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Invest in tobacco prevention to improve health, ease health disparities

Dedicating just a small percentage of cigarette taxes to prevention will directly improve the health of Black, Indigenous, other communities of color and youth.

Menthol flavored cigarettes are displayed in a store in New York City.
Menthol flavored cigarettes are displayed in a store in New York City.
REUTERS/Lucas Jackson

Minnesota is facing concurrent health crises, including the COVID-19 pandemic and the existing epidemics of systemic racism and youth tobacco use. All three have severe health risks that have been worsened by a common thread: Big Tobacco. Thankfully, we have a prime opportunity to address these threats. Dedicating just a small percentage of cigarette taxes to prevention will directly improve the health of Black, Indigenous, other communities of color and youth. In turn, all Minnesotans will benefit.

Dedicated funding is urgently needed to address Minnesota’s stalled adult smoking rates and the youth tobacco epidemic. For the past 20 years ClearWay Minnesota, the foundation created with 3 percent of the 1998 tobacco settlement, has provided the majority of funding for tobacco prevention in Minnesota. ClearWay Minnesota will sunset at the end of 2021, leaving a gap in prevention resources. The pandemic adds urgency since smokers are at increased risk for severe illness from COVID-19 and communities targeted by the tobacco industry are some of the hardest hit by COVID-19.

The history of insidious methods to get the highly addictive menthol and other commercial tobacco products into underserved areas is yet another way in which systemic racism has made communities more vulnerable. Investing in prevention and treatment is the first step Minnesota can take to address smoking’s unjust toll in our Black, Indigenous and LGBTQ communities.

If Minnesota dedicates just two or three pennies of each dollar of tobacco revenues we can promote youth prevention, expand culturally appropriate treatment programs and forge community partnerships. In particular, we must protect youth from an industry that uses flavors, high nicotine levels and ubiquitous marketing to addict the next generation of customers.

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The Minnesota Department of Health recently released 2020 Minnesota Youth Tobacco Survey findings, which show the youth e-cigarette epidemic continues. One in five Minnesota high-schoolers reported using e-cigarettes within the past 30 days. Overall, more youth are vaping frequently, and 70 percent of youth e-cigarette users reported signs of dependence. While Minnesota has achieved historically low levels of youth cigarette-smoking, e-cigarette use has wiped out decades of progress to reduce youth tobacco rates.

Dr. Zeke McKinney
Dr. Zeke McKinney
Meanwhile, last year Minnesota collected about $600 million in tobacco taxes and more than $150 million a year in tobacco settlement fees. Yet the state spends about 1 percent of each tobacco revenue dollar on prevention and treatment. Dedicating an additional $15 million in existing cigarette taxes to health would translate to spending 2 or 3 pennies of each tobacco dollar on prevention.

Right now, the taxes conference committee is reconciling the House and Senate Tax omnibus bills – both of which dedicate existing cigarette tax revenue to prevention and treatment. These proposals would help Minnesota boost under-funded tobacco prevention and treatment activities at the Minnesota Department of Health to address health disparities and high youth tobacco rates.

Janelle Waldock
Janelle Waldock
As members of the conference committee continue to discuss and finalize the omnibus tax bill, we urge them to include ongoing investments in tobacco prevention and treatment efforts.

Investing in tobacco prevention will pay tremendous dividends by lowering smoking rates, preventing youth addiction and easing health disparities. We all win with that kind of investment.

Dr. Zeke McKinney is a physician and researcher at HealthPartners, an affiliate assistant professor at the University of Minnesota School of Public Health, and president-elect of the Twin Cities Medical Society. Janelle Waldock is senior director of policy, Blue Cross and Blue Shield of Minnesota and co-chair of Minnesotans for a Smoke-Free Generation.


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