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AP: Tobacco Tax Fails in Vote Count
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Sponsored
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John was moderator of the only 2014 gubernatorial debate, and was named by \u003cem>The Washington Post\u003c/em> to two \"Best Of\" lists: the 2015 list of top state politics reporters and 2014's list of America's most influential statehouse reporters.","avatar":"https://secure.gravatar.com/avatar/c0ac98482caf0b8229a792662b38722a?s=600&d=blank&r=g","twitter":"johnmyers","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]}],"headData":{"title":"John Myers | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/c0ac98482caf0b8229a792662b38722a?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/c0ac98482caf0b8229a792662b38722a?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/jmyers"},"kqednewsstaffandwires":{"type":"authors","id":"237","meta":{"index":"authors_1591205172","id":"237","found":true},"name":"KQED News Staff and Wires","firstName":"KQED News Staff and Wires","lastName":null,"slug":"kqednewsstaffandwires","email":"onlinenewsstaff@kqed.org","display_author_email":false,"staff_mastheads":[],"title":null,"bio":null,"avatar":"https://secure.gravatar.com/avatar/72295af8ebbfbd19a4948f5271285664?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["contributor"]},{"site":"news","roles":["contributor"]},{"site":"lowdown","roles":["author"]},{"site":"stateofhealth","roles":["contributor"]},{"site":"food","roles":["author"]}],"headData":{"title":"KQED News Staff and Wires | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/72295af8ebbfbd19a4948f5271285664?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/72295af8ebbfbd19a4948f5271285664?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/kqednewsstaffandwires"},"adembosky":{"type":"authors","id":"3205","meta":{"index":"authors_1591205172","id":"3205","found":true},"name":"April Dembosky","firstName":"April","lastName":"Dembosky","slug":"adembosky","email":"adembosky@kqed.org","display_author_email":false,"staff_mastheads":["news","science"],"title":"KQED Health Correspondent","bio":"April Dembosky is the health correspondent for KQED News and a regular contributor to NPR. She specializes in covering altered states of mind, from postpartum depression to methamphetamine-induced psychosis to the insanity defense. Her investigative series on insurance companies sidestepping mental health laws won multiple awards, including first place in beat reporting from the national Association of Health Care Journalists. She is the recipient of numerous other prizes and fellowships, including a national Edward R. Murrow award for investigative reporting, a Society of Professional Journalists award for long-form storytelling, and a Carter Center Fellowship for Mental Health Journalism.\r\n\r\nDembosky reported and produced \u003cem>Soundtrack of Silence\u003c/em>, an audio documentary about music and memory that is currently being made into a feature film by Paramount Pictures.\r\n\r\nBefore joining KQED in 2013, Dembosky covered technology and Silicon Valley for \u003cem>The Financial Times of London,\u003c/em> and contributed business and arts stories to \u003cem>Marketplace \u003c/em>and \u003cem>The New York Times.\u003c/em> She got her undergraduate degree in philosophy from Smith College and her master's in journalism from the University of California, Berkeley. She is a classically trained violinist and proud alum of the first symphony orchestra at Burning Man.","avatar":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twitter":"adembosky","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["author"]},{"site":"stateofhealth","roles":["editor"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["editor"]}],"headData":{"title":"April Dembosky | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/ef92999be4ceb9ea60701e7dc276f813?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/adembosky"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"news","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"news_11955931":{"type":"posts","id":"news_11955931","meta":{"index":"posts_1591205157","site":"news","id":"11955931","score":null,"sort":[1689721114000]},"guestAuthors":[],"slug":"californians-are-smoking-less-why-that-means-less-funding-for-some-early-childhood-services","title":"Californians Are Smoking Less. Why That Means Less Funding for Some Early Childhood Services","publishDate":1689721114,"format":"standard","headTitle":"Californians Are Smoking Less. Why That Means Less Funding for Some Early Childhood Services | KQED","labelTerm":{"term":18481,"site":"news"},"content":"\u003cp>For 25 years, some of California’s best-known early childhood services have been funded by an almost ironic source: Taxes on cigarettes and other tobacco products.\u003c/p>\n\u003cp>That was the deal voters made when they passed Proposition 10 in 1998, levying a tobacco tax and dedicating the money for programs that would help families with young children.\u003c/p>\n\u003cp>The arrangement was never supposed to last forever. Advocates for youth services have known from the beginning that \u003ca href=\"https://calmatters.org/health/2023/04/california-tobacco-ban-bill/\">fewer people would smoke over time\u003c/a>, and the funding would fall.\u003c/p>\n\u003cp>Now, the money for so-called \u003ca href=\"https://www.ccfc.ca.gov/\">First 5 California\u003c/a> programs is starting to plummet and First 5 leaders around the state say they are beginning to trim their budgets and cut back on programs.[pullquote size=\"medium\" align=\"right\" citation=\"Amy Travis, executive director, First 5 Kern County\"]‘We know tobacco use is declining, so I think it’s a matter of asking what’s next? Is that alcohol, marijuana, sugary beverages?’[/pullquote] The trend is accelerating following last year’s approval of Proposition 31 to uphold a state law \u003ca href=\"https://calmatters.org/california-voter-guide-2022/propositions/prop-31-flavored-tobacco-ban/\">banning the sale of flavored tobacco products\u003c/a>, compelling youth programs to adjust their budget assumptions.\u003c/p>\n\u003cp>“We all expect revenues to go down, the question is what will be the magnitude,” said Michael Ong, chair of the state’s \u003ca href=\"https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CTCB/Pages/TobaccoEducationAndResearchOversightCommittee.aspx#:~:text=The%20Tobacco%20Education%20and%20Research,and%20for%20tobacco%2Drelated%20research.\">Tobacco Education and Research Oversight Committee\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The cuts are unfolding in different ways based on local decisions. For example, the First 5 in Stanislaus County most recently cut one of its \u003ca href=\"https://www.first5stan.org/familynetwork/planetbaby.shtm\">PlanetBaby!\u003c/a> programs, which provide support for pregnant women and moms of babies up to a year old. That comes in addition to other recent funding cuts for programs supporting foster children and dental health services.\u003c/p>\n\u003cp>First 5 funds a broad number of programs in partnership with nonprofits, local hospitals, clinics and county health and education offices. Services vary by county, but some of the programs they fund include: children’s mobile immunization clinics, dental services, developmental screenings, family case management, parenting classes, and home visits from a nurse for first-time mothers.\u003c/p>\n\u003ch2>First 5 California revenue falling\u003c/h2>\n\u003cp>By 2026, the First 5 Association of California expects to receive almost 30% less from tobacco tax compared to 2021. It came up with yearly projections based on updated tobacco tax estimates from the state’s Department of Finance.\u003c/p>\n\u003cp>Last spring, First 5 projected it would receive approximately $348 million from California’s cigarette taxes this budget year. After voters passed the flavored tobacco ban, updated estimates show that First 5 expects to receive $38 million less than that.\u003c/p>\n\u003cp>By 2026 that number could go down to $280 million, according to the projections. How much of that each local First 5 gets is based on a formula that takes into account a county’s birth rate.\u003c/p>\n\u003cp>It’s far less than First 5 received from tobacco taxes two decades ago. In 1999-2000, First 5 received about $690 million in tobacco tax revenue, the most ever, according to First 5 California.\u003c/p>\n\u003cp>California tacks on \u003ca href=\"https://www.cdtfa.ca.gov/industry/cigarette-and-tobacco-products.htm\">$2.87 tax to each standard pack of cigarettes\u003c/a>. From 1989 to 2019, \u003ca href=\"https://www.ucsf.edu/news/2023/03/424991/californias-anti-smoking-push-spurs-big-savings-health-costs#:~:text=Over%20three%20decades%20that%20witnessed,small%20but%20yielded%20large%20savings.\">California’s smoking rate\u003c/a> among adults has dropped from 22% to 10%, according to UCSF research.\u003c/p>\n\u003cp>Experts say tobacco tax projections should be taken cautiously as revenues are difficult to forecast immediately after a major change, such as the flavored tobacco ban.\u003c/p>\n\u003cp>Ong, chair of the state tobacco oversight committee, said First 5s would ideally try to diversify their sources of revenue if they can. “But that’s a pretty tall order for county governments,” Ong said.