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Lower cigarette tax will cost state

Last modified: 4/27/2011 12:00:00 AM
The cost of cutting cigarette taxes by a dime, as the House of Representative would like, will undoubtedly cost New Hampshire much more than the loss of $9 million in revenue.

Encouraging smoking by reducing the cost will pose a significant and long-term health-care cost to the state, especially as it relates to pregnant women and children.

Consider that the first-year medical costs alone of a premature birth are about 10 times greater ($32,325) than that of an uncomplicated full-term birth ($3,325).

Smoking directly affects fetal growth and, as a result, increases the risk of a baby being born smaller or with low birth weight. So how many more women will be induced to smoke if cigarette taxes drop? It is a tough question, but the tobacco lobby clearly believes lower taxes will create more smokers.

It is estimated that about 165,000 people smoke in New Hampshire. Unfortunately, many of these are pregnant women who are increasing their odds of a premature delivery by smoking. And many of those pregnant women's deliveries and care will be paid for through Medicaid.

State budget writers need to consider that pregnant women on Medicaid are 2.5 times more likely than other pregnant women to smoke, according to Medicaid data analyzed by the Centers for Disease Control and Prevention. Moreover, joint estimates by the CDC and the Centers for Medicare and Medicaid Services, have found that smoking-attributable neonatal health care costs for Medicaid total almost $228 million, or about $738 per pregnant smoker.

In fact, clinical trials have shown that, for every $1 invested in smoking cessation programs for pregnant women, $7.75 is saved in short-term medical costs and an additional $7.63 (in 2002 dollars) is saved in long-term costs by preventing disability among low birth-weight infants who survive.

A drop in the cigarette tax will have the opposite effect: increasing smoking rates among pregnant women which will cost everyone more.

Studies show that women who stop smoking before or early in pregnancy decrease their risk of having a low birth-weight baby to nearly that of women who have never smoked. Women who stop smoking later in pregnancy can still significantly increase their chances of a healthy birth outcome.

So why would our state want to take steps to encourage pregnant women to smoke by making cigarettes more affordable? The cost is simply too high for taxpayers and children.

(Dr. Becky Ewing of Hopkinton is program services committee chairwoman for the March of Dimes, New Hampshire chapter, and a member of the steering committee of the Northern New England Perinatal Quality Improvement Network.)


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