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NEW ORLEANS — State lawmakers are considering new strategies to reduce harm from cigarette smoking as a way to cut public health costs as new smoke-free tobacco and nicotine products prepare to enter the American market.
Heated tobacco products, which heat tobacco to deliver nicotine aerosol — without the burning and combustion that sends deadly chemicals into the body — have contributed to substantial reduction in cigarette use in other nations. In the United States, where about one in 10 Americans smoke cigarettes on a near-daily basis, advocates for tobacco harm reduction believe heated tobacco products could save thousands of lives and billions in public health costs.
“We spend about a quarter of a trillion dollars a year on treating the consequences of tobacco use. So it’s frustrating because there is indeed alternatives,” Tom Price, the former secretary of Health and Human Services in President Trump’s first term and now Philip Morris International consultant, told lawmakers at the Council of State Governments annual meeting here.
Price, a former top budget writer in Congress and a former Georgia state senator, said heated tobacco products have the potential to save money for state health plans. The financial costs of lost cigarette tax revenue in the short term, he said, would pale in comparison to the long-term budget savings reaped by significantly reducing the public health costs of treating smokers.
“We in Georgia spend about $2 billion a year caring for folks with some challenge as a consequence of smoking cigarettes. I promise you that our revenue from tobacco, from cigarette sales, is not $2 billion a year,” Price said.
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Mississippi Sen. Daniel Sparks (R), the author of a new law that taxes heated tobacco products at a lower rate than traditional cigarettes, said the goal was to provide smokers with a better alternative to cigarettes that does not carry the difficulties of quitting altogether — which remains the most beneficial option.
“It’s a habit. If you talk to someone who smokes, they missed the habit,” Sparks said. “Instead of just saying, stop doing this, the heated tobacco product allows them to continue with that process at much less harm, and it mimics the use of a cigarette even how the delivery mechanism is.”
Sparks, who serves on the Senate Economic and Workforce Development Committee and the Senate Drug Policy Committee, said high smoking rates in his state has cost billions in lost productivity. Shifting those smokers to better options, he said, would help bolster economic activity.
“Primarily for me, the measurement is in lost productivity. It is when people are sick, it is when people become disabled,” Sparks said. “If that person is no longer gainfully employed, and they’re at an age where they could be gainfully employed, that loss to the state in GDP, and all the revenue, not just in what they would spend their money on, in a sales tax or a payroll tax or something of that regard, but just their output, their work product.”
A U.S. affiliate of Philip Morris International is preparing to introduce a heated tobacco product called IQOS into the American marketplace. Heated tobacco products, like IQOS, have already contributed to a nearly 50% reduction in cigarette use in Japan.
The company submitted more than two million pages of documents in its applications to the federal Food and Drug Administration, which, after a nearly four year review, said the IQOS heated tobacco system can significantly reduce exposure to harmful and potentially harmful chemicals and contribute to public health.
“There’s been this huge explosion in technology and innovation to bring about smoke free harm reduction products,” said Dr. Brian Erkkila, Phillip Morris International’s director of regulatory science. “The amount of science in this field has just exploded exponentially, leading the way to reduced risk products.”
In Mississippi, Sparks said taxing heated products at lower rates than traditional cigarettes could spur smokers to make a switch, in a way that satisfied both conservative Republicans and progressive Democrats in the legislature.
“We pass tax policy based on what we want people to do or not do. We pass laws that tell people what we want to do or not do, and what we’re hoping to do is reduce risk and increased productivity,” Sparks said.
“We were trying to show there is a difference between a heated tobacco product and a combustible cigarette,” he added. “We wanted to reflect a lesser tax than what we would traditionally tax a cigarette.”
Price, the former Trump administration health czar, said making HTPs more widely available would result in cost savings at a massive scale.
“If you were to push a program in your state that took a portion of those who are state health benefit plan recipients, and it’s oftentimes the largest group of individuals insured in the state under one plan, and put in place a tobacco harm reduction program that that strategy, I think, would prove incredibly beneficial for not just that state, but for the country,” he said.