\u003c/p>\n\u003cp>Statewide, tobacco tax dollars make up \u003ca href=\"https://www.ccfc.ca.gov/pdf/about/budget_perf/annual_report_pdfs/Annual-Report-21-22.pdf\">about 73% of First 5’s annual budget (PDF)\u003c/a>, although this largely varies by county. For example, First 5 in Kern County relies almost entirely on tobacco taxes. Meanwhile, the First 5 in Monterey County said in its \u003ca href=\"https://www.ccfc.ca.gov/pdf/about/budget_perf/annual_report_pdfs/Annual-Report-21-22.pdf\">most recent annual report (PDF)\u003c/a> that almost 40% of its funding now comes from grants and philanthropy.\u003c/p>\n\u003ch2>How to replace tobacco tax money\u003c/h2>\n\u003cp>Last month, a Kern County grand jury \u003ca href=\"https://www.kerncounty.com/home/showpublisheddocument/10071/638227612221530000\">released a report\u003c/a> where it determined that its local First 5 would need to find additional revenue streams, other than tobacco, “to offset this downward spiral.” One possibility, according to the report: have California and local governments increase alcohol taxes.\u003c/p>\n\u003cp>And while taxes aren’t an easy sell to voters, especially in a red county like Kern, it’s important to consider all options, said Amy Travis, executive director of First 5 Kern County.\u003c/p>\n\u003cp>“We know it (tax) works,” said Travis. “We know tobacco use is declining, so I think it’s a matter of asking what’s next? Is that alcohol, marijuana, sugary beverages?”\u003c/p>\n\u003cp>Shammy Karim, executive director at First 5 Stanislaus County said any new funding stream should come at the state level to maintain some uniformity and equity in the types of services available in all 58 counties.\u003c/p>\n\u003cp>“I used to work in Santa Clara County, and in Santa Clara County, I could reach out to Google or Apple or other Silicon Valley organizations and say, here’s what I need. And most of the time, I would get it,” Karim said. “I don’t have the opportunity to do that here.”\u003c/p>\n\u003cp>In Orange County, some immediate cuts are coming in the form of less funding for nonprofits that run shelter beds for families with young children.\u003c/p>\n\u003cp>“We didn’t pull the rug underneath them but we have been working on a plan to reduce our funding in the homeless services arena,” said Kim Goll, the executive director of First 5 Orange County. While First 5 is not the only funder of these shelter services, losing their share could result in less staffing, for example, Goll said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Our community will feel those cuts and we’ll be a smaller organization because of the flavor ban.”\u003c/p>\n\n","blocks":[],"excerpt":"A new ban on flavored tobacco products is accelerating a decline in nicotine tax revenue that funds California's early childhood services. Some programs are already making cuts.","status":"publish","parent":0,"modified":1689721114,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":1001},"headData":{"title":"Californians Are Smoking Less. Why That Means Less Funding for Some Early Childhood Services | KQED","description":"A new ban on flavored tobacco products is accelerating a decline in nicotine tax revenue that funds California's early childhood services. Some programs are already making cuts.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"nprByline":"\u003ca href=\"https://calmatters.org/author/anaibarra/\">Ana B. Ibarra\u003c/a>","excludeFromSiteSearch":"Include","showOnAuthorArchivePages":"No","articleAge":"0","path":"/news/11955931/californians-are-smoking-less-why-that-means-less-funding-for-some-early-childhood-services","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>For 25 years, some of California’s best-known early childhood services have been funded by an almost ironic source: Taxes on cigarettes and other tobacco products.\u003c/p>\n\u003cp>That was the deal voters made when they passed Proposition 10 in 1998, levying a tobacco tax and dedicating the money for programs that would help families with young children.\u003c/p>\n\u003cp>The arrangement was never supposed to last forever. Advocates for youth services have known from the beginning that \u003ca href=\"https://calmatters.org/health/2023/04/california-tobacco-ban-bill/\">fewer people would smoke over time\u003c/a>, and the funding would fall.\u003c/p>\n\u003cp>Now, the money for so-called \u003ca href=\"https://www.ccfc.ca.gov/\">First 5 California\u003c/a> programs is starting to plummet and First 5 leaders around the state say they are beginning to trim their budgets and cut back on programs.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘We know tobacco use is declining, so I think it’s a matter of asking what’s next? Is that alcohol, marijuana, sugary beverages?’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Amy Travis, executive director, First 5 Kern County","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp> The trend is accelerating following last year’s approval of Proposition 31 to uphold a state law \u003ca href=\"https://calmatters.org/california-voter-guide-2022/propositions/prop-31-flavored-tobacco-ban/\">banning the sale of flavored tobacco products\u003c/a>, compelling youth programs to adjust their budget assumptions.\u003c/p>\n\u003cp>“We all expect revenues to go down, the question is what will be the magnitude,” said Michael Ong, chair of the state’s \u003ca href=\"https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CTCB/Pages/TobaccoEducationAndResearchOversightCommittee.aspx#:~:text=The%20Tobacco%20Education%20and%20Research,and%20for%20tobacco%2Drelated%20research.\">Tobacco Education and Research Oversight Committee\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The cuts are unfolding in different ways based on local decisions. For example, the First 5 in Stanislaus County most recently cut one of its \u003ca href=\"https://www.first5stan.org/familynetwork/planetbaby.shtm\">PlanetBaby!\u003c/a> programs, which provide support for pregnant women and moms of babies up to a year old. That comes in addition to other recent funding cuts for programs supporting foster children and dental health services.\u003c/p>\n\u003cp>First 5 funds a broad number of programs in partnership with nonprofits, local hospitals, clinics and county health and education offices. Services vary by county, but some of the programs they fund include: children’s mobile immunization clinics, dental services, developmental screenings, family case management, parenting classes, and home visits from a nurse for first-time mothers.\u003c/p>\n\u003ch2>First 5 California revenue falling\u003c/h2>\n\u003cp>By 2026, the First 5 Association of California expects to receive almost 30% less from tobacco tax compared to 2021. It came up with yearly projections based on updated tobacco tax estimates from the state’s Department of Finance.\u003c/p>\n\u003cp>Last spring, First 5 projected it would receive approximately $348 million from California’s cigarette taxes this budget year. After voters passed the flavored tobacco ban, updated estimates show that First 5 expects to receive $38 million less than that.\u003c/p>\n\u003cp>By 2026 that number could go down to $280 million, according to the projections. How much of that each local First 5 gets is based on a formula that takes into account a county’s birth rate.\u003c/p>\n\u003cp>It’s far less than First 5 received from tobacco taxes two decades ago. In 1999-2000, First 5 received about $690 million in tobacco tax revenue, the most ever, according to First 5 California.\u003c/p>\n\u003cp>California tacks on \u003ca href=\"https://www.cdtfa.ca.gov/industry/cigarette-and-tobacco-products.htm\">$2.87 tax to each standard pack of cigarettes\u003c/a>. From 1989 to 2019, \u003ca href=\"https://www.ucsf.edu/news/2023/03/424991/californias-anti-smoking-push-spurs-big-savings-health-costs#:~:text=Over%20three%20decades%20that%20witnessed,small%20but%20yielded%20large%20savings.\">California’s smoking rate\u003c/a> among adults has dropped from 22% to 10%, according to UCSF research.\u003c/p>\n\u003cp>Experts say tobacco tax projections should be taken cautiously as revenues are difficult to forecast immediately after a major change, such as the flavored tobacco ban.\u003c/p>\n\u003cp>Ong, chair of the state tobacco oversight committee, said First 5s would ideally try to diversify their sources of revenue if they can. “But that’s a pretty tall order for county governments,” Ong said.\u003c/p>\n\u003cp>Statewide, tobacco tax dollars make up \u003ca href=\"https://www.ccfc.ca.gov/pdf/about/budget_perf/annual_report_pdfs/Annual-Report-21-22.pdf\">about 73% of First 5’s annual budget (PDF)\u003c/a>, although this largely varies by county. For example, First 5 in Kern County relies almost entirely on tobacco taxes. Meanwhile, the First 5 in Monterey County said in its \u003ca href=\"https://www.ccfc.ca.gov/pdf/about/budget_perf/annual_report_pdfs/Annual-Report-21-22.pdf\">most recent annual report (PDF)\u003c/a> that almost 40% of its funding now comes from grants and philanthropy.\u003c/p>\n\u003ch2>How to replace tobacco tax money\u003c/h2>\n\u003cp>Last month, a Kern County grand jury \u003ca href=\"https://www.kerncounty.com/home/showpublisheddocument/10071/638227612221530000\">released a report\u003c/a> where it determined that its local First 5 would need to find additional revenue streams, other than tobacco, “to offset this downward spiral.” One possibility, according to the report: have California and local governments increase alcohol taxes.\u003c/p>\n\u003cp>And while taxes aren’t an easy sell to voters, especially in a red county like Kern, it’s important to consider all options, said Amy Travis, executive director of First 5 Kern County.