Smoking rates have fallen steadily and dramatically in the past 20 years, thanks to a multipronged effort that has driven up the price of cigarettes, cut down on the places where they can be smoked, publicized the harmful health effects and provided support to those who want to quit.

But new tobacco products continue to come to market, and high tobacco use persists within certain demographics. As much as smoking has seemed to disappear, the problem is far from over, and Maine cannot afford to rest on the successes of the past two decades.

A proposal in Gov. LePage’s budget plan runs that risk. It uses $20 million from the Fund for a Healthy Maine to maintain reimbursement rates for primary care doctors who work with MaineCare patients, bolstering smoking cessation at the expense of proven and effective prevention efforts when both are needed to keep smoking rates, and health care costs, from rising.

The Fund for a Healthy Maine was created as a result of the 1998 tobacco settlement to funnel the state’s portion to Healthy Maine Partnerships, groups that organize and coordinate smoking prevention and cessation efforts, as well as other public health initiatives, at the local level.

Maine has done better than most states at making sure at least some of the settlement money is put toward anti-tobacco initiatives, and the state has benefited. In 1997, Maine had the highest youth smoking rate in the country. It is now solidly middle-of-the-pack.

The governor’s plan would gut the Healthy Maine Partnerships and put these gains in peril, while also jeopardizing the groups’ efforts to reduce obesity, promote cardiovascular health and coordinate the response to epidemics. In Maine, the partnerships take the place of public health departments, and they could not be replaced easily.

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It’s not that LePage’s proposal misuses the money – increasing access to primary care certainly would help MaineCare patients, who smoke at twice the rate of other Mainers. But there’s no reason the state cannot fund the governor’s initiative and keep whole the Healthy Maine Partnerships.

Maine last raised its cigarette tax in 2005, and it is falling behind the rest of the Northeast. An increase would help fund further anti-tobacco initiatives and serve as a disincentive to smokers.

The state also should tax loose tobacco and cigars at the same rate as cigarettes. That alone would raise an estimated $9 million to $11 million.

Smoking has declined not just because of rising prices, increased awareness, stricter rules or better treatment, but because of a steady commitment to all those initiatives. We shouldn’t stop now.


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