Annals of Health Law
STRATEGY AGAINST SMOKING
hundreds of thousands of children who have lost at least one parent, 31
property losses from smoking-caused fires ($0.5 billion per year), 32 and
tobacco related cleaning and maintenance. 33
On the other hand, tobacco sales also generate direct income through
taxes, which differs considerably from state to state. 34 In 2009, total
tobacco tax revenues amounted to more than $17 billion. 35 Further benefits
from tobacco include the direct and indirect creation of jobs, taxes paid by
the United States manufacturers themselves, money spent on advertisement,
and the controversially discussed36 savings in social security expenditures,
pensions, and benefits due to tobacco-caused premature deaths.
B. Present Tobacco Control Strategies
The present tobacco control strategies can be divided into four main
groups: increasing prices through taxation, information campaigns,
restriction of advertisement and promotion, and the regulation of smoking
in public areas. Providing programs against tobacco addiction is dealt with
as a separate aspect. While each individual approach shows an effect for
itself, a combination of these strategies is considered to be more effective
than the added effectiveness of each independent one. 37 One key element of
31. See Bruce N. Leistikow, Daniel C. Martin, Christina E. Milano, Estimates of
Smoking-Attributable Deaths at Ages 15-54, Motherless or Fatherless Youths, and Resulting
Social Security Costs in the United States in 1994, 30 PREVENTATIVE MED. 353 passim
32. JOHN R. HALL, JR., THE SMOKING-MATERIAL FIRE PROBLEM 1 (2007).
33. Cf. DAVID H. MUDARRI, THE COSTS AND BENEFITS OF SMOKING RESTRICTIONS: AN
ASSESSMENT OF THE SMOKE-FREE ENVIRONMENT ACT OF 1993 (H.R. 3434) at ES8-ES9
34. See FEDERATION OF TAX ADM’RS, STATE EXCISE TAX RATES ON CIGARETTES (As of
Jan. 1, 2012), available at http://www.taxadmin.org/fta/rate/cigarette.pdf (last visited on
Aug. 26, 2012). See infra Part I. B.
35. THEURBANINSTITUTE-BROOKINGSINSTITUTIONTAXPOLICYCENTER,STATE AND
LOCAL TOBACCO TAX REVENUE, SELECTED YEARS 1977-2009 (2011), available at
http://www.taxpolicycenter.org/ taxfacts/ displayafact.cfm?Docid=403 (last visited on Aug.
36. See, e.g., Thomas A. Hodgson, Cigarette Smoking and Lifetime Medical
Expenditures, 70 MILBANK Q. 81 passim (1992); Barbara C. Lippiatt, Measuring Medical
Cost and Life Expectancy – Impacts of Changes in Cigarette Sales, 19 PREVENTATIVE. MED.
515 passim (1990); Kenneth E. Warner, Thomas A. Hodgson, Caitlin E. Carroll, Medical
Costs of Smoking in the United States: Estimates, Their Validity, and Their Implications, 8
TOBACCO CONTROL 290 passim (1999); Kenneth E. Warner, Health and Economic
Implications of a Tobacco-Free-Society, 258 J. AM. MED. ASS’N 2080 passim (1987); Wendy
Max, The Financial Impact of Smoking on Health-Related Costs: A Review of the Literature,
15 AM. J. HEALTH PROMOTION 321 passim (2001).
37. John P. Pierce, Victoria M. White, Sherry L. Emery, What Public Health Strategies
are Needed to Reduce Smoking Initiation?, 21 TOBACCO CONTROL 258, 260 (2012); Robert
L. Rabin, Tobacco Control Strategies: Past Efficacy and Future Promise, 41 LOY. L. A. L.