\u003c/p>\n\u003cp>“We know it (tax) works,” said Travis. “We know tobacco use is declining, so I think it’s a matter of asking what’s next? Is that alcohol, marijuana, sugary beverages?”\u003c/p>\n\u003cp>Shammy Karim, executive director at First 5 Stanislaus County said any new funding stream should come at the state level to maintain some uniformity and equity in the types of services available in all 58 counties.\u003c/p>\n\u003cp>“I used to work in Santa Clara County, and in Santa Clara County, I could reach out to Google or Apple or other Silicon Valley organizations and say, here’s what I need. And most of the time, I would get it,” Karim said. “I don’t have the opportunity to do that here.”\u003c/p>\n\u003cp>In Orange County, some immediate cuts are coming in the form of less funding for nonprofits that run shelter beds for families with young children.\u003c/p>\n\u003cp>“We didn’t pull the rug underneath them but we have been working on a plan to reduce our funding in the homeless services arena,” said Kim Goll, the executive director of First 5 Orange County. While First 5 is not the only funder of these shelter services, losing their share could result in less staffing, for example, Goll said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Our community will feel those cuts and we’ll be a smaller organization because of the flavor ban.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11955931/californians-are-smoking-less-why-that-means-less-funding-for-some-early-childhood-services","authors":["byline_news_11955931"],"categories":["news_8"],"tags":["news_32928","news_32929","news_23477","news_32927","news_2561"],"affiliates":["news_18481"],"featImg":"news_11955937","label":"news_18481"},"news_11563885":{"type":"posts","id":"news_11563885","meta":{"index":"posts_1591205157","site":"news","id":"11563885","score":null,"sort":[1499885624000]},"guestAuthors":[],"slug":"is-the-new-tobacco-tax-causing-a-drop-in-smoking-big-time-indicators-suggest","title":"Is the New Tobacco Tax Causing a Drop in Smoking? Big Time, Indicators Suggest","publishDate":1499885624,"format":"standard","headTitle":"The California Report | KQED News","labelTerm":{},"content":"\u003cp>Last fall, California voters approved the biggest increase in cigarette taxes since the state first began levying tobacco in the 1950s. Advocates for Proposition 56, which passed with a fairly overwhelming 64 percent of the vote, argued that a $2-per-pack tax hike would hurt pocketbooks enough to nudge millions of California smokers to quit, or at least to light up less frequently.\u003c/p>\n\u003cp>When the tax went into effect in April, smokers saw the average cost of a pack of cigarettes soar from under $6 to up to $9, making California one of the most expensive states in which to buy cigarettes. But the question then: Was that enough to force smokers to kick an increasingly expensive habit?\u003c/p>\n\u003cp>The early data suggest that yes, California cigarette sales have declined significantly since prices went up. In fact, the drop is even sharper than the state anticipated -- which could spell trouble for state coffers.\u003c/p>\n\u003cp>[cigtax]\u003c/p>\n\u003cp>Cigarette pack \"distributions\" -- tax lingo for a pack of cigarettes typically sold from a distributor to a retailer, and a good proxy for consumption -- dropped 56 percent year-over-year in the two months following the tax increase, according to data obtained from the California Department of Tax and Fee Administration and analyzed by CALmatters. That’s a decline of nearly 82 million packs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This is a big effect,” said Dr. Stanton Glantz, a researcher at UCSF's Center for Tobacco Control Research and Education. “I have felt for a long time where we’re getting to the point in California where smoking is so low that a couple of good shoves like this one, and we might be rid of it.”\u003c/p>\n\u003cp>Glantz and other tobacco experts cautioned that it is still far too early to make definitive conclusions: It’s difficult to draw inferences from two months of data, as both suppliers and consumers are still figuring out what they can and can’t afford.\u003c/p>\n\u003cp>Knowing that prices were about to rise, tobacco distributors and smokers also rushed to stockpile as many cigarettes as possible the month preceding the tax hike, deflating the April and May figures. California cigarette distributors sold nearly 104 million cigarette packs in March, by far the most of any month in the last two years.\u003c/p>\n\u003cp>[contextly_sidebar id=\"7wYFkDkJqpG5LX8BPIbgWZ6c23FJqkpm\"]\u003c/p>\n\u003cp>But even after adjusting for stockpiling, the tax hike appears to be having a major impact: Cigarette sales still dropped 23 percent year-over-year for the three-month period, including the pretax run-up.\u003c/p>\n\u003cp>Experts say cigarette consumption will likely rise slightly in the months ahead, before stabilizing in the next four to five months. Lower-income and younger smokers are typically the first to cut back in response to a tax hike.\u003c/p>\n\u003cp>But what’s beneficial for public health isn’t necessarily good for the state budget, at least in the near term.\u003c/p>\n\u003cp>Proposition 56 was supposed to generate an additional $1.3 billion in revenue for the state to shore up Medi-Cal, the state health insurance program for low-income Californians. In the two months since the tax has been in place, the state has raised a total of $182 million -- below what the Brown administration was expecting.\u003c/p>\n\u003cp>\"Sales are still more sluggish than had been originally anticipated,\" H.D. Palmer, spokesman for the Department of Finance, said via email. \"Given that we only have two months of data, it is too early to predict a trend. If the current trend holds, we would likely make a revision to our expected decline in consumption.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"B6j14NxRMaFQ9SqSivOZuj8kr97QZdE1\"]\u003c/p>\n\u003cp>How the new cigarette tax revenue would be spent became a \u003ca href=\"http://www.latimes.com/politics/la-pol-sac-tobacco-tax-budget-20170316-story.html\" target=\"_blank\" rel=\"noopener noreferrer\">hot-button issue\u003c/a> in state budget negotiations last month. Ultimately, legislators and Gov. Jerry Brown agreed to divide the new revenue between increased payments to physicians and general Medi-Cal expenses.\u003c/p>\n\u003cp>Palmer said that if cigarette tax revenues continue to come in lower than anticipated, the administration would need to identify an alternative revenue source or propose cutbacks to Medi-Cal.\u003c/p>\n\u003cp>Of course, tax revenue is just one side of the equation when it comes to the fiscal effects of the new cigarette tax. Savings from lower health care costs as more low-income smokers quit are not factored into the revenue side of the state budget.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://calmatters.org/\" target=\"_blank\" rel=\"noopener noreferrer\">CALmatters.org\u003c/a> is a nonprofit, nonpartisan media venture explaining California policies and politic\u003c/em>s.\u003c/p>\n\n","blocks":[],"excerpt":"Two months after California enacted a new $2-per-pack tax, one cigarette sales indicator has dropped 56 percent -- further than the state expected.","status":"publish","parent":0,"modified":1499903494,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":21,"wordCount":732},"headData":{"title":"Is the New Tobacco Tax Causing a Drop in Smoking? Big Time, Indicators Suggest | KQED","description":"Two months after California enacted a new $2-per-pack tax, one cigarette sales indicator has dropped 56 percent -- further than the state expected.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"11563885 https://ww2.kqed.org/news/?p=11563885","disqusUrl":"https://ww2.kqed.org/news/2017/07/12/is-the-new-tobacco-tax-causing-a-drop-in-smoking-big-time-indicators-suggest/","disqusTitle":"Is the New Tobacco Tax Causing a Drop in Smoking? Big Time, Indicators Suggest","source":"CALmatters","sourceUrl":"https://calmatters.org/","nprByline":"\u003cstrong>\u003ca href=\"https://calmatters.org/articles/author/matt-levin/\">Matt Levin\u003c/a>\u003c/strong>","path":"/news/11563885/is-the-new-tobacco-tax-causing-a-drop-in-smoking-big-time-indicators-suggest","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Last fall, California voters approved the biggest increase in cigarette taxes since the state first began levying tobacco in the 1950s. Advocates for Proposition 56, which passed with a fairly overwhelming 64 percent of the vote, argued that a $2-per-pack tax hike would hurt pocketbooks enough to nudge millions of California smokers to quit, or at least to light up less frequently.\u003c/p>\n\u003cp>When the tax went into effect in April, smokers saw the average cost of a pack of cigarettes soar from under $6 to up to $9, making California one of the most expensive states in which to buy cigarettes. But the question then: Was that enough to force smokers to kick an increasingly expensive habit?\u003c/p>\n\u003cp>The early data suggest that yes, California cigarette sales have declined significantly since prices went up. In fact, the drop is even sharper than the state anticipated -- which could spell trouble for state coffers.\u003c/p>\n\u003cp>[cigtax]\u003c/p>\n\u003cp>Cigarette pack \"distributions\" -- tax lingo for a pack of cigarettes typically sold from a distributor to a retailer, and a good proxy for consumption -- dropped 56 percent year-over-year in the two months following the tax increase, according to data obtained from the California Department of Tax and Fee Administration and analyzed by CALmatters. That’s a decline of nearly 82 million packs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This is a big effect,” said Dr. Stanton Glantz, a researcher at UCSF's Center for Tobacco Control Research and Education. “I have felt for a long time where we’re getting to the point in California where smoking is so low that a couple of good shoves like this one, and we might be rid of it.”\u003c/p>\n\u003cp>Glantz and other tobacco experts cautioned that it is still far too early to make definitive conclusions: It’s difficult to draw inferences from two months of data, as both suppliers and consumers are still figuring out what they can and can’t afford.\u003c/p>\n\u003cp>Knowing that prices were about to rise, tobacco distributors and smokers also rushed to stockpile as many cigarettes as possible the month preceding the tax hike, deflating the April and May figures. California cigarette distributors sold nearly 104 million cigarette packs in March, by far the most of any month in the last two years.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But even after adjusting for stockpiling, the tax hike appears to be having a major impact: Cigarette sales still dropped 23 percent year-over-year for the three-month period, including the pretax run-up.\u003c/p>\n\u003cp>Experts say cigarette consumption will likely rise slightly in the months ahead, before stabilizing in the next four to five months. Lower-income and younger smokers are typically the first to cut back in response to a tax hike.\u003c/p>\n\u003cp>But what’s beneficial for public health isn’t necessarily good for the state budget, at least in the near term.\u003c/p>\n\u003cp>Proposition 56 was supposed to generate an additional $1.3 billion in revenue for the state to shore up Medi-Cal, the state health insurance program for low-income Californians. In the two months since the tax has been in place, the state has raised a total of $182 million -- below what the Brown administration was expecting.\u003c/p>\n\u003cp>\"Sales are still more sluggish than had been originally anticipated,\" H.D. Palmer, spokesman for the Department of Finance, said via email. \"Given that we only have two months of data, it is too early to predict a trend. If the current trend holds, we would likely make a revision to our expected decline in consumption.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>How the new cigarette tax revenue would be spent became a \u003ca href=\"http://www.latimes.com/politics/la-pol-sac-tobacco-tax-budget-20170316-story.html\" target=\"_blank\" rel=\"noopener noreferrer\">hot-button issue\u003c/a> in state budget negotiations last month. Ultimately, legislators and Gov. Jerry Brown agreed to divide the new revenue between increased payments to physicians and general Medi-Cal expenses.\u003c/p>\n\u003cp>Palmer said that if cigarette tax revenues continue to come in lower than anticipated, the administration would need to identify an alternative revenue source or propose cutbacks to Medi-Cal.\u003c/p>\n\u003cp>Of course, tax revenue is just one side of the equation when it comes to the fiscal effects of the new cigarette tax. Savings from lower health care costs as more low-income smokers quit are not factored into the revenue side of the state budget.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://calmatters.org/\" target=\"_blank\" rel=\"noopener noreferrer\">CALmatters.org\u003c/a> is a nonprofit, nonpartisan media venture explaining California policies and politic\u003c/em>s.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11563885/is-the-new-tobacco-tax-causing-a-drop-in-smoking-big-time-indicators-suggest","authors":["byline_news_11563885"],"programs":["news_6944","news_72"],"categories":["news_1758","news_457","news_8","news_13"],"tags":["news_458","news_423","news_17286","news_2561"],"affiliates":["news_18481"],"featImg":"news_11563889","label":"source_news_11563885"},"stateofhealth_339838":{"type":"posts","id":"stateofhealth_339838","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"339838","score":null,"sort":[1496833243000]},"guestAuthors":[],"slug":"is-the-fight-over-tobacco-tax-money-about-helping-patients-or-enriching-doctors","title":"Is the Fight Over Tobacco Tax Money About Helping Patients or Helping Doctors?","publishDate":1496833243,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>One of the biggest budget fights unfolding behind closed doors in Sacramento this week is over how to spend the $1.2 billion raised by the state’s new tobacco tax, with dentists, doctors, gynecologists, and podiatrists all vying for a cut.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The biggest ask comes from the California Medical Association, which wants at least half of the money, $610 million a year, to increase payments to doctors who treat low-income patients on Medi-Cal. The group has long argued that low reimbursement rates force doctors to limit the number of Medi-Cal patients they can see, making it harder for some patients to find care. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We’ve let this program atrophy for so long, you have to put a substantial amount toward it to make a difference in access to care,” says Dustin Corcoran, CEO of the \u003ca href=\"https://www.cmanet.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Medical Association\u003c/a>. “It’s been a systemic problem for years, and Prop 56 was an important investment in that.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The 2016 \u003ca href=\"http://vig.cdn.sos.ca.gov/2016/general/en/pdf/text-proposed-laws.pdf#prop56\" target=\"_blank\" rel=\"noopener noreferrer\">ballot initiative\u003c/a> that raised the tobacco tax earmarked the revenue to \"augment spending on health care for low–income Californians,” in part, by \"providing improved payments for all healthcare.\" That fuels the medical association's argument that increasing Medi-Cal payments to doctors should be the first priority. Other health advocates say California should also bring back services Medi-Cal used to cover before the recession (hearing tests, vision care, podiatry exams); and, allow undocumented immigrant young adults to receive Medi-Cal coverage until age 26. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But the loudest fight over the money has revolved around the payments for doctors. The California Medical Association has been highly critical of Gov. Jerry Brown, who has routinely refused to increase doctors’ payments in years past, and whose draft budget again snubbed doctors, allocating the entirety of the tobacco tax proceeds to cover the general costs of the Medi-Cal program in the next fiscal year, namely, new patients coming on to the Medi-Cal rolls. \u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The thinking behind this is simple, says H.D. Palmer, the governor’s spokesman on finance and the budget. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Eighty percent of Medi-Cal patients are covered by managed care plans, Palmer explains. These insurance companies, contracted by the state to run the Medi-Cal program, are the ones who negotiate payment rates with doctors, not the governor. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Four out of every five participants in the Medi-Cal program are in managed care,” Palmer says repeatedly. “Rates are specifically negotiated between the plans and their network of providers. That’s not a negotiation that the state is in the middle of.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state can only raise reimbursement rates for doctors with whom it contracts directly in “fee-for-service” arrangements. Those doctors serve just one out of five Medi-Cal patients. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Managed care plans may look to the state rates when setting payment rates for doctors in their own networks. But insurance experts say that only happens to a minor extent. Plans rely more on a range of actuarial risk data to set rates, and increasingly, plans are paying doctors a fixed, “capitated” payment to manage each patient’s overall health for the year, rather than paying for individual appointments or medical procedures.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Fight with Governor\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Nonetheless, both the state Senate and Assembly have rejected the governor’s spending plan for the tobacco tax. Instead, each house has proposed setting aside hundreds of millions of dollars to fund provider rate increases that would directly benefit doctors who serve the 20 percent of Medi-Cal patients not covered by managed-care.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“That’s still three million people,” says Anthony Wright, executive director of \u003ca href=\"http://www.health-access.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Health Access\u003c/a>, a patient advocacy group. “There is a rationale to do this.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Wright points to dental care and family planning services as two specialties that mainly operate outside managed care plans, and have a “demonstrated need” for improved access.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">A \u003ca href=\"https://www.auditor.ca.gov/pdfs/reports/2013-125.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">state audit\u003c/a> found 16 counties in California had no dentists accepting new Medi-Cal patients, while Planned Parenthood recently announced it will close three of its reproductive health clinics in Northern California, and Women’s Health Specialists \u003ca href=\"https://ww2.kqed.org/stateofhealth/2017/05/19/womens-health-clinics-in-california-struggle-in-a-shifting-healthcare-landscape/\" target=\"_blank\" rel=\"noopener noreferrer\">closed another two\u003c/a>. Both clinic operators cited low Medi-Cal reimbursement rates for family planning services as the main reason for the closures.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">More than half of Planned Parenthood’s patients are covered by fee-for-service contracts with the state, and the Medi-Cal managed care contracts it does have, covering 31 percent of patients, specifically set fees to match the state rate, says Beth Parker, chief legal counsel for Planned Parenthood. A fee bump could help prevent more clinic closures. Also, making it easy for women to get contraception saves the state more money in the long run.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“California pays for \u003ca href=\"https://www.guttmacher.org/fact-sheet/state-facts-about-unintended-pregnancy-california\" target=\"_blank\" rel=\"noopener noreferrer\">64 percent of unplanned births\u003c/a> in the state through the Medi-Cal program,\" she says. \"So every time an unplanned pregnancy is averted, it saves the state a tremendous amount of money, not just in the maternity costs, but also all the social services costs that come after.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state Senate and Assembly are both proposing giving a small portion of the tobacco tax money specifically to family planning providers ($50 million) and dentists (up to $247 million). Up to $700 million would go to other doctors to increase payments.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But the bigger question is whether or not raising rates for doctors actually prods them to accept more Medi-Cal patients.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“There’s always a question of whether or not physicians respond to economic stimuli that simply,” said Suzanne Delbanco, executive director for \u003ca href=\"https://www.catalyze.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Catalyst for Payment Reform\u003c/a>. “If an increase in fee schedules will make them take more patients, it’s hard to say what the right level of increase would be to lead to that scenario.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">For example, after Tennessee’s Medicaid program increased reimbursement rates for dentists, the number of dentists participating in the program more than doubled. But the number of children who got dental care only went up by 38 percent, according to\u003c/span>\u003ca href=\"https://tely2.kqed.org/owa/redir.aspx?C=DgRDGvMxpSQbiM7sxd2OnXy3MuxXAq4cOeo1xBbuoleVreZvnazUCA..&URL=http%3a%2f%2fwww.nashp.org%2fsites%2fdefault%2ffiles%2fCHCF_dental_rates.pdf\">\u003cspan style=\"font-weight: 400\"> a study\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> by the National Academy for State Health Policy.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The federal government tried it, too: The Affordable Care Act mandated an increase in Medicaid payments to primary care doctors for two years. In California, doctors got paid 136 percent more, but state health officials say they don't know if the increase affected the rate of patients accessing primary care in the state at all.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>California proposals\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">That’s why the California Medical Association developed a plan, taken up by the state Assembly, to give supplemental payments to doctors based on the percentage of Medi-Cal patients they see in their practice. Doctors would get extra money if 5 percent of their patients were on Medi-Cal; they'd get more if the proportion were 10 percent, and more at 15 percent, and so on up to 30 percent.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">All doctors would be eligible for these lump sums, whether they’re contracted by the state or by managed care plans.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Many physicians have to severely limit their patient population on Medi-Cal because they lose money on each patient,” says Dustin Corcoran, the California Medical Association’s CEO. “If we can improve that and incentivize physicians to enter the space, we think that would do a lot to improve access.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But patient advocate Anthony Wright says this plan amounts to giving doctors a “bonus” for work they’ve already done, and in some cases, arguably, would have done anyway.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Instead, Wright’s group has convinced the Senate to advocate for rate increases based on data, carefully evaluating geographic regions and medical specialties for shortages, then directing money where the need is most acute. Again, these rate increases would apply to doctors seeing 20 percent of Medi-Cal patients.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We think that would be a more targeted and data-driven way to make an impact on access to care,” Wright said. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The Legislature must pass a final budget by June 15, and whether lawmakers unite behind the Assembly plan, the Senate plan, or a compromise plan, they still have to convince the governor. With the number of people enrolling in Medi-Cal increasing every year, and federal funding for the program uncertain because of political infighting in D.C., Jerry Brown seems more skeptical than ever of spending new money.\u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"Doctors groups want at least half of the tax money, $610 million a year, to increase payments to doctors who treat Medi-Cal patients.","status":"publish","parent":0,"modified":1539629169,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":32,"wordCount":1431},"headData":{"title":"Is the Fight Over Tobacco Tax Money About Helping Patients or Helping Doctors? | KQED","description":"Doctors groups want at least half of the tax money, $610 million a year, to increase payments to doctors who treat Medi-Cal patients.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"339838 https://ww2.kqed.org/stateofhealth/?p=339838","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/06/07/is-the-fight-over-tobacco-tax-money-about-helping-patients-or-enriching-doctors/","disqusTitle":"Is the Fight Over Tobacco Tax Money About Helping Patients or Helping Doctors?","path":"/stateofhealth/339838/is-the-fight-over-tobacco-tax-money-about-helping-patients-or-enriching-doctors","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>One of the biggest budget fights unfolding behind closed doors in Sacramento this week is over how to spend the $1.2 billion raised by the state’s new tobacco tax, with dentists, doctors, gynecologists, and podiatrists all vying for a cut.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The biggest ask comes from the California Medical Association, which wants at least half of the money, $610 million a year, to increase payments to doctors who treat low-income patients on Medi-Cal. The group has long argued that low reimbursement rates force doctors to limit the number of Medi-Cal patients they can see, making it harder for some patients to find care. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We’ve let this program atrophy for so long, you have to put a substantial amount toward it to make a difference in access to care,” says Dustin Corcoran, CEO of the \u003ca href=\"https://www.cmanet.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Medical Association\u003c/a>. “It’s been a systemic problem for years, and Prop 56 was an important investment in that.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The 2016 \u003ca href=\"http://vig.cdn.sos.ca.gov/2016/general/en/pdf/text-proposed-laws.pdf#prop56\" target=\"_blank\" rel=\"noopener noreferrer\">ballot initiative\u003c/a> that raised the tobacco tax earmarked the revenue to \"augment spending on health care for low–income Californians,” in part, by \"providing improved payments for all healthcare.\" That fuels the medical association's argument that increasing Medi-Cal payments to doctors should be the first priority. Other health advocates say California should also bring back services Medi-Cal used to cover before the recession (hearing tests, vision care, podiatry exams); and, allow undocumented immigrant young adults to receive Medi-Cal coverage until age 26. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But the loudest fight over the money has revolved around the payments for doctors. The California Medical Association has been highly critical of Gov. Jerry Brown, who has routinely refused to increase doctors’ payments in years past, and whose draft budget again snubbed doctors, allocating the entirety of the tobacco tax proceeds to cover the general costs of the Medi-Cal program in the next fiscal year, namely, new patients coming on to the Medi-Cal rolls. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The thinking behind this is simple, says H.D. Palmer, the governor’s spokesman on finance and the budget. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Eighty percent of Medi-Cal patients are covered by managed care plans, Palmer explains. These insurance companies, contracted by the state to run the Medi-Cal program, are the ones who negotiate payment rates with doctors, not the governor. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Four out of every five participants in the Medi-Cal program are in managed care,” Palmer says repeatedly. “Rates are specifically negotiated between the plans and their network of providers. That’s not a negotiation that the state is in the middle of.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state can only raise reimbursement rates for doctors with whom it contracts directly in “fee-for-service” arrangements. Those doctors serve just one out of five Medi-Cal patients. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Managed care plans may look to the state rates when setting payment rates for doctors in their own networks. But insurance experts say that only happens to a minor extent. Plans rely more on a range of actuarial risk data to set rates, and increasingly, plans are paying doctors a fixed, “capitated” payment to manage each patient’s overall health for the year, rather than paying for individual appointments or medical procedures.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Fight with Governor\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Nonetheless, both the state Senate and Assembly have rejected the governor’s spending plan for the tobacco tax. Instead, each house has proposed setting aside hundreds of millions of dollars to fund provider rate increases that would directly benefit doctors who serve the 20 percent of Medi-Cal patients not covered by managed-care.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“That’s still three million people,” says Anthony Wright, executive director of \u003ca href=\"http://www.health-access.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Health Access\u003c/a>, a patient advocacy group. “There is a rationale to do this.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Wright points to dental care and family planning services as two specialties that mainly operate outside managed care plans, and have a “demonstrated need” for improved access.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">A \u003ca href=\"https://www.auditor.ca.gov/pdfs/reports/2013-125.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">state audit\u003c/a> found 16 counties in California had no dentists accepting new Medi-Cal patients, while Planned Parenthood recently announced it will close three of its reproductive health clinics in Northern California, and Women’s Health Specialists \u003ca href=\"https://ww2.kqed.org/stateofhealth/2017/05/19/womens-health-clinics-in-california-struggle-in-a-shifting-healthcare-landscape/\" target=\"_blank\" rel=\"noopener noreferrer\">closed another two\u003c/a>. Both clinic operators cited low Medi-Cal reimbursement rates for family planning services as the main reason for the closures.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">More than half of Planned Parenthood’s patients are covered by fee-for-service contracts with the state, and the Medi-Cal managed care contracts it does have, covering 31 percent of patients, specifically set fees to match the state rate, says Beth Parker, chief legal counsel for Planned Parenthood. A fee bump could help prevent more clinic closures. Also, making it easy for women to get contraception saves the state more money in the long run.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“California pays for \u003ca href=\"https://www.guttmacher.org/fact-sheet/state-facts-about-unintended-pregnancy-california\" target=\"_blank\" rel=\"noopener noreferrer\">64 percent of unplanned births\u003c/a> in the state through the Medi-Cal program,\" she says. \"So every time an unplanned pregnancy is averted, it saves the state a tremendous amount of money, not just in the maternity costs, but also all the social services costs that come after.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The state Senate and Assembly are both proposing giving a small portion of the tobacco tax money specifically to family planning providers ($50 million) and dentists (up to $247 million). Up to $700 million would go to other doctors to increase payments.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But the bigger question is whether or not raising rates for doctors actually prods them to accept more Medi-Cal patients.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“There’s always a question of whether or not physicians respond to economic stimuli that simply,” said Suzanne Delbanco, executive director for \u003ca href=\"https://www.catalyze.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Catalyst for Payment Reform\u003c/a>. “If an increase in fee schedules will make them take more patients, it’s hard to say what the right level of increase would be to lead to that scenario.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">For example, after Tennessee’s Medicaid program increased reimbursement rates for dentists, the number of dentists participating in the program more than doubled. But the number of children who got dental care only went up by 38 percent, according to\u003c/span>\u003ca href=\"https://tely2.kqed.org/owa/redir.aspx?C=DgRDGvMxpSQbiM7sxd2OnXy3MuxXAq4cOeo1xBbuoleVreZvnazUCA..&URL=http%3a%2f%2fwww.nashp.org%2fsites%2fdefault%2ffiles%2fCHCF_dental_rates.pdf\">\u003cspan style=\"font-weight: 400\"> a study\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> by the National Academy for State Health Policy.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The federal government tried it, too: The Affordable Care Act mandated an increase in Medicaid payments to primary care doctors for two years. In California, doctors got paid 136 percent more, but state health officials say they don't know if the increase affected the rate of patients accessing primary care in the state at all.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>California proposals\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">That’s why the California Medical Association developed a plan, taken up by the state Assembly, to give supplemental payments to doctors based on the percentage of Medi-Cal patients they see in their practice. Doctors would get extra money if 5 percent of their patients were on Medi-Cal; they'd get more if the proportion were 10 percent, and more at 15 percent, and so on up to 30 percent.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">All doctors would be eligible for these lump sums, whether they’re contracted by the state or by managed care plans.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Many physicians have to severely limit their patient population on Medi-Cal because they lose money on each patient,” says Dustin Corcoran, the California Medical Association’s CEO. “If we can improve that and incentivize physicians to enter the space, we think that would do a lot to improve access.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But patient advocate Anthony Wright says this plan amounts to giving doctors a “bonus” for work they’ve already done, and in some cases, arguably, would have done anyway.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Instead, Wright’s group has convinced the Senate to advocate for rate increases based on data, carefully evaluating geographic regions and medical specialties for shortages, then directing money where the need is most acute. Again, these rate increases would apply to doctors seeing 20 percent of Medi-Cal patients.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We think that would be a more targeted and data-driven way to make an impact on access to care,” Wright said. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The Legislature must pass a final budget by June 15, and whether lawmakers unite behind the Assembly plan, the Senate plan, or a compromise plan, they still have to convince the governor. With the number of people enrolling in Medi-Cal increasing every year, and federal funding for the program uncertain because of political infighting in D.C., Jerry Brown seems more skeptical than ever of spending new money.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/339838/is-the-fight-over-tobacco-tax-money-about-helping-patients-or-enriching-doctors","authors":["3205"],"categories":["stateofhealth_2442","stateofhealth_15","stateofhealth_14"],"tags":["stateofhealth_2808","stateofhealth_2519"],"featImg":"stateofhealth_99973","label":"stateofhealth"},"news_11097450":{"type":"posts","id":"news_11097450","meta":{"index":"posts_1591205157","site":"news","id":"11097450","score":null,"sort":[1474527947000]},"guestAuthors":[],"slug":"would-californias-proposed-tobacco-tax-hike-reduce-smoking-just-ask-new-yorkers","title":"Would California's Proposed Tobacco Tax Hike Reduce Smoking? Just Ask New Yorkers","publishDate":1474527947,"format":"image","headTitle":"Election 2016 | The California Report | KQED News","labelTerm":{"term":72,"site":"news"},"content":"\u003cp>Each time New York increased its tobacco tax -- now at $4.35 a pack -- calls to the state's Quitline spiked.\u003c/p>\n\u003cp>In New York City, Mayor Michael Bloomberg \u003ca href=\"http://www.wnyc.org/story/bloomberg-pushed-new-yorkers-health-and-often-they-pushed-back/\">raised the tax even more\u003c/a>.\u003c/p>\n\u003cp>“I was so angry with him, I could hardly afford it,” says Elizabeth Lane, a Harlem resident who paid $12 a pack. “I had to beg, borrow and steal to get money to buy cigarettes.”\u003c/p>\n\u003cp>At first, Lane managed to cut down from seven packs a week to four. But sometimes she still didn’t have money to buy laundry detergent or toilet paper. In 2013, after smoking for 40 years, the price tag, her doctor’s warnings and her daughter’s guilt trips -- it all came together.\u003c/p>\n\u003cp>She quit.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I said, ‘Lord, I’ve been waiting a long time for this. When will you answer my prayer?’ ” she says. “And he answered this time.\"\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/284110040\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>California currently has one of the lowest cigarette taxes in the country: 87 cents per pack. If voters pass \u003ca href=\"https://www.oag.ca.gov/system/files/initiatives/pdfs/15-0081%20(Tobacco%20Tax%20V3).pdf?\">Proposition 56\u003c/a> in November, the tax would go up to $2.87 a pack. Backers of the measure, including the American Cancer Society and the American Lung Association, hope to hit people hard enough in the wallet that they quit smoking, or never start.\u003c/p>\n\u003cp>Studies support the goal. For every 10 percent increase in the price of cigarettes, smoking goes down 4 percent, according to the 2014 \u003ca href=\"http://www.surgeongeneral.gov/library/reports/50-years-of-progress/index.html\">Surgeon General’s Report\u003c/a>.\u003c/p>\n\u003cp>“Part of that is people quitting. Part of that is people cutting down,” says Stanton Glantz, a professor of medicine at UCSF and director of the Center for Tobacco Control Research and Education.\u003c/p>\n\u003cp>In New York City, smoking rates declined from 22 percent of the local population to 15 percent in the decade that the tax, and a ban on smoking in restaurants and bars, was implemented.\u003c/p>\n\u003cp>California's smoking rate is about 12 percent, the second lowest in the country after Utah. Most people here who do smoke, Glantz says, don’t smoke that much.\u003c/p>\n\u003cp>“It may be that a price increase that will follow Prop. 56 will be enough to just get these light, intermittent smokers to just say, 'Forget it,'\" he says.\u003c/p>\n\u003cp>Glantz’s colleague, behavioral economist Justin White, explains the psychology behind this. He says the vast majority of smokers wish they could quit. They know it’s bad for them. But addiction is a powerful force.\u003c/p>\n\u003cp>“There’s this universal tendency towards immediate gratification,” White says.\u003c/p>\n\u003cfigure id=\"attachment_11097648\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11097648\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2016/09/NYCSmokin-800x544.jpg\" alt=\"A man smokes a cigarette in New York City, where the current tobacco tax is $4.35 a pack.\" width=\"800\" height=\"544\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2016/09/NYCSmokin-800x544.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/NYCSmokin-400x272.jpg 400w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/NYCSmokin.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/NYCSmokin-1180x802.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/NYCSmokin-960x653.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A man smokes a cigarette in New York City, where the current tobacco tax is $4.35 a pack. \u003ccite>(T. Carrigan/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The craving for a cigarette right now easily overwhelms fears of heart disease or lung cancer in the future. But, White says, a cigarette tax can flip that. A tax also hits right now, and that has the power to compete with the desire for a cigarette.\u003c/p>\n\u003cp>“Increasing taxes is a way to really bring that back to equilibrium, the cost in the future versus the benefits now,” White says.\u003c/p>\n\u003cp>The question is, how much. He says a $1 or $2 tax is enough to sway smokers with a mild self-control problem. But for smokers with a strong addiction, the tax needs to be between $5 and $10 to work.\u003c/p>\n\u003cp>Either way, White says, a tax is most effective when paired with support from a cessation program.\u003c/p>\n\u003cp>And this is where opponents have been digging into Proposition 56. The No on 56 campaign, backed by tobacco companies R.J, Reynolds and Philip Morris, have raised $56 million to defeat the measure. Supporters have raised $17.5 million.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It may be that a price increase will be enough to just get these light, intermittent smokers to just say, 'Forget it.''\u003ccite>Stanton Glantz, professor of medicine at UCSF\u003c/cite>\u003c/aside>\n\u003cp>Opponents are investing in \u003ca href=\"http://audio.californiareport.org/archive/R201609160850/b\">radio ads\u003c/a> that say proponents “are telling us Proposition 56 is all about helping people stop smoking. But follow the money, and you’ll find out that only 13 percent of the new taxes would actually help people quit.”\u003c/p>\n\u003cp>This is true. Of the \u003ca href=\"http://www.lao.ca.gov/BallotAnalysis/Proposition?number=56&year=2016\">$1.4 billion\u003c/a> that Proposition 56 is expected to raise from the tax, 13 percent would go to the state’s cessation programs.\u003c/p>\n\u003cp>But UCSF professor Stanton Glantz says that’s still $100 million, and that’s enough to fully serve all would-be quitters who need help. The rest of the tax money would go to Medi-Cal, the state’s low-income health care program, which covers care for one in three Californians.\u003c/p>\n\u003cp>Opponents ultimately reject the tax, no matter how the revenues would be spent.\u003c/p>\n\u003cp>“I’m opposed to every manner of taxing,” says Steven Greenhut, Western Region director for the R Street Institute, a free market think tank that promotes limited government. “Let people make their own choices.”\u003c/p>\n\u003cp>He doesn’t like that Proposition 56 would tax e-cigarettes, too.\u003c/p>\n\u003cp>“Vaping is not entirely safe,” he says. “But it’s pretty clear that vaping is far less harmful than smoking.”\u003c/p>\n\u003cfigure id=\"attachment_11097727\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11097727\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2016/09/Vapin-800x533.jpg\" alt=\"A man blows vapor from an e-cigarette at a vape lounge in San Francisco.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2016/09/Vapin-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/Vapin-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/Vapin.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/Vapin-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/Vapin-960x640.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A man blows vapor from an e-cigarette at a vape lounge in San Francisco. \u003ccite>(Justin Sullivan/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Early studies do show that e-cigarettes may have fewer health impacts. But to what degree is unsettled. Either way, Greenhut says it’s premature to tax them.\u003c/p>\n\u003cp>“If you’re going to try to get people to stop smoking, why would you hammer a product that is arguably used to reduce smoking?” he says.\u003c/p>\n\u003cp>The science on this question is even more uncertain. \u003ca href=\"https://www.sciencedaily.com/releases/2016/07/160711092301.htm\">Some studies\u003c/a> show teens who vape are more likely to smoke cigarettes, anywhere from two to six times more likely. But some \u003ca href=\"https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/456704/McNeill-Hajek_report_authors_note_on_evidence_for_95_estimate.pdf\">British studies\u003c/a> have found that e-cigarettes can help people quit smoking.\u003c/p>\n\u003cp>No e-cigarette company has filed an application with the FDA to qualify their product as a cessation device. If they did and they succeeded, they would be exempt from the Proposition 56 tax, as is the case with nicotine gun and patches.\u003c/p>\n\u003cp>For Elizabeth Lane in New York, the nicotine patch was her ticket to quitting. Now, she no longer huffs and puffs when she walks.\u003c/p>\n\u003cp>“I can walk up stairs. I don’t cough,” she says. “And the circulation in my legs has improved.”\u003c/p>\n\u003cp>She says now she saves the money that she used to spend on cigarettes so she can buy birthday and Christmas presents for her daughter and granddaughter.\u003c/p>\n\u003cp>“Instead of being on the receiving end all the time, you know, give me, give me, give me,” she says, “I can give now.”\u003c/p>\n\u003cp>\u003cem>Additional reporting by \u003ca href=\"http://www.wnyc.org/people/fred-mogul/\">Fred Mogul\u003c/a> from WNYC.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>California Counts is a collaboration with four public media organizations in California to cover the 2016 election. This includes \u003ca href=\"http://www.scpr.org/\" target=\"_blank\">KPCC in Los Angeles\u003c/a>, \u003ca href=\"http://www.kqed.org/\" target=\"_blank\">KQED in San Francisco\u003c/a>, \u003ca href=\"http://www.capradio.org/\" target=\"_blank\">Capital Public Radio in Sacramento\u003c/a> and \u003ca href=\"http://www.kpbs.org/\" target=\"_blank\">KPBS in San Diego\u003c/a>.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"California has one of the lowest tobacco taxes in the nation. If voters pass Proposition 56 in November, it would rise from 87 cents to $2.87 a pack.","status":"publish","parent":0,"modified":1474667358,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":39,"wordCount":1225},"headData":{"title":"Would California's Proposed Tobacco Tax Hike Reduce Smoking? Just Ask New Yorkers | KQED","description":"California has one of the lowest tobacco taxes in the nation. If voters pass Proposition 56 in November, it would rise from 87 cents to $2.87 a pack.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"11097450 http://ww2.kqed.org/news/?p=11097450","disqusUrl":"https://ww2.kqed.org/news/2016/09/22/would-californias-proposed-tobacco-tax-hike-reduce-smoking-just-ask-new-yorkers/","disqusTitle":"Would California's Proposed Tobacco Tax Hike Reduce Smoking? Just Ask New Yorkers","nprStoryId":"494979298","path":"/news/11097450/would-californias-proposed-tobacco-tax-hike-reduce-smoking-just-ask-new-yorkers","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Each time New York increased its tobacco tax -- now at $4.35 a pack -- calls to the state's Quitline spiked.\u003c/p>\n\u003cp>In New York City, Mayor Michael Bloomberg \u003ca href=\"http://www.wnyc.org/story/bloomberg-pushed-new-yorkers-health-and-often-they-pushed-back/\">raised the tax even more\u003c/a>.\u003c/p>\n\u003cp>“I was so angry with him, I could hardly afford it,” says Elizabeth Lane, a Harlem resident who paid $12 a pack. “I had to beg, borrow and steal to get money to buy cigarettes.”\u003c/p>\n\u003cp>At first, Lane managed to cut down from seven packs a week to four. But sometimes she still didn’t have money to buy laundry detergent or toilet paper. In 2013, after smoking for 40 years, the price tag, her doctor’s warnings and her daughter’s guilt trips -- it all came together.\u003c/p>\n\u003cp>She quit.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I said, ‘Lord, I’ve been waiting a long time for this. When will you answer my prayer?’ ” she says. “And he answered this time.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/284110040&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/284110040'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>California currently has one of the lowest cigarette taxes in the country: 87 cents per pack. If voters pass \u003ca href=\"https://www.oag.ca.gov/system/files/initiatives/pdfs/15-0081%20(Tobacco%20Tax%20V3).pdf?\">Proposition 56\u003c/a> in November, the tax would go up to $2.87 a pack. Backers of the measure, including the American Cancer Society and the American Lung Association, hope to hit people hard enough in the wallet that they quit smoking, or never start.\u003c/p>\n\u003cp>Studies support the goal. For every 10 percent increase in the price of cigarettes, smoking goes down 4 percent, according to the 2014 \u003ca href=\"http://www.surgeongeneral.gov/library/reports/50-years-of-progress/index.html\">Surgeon General’s Report\u003c/a>.\u003c/p>\n\u003cp>“Part of that is people quitting. Part of that is people cutting down,” says Stanton Glantz, a professor of medicine at UCSF and director of the Center for Tobacco Control Research and Education.\u003c/p>\n\u003cp>In New York City, smoking rates declined from 22 percent of the local population to 15 percent in the decade that the tax, and a ban on smoking in restaurants and bars, was implemented.\u003c/p>\n\u003cp>California's smoking rate is about 12 percent, the second lowest in the country after Utah. Most people here who do smoke, Glantz says, don’t smoke that much.\u003c/p>\n\u003cp>“It may be that a price increase that will follow Prop. 56 will be enough to just get these light, intermittent smokers to just say, 'Forget it,'\" he says.\u003c/p>\n\u003cp>Glantz’s colleague, behavioral economist Justin White, explains the psychology behind this. He says the vast majority of smokers wish they could quit. They know it’s bad for them. But addiction is a powerful force.\u003c/p>\n\u003cp>“There’s this universal tendency towards immediate gratification,” White says.\u003c/p>\n\u003cfigure id=\"attachment_11097648\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11097648\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2016/09/NYCSmokin-800x544.jpg\" alt=\"A man smokes a cigarette in New York City, where the current tobacco tax is $4.35 a pack.\" width=\"800\" height=\"544\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2016/09/NYCSmokin-800x544.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/NYCSmokin-400x272.jpg 400w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/NYCSmokin.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/NYCSmokin-1180x802.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/NYCSmokin-960x653.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A man smokes a cigarette in New York City, where the current tobacco tax is $4.35 a pack. \u003ccite>(T. Carrigan/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The craving for a cigarette right now easily overwhelms fears of heart disease or lung cancer in the future. But, White says, a cigarette tax can flip that. A tax also hits right now, and that has the power to compete with the desire for a cigarette.\u003c/p>\n\u003cp>“Increasing taxes is a way to really bring that back to equilibrium, the cost in the future versus the benefits now,” White says.\u003c/p>\n\u003cp>The question is, how much. He says a $1 or $2 tax is enough to sway smokers with a mild self-control problem. But for smokers with a strong addiction, the tax needs to be between $5 and $10 to work.\u003c/p>\n\u003cp>Either way, White says, a tax is most effective when paired with support from a cessation program.\u003c/p>\n\u003cp>And this is where opponents have been digging into Proposition 56. The No on 56 campaign, backed by tobacco companies R.J, Reynolds and Philip Morris, have raised $56 million to defeat the measure. Supporters have raised $17.5 million.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It may be that a price increase will be enough to just get these light, intermittent smokers to just say, 'Forget it.''\u003ccite>Stanton Glantz, professor of medicine at UCSF\u003c/cite>\u003c/aside>\n\u003cp>Opponents are investing in \u003ca href=\"http://audio.californiareport.org/archive/R201609160850/b\">radio ads\u003c/a> that say proponents “are telling us Proposition 56 is all about helping people stop smoking. But follow the money, and you’ll find out that only 13 percent of the new taxes would actually help people quit.”\u003c/p>\n\u003cp>This is true. Of the \u003ca href=\"http://www.lao.ca.gov/BallotAnalysis/Proposition?number=56&year=2016\">$1.4 billion\u003c/a> that Proposition 56 is expected to raise from the tax, 13 percent would go to the state’s cessation programs.\u003c/p>\n\u003cp>But UCSF professor Stanton Glantz says that’s still $100 million, and that’s enough to fully serve all would-be quitters who need help. The rest of the tax money would go to Medi-Cal, the state’s low-income health care program, which covers care for one in three Californians.\u003c/p>\n\u003cp>Opponents ultimately reject the tax, no matter how the revenues would be spent.\u003c/p>\n\u003cp>“I’m opposed to every manner of taxing,” says Steven Greenhut, Western Region director for the R Street Institute, a free market think tank that promotes limited government. “Let people make their own choices.”\u003c/p>\n\u003cp>He doesn’t like that Proposition 56 would tax e-cigarettes, too.\u003c/p>\n\u003cp>“Vaping is not entirely safe,” he says. “But it’s pretty clear that vaping is far less harmful than smoking.”\u003c/p>\n\u003cfigure id=\"attachment_11097727\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11097727\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2016/09/Vapin-800x533.jpg\" alt=\"A man blows vapor from an e-cigarette at a vape lounge in San Francisco.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2016/09/Vapin-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/Vapin-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/Vapin.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/Vapin-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/10/2016/09/Vapin-960x640.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A man blows vapor from an e-cigarette at a vape lounge in San Francisco. \u003ccite>(Justin Sullivan/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Early studies do show that e-cigarettes may have fewer health impacts. But to what degree is unsettled. Either way, Greenhut says it’s premature to tax them.\u003c/p>\n\u003cp>“If you’re going to try to get people to stop smoking, why would you hammer a product that is arguably used to reduce smoking?” he says.\u003c/p>\n\u003cp>The science on this question is even more uncertain. \u003ca href=\"https://www.sciencedaily.com/releases/2016/07/160711092301.htm\">Some studies\u003c/a> show teens who vape are more likely to smoke cigarettes, anywhere from two to six times more likely. But some \u003ca href=\"https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/456704/McNeill-Hajek_report_authors_note_on_evidence_for_95_estimate.pdf\">British studies\u003c/a> have found that e-cigarettes can help people quit smoking.\u003c/p>\n\u003cp>No e-cigarette company has filed an application with the FDA to qualify their product as a cessation device. If they did and they succeeded, they would be exempt from the Proposition 56 tax, as is the case with nicotine gun and patches.\u003c/p>\n\u003cp>For Elizabeth Lane in New York, the nicotine patch was her ticket to quitting. Now, she no longer huffs and puffs when she walks.\u003c/p>\n\u003cp>“I can walk up stairs. I don’t cough,” she says. “And the circulation in my legs has improved.”\u003c/p>\n\u003cp>She says now she saves the money that she used to spend on cigarettