the dangers of smoking? Plenty.

To start, Indiana’s new governor and the General Assembly need to give strong consideration to increasing the state’s cigarette tax, which at 99.5 cents per pack is well below the national average of $1.65. Michigan and Illinois, in contrast, levy a per pack tax of about $2.

A tax increase would have two benefits. First, research has long shown that higher cigarette taxes help prevent adults, and especially teenagers, from ever starting to smoke. It’s a tax that truly saves lives.

Second, money raised through the tax increase could be dedicated to reducing the state’s high rate of tobacco use. The Centers for Disease Control and Prevention recommends that Indiana invest about $80 million a year on efforts to fight tobacco addiction. Instead, the state spends only $7 million a year.

“We don’t have to accept the fact we’re 44th (in the nation) in smoking,” Paul Halverson, founding dean of the Fairbanks School of Public Health, told IndyStar’s Shari Rudavsky. “We’re spending $6.8 billion in costs related to tobacco, and in some ways, this is like a hidden tax we’re all paying because we’re not taking actions that will change our state. This is not something we just have to accept. This is something we have to do something about.”

Halverson makes three great points: The damage that tobacco inflicts is a high tax on all Hoosiers. Change is possible. But we have to act.

And that action needs to start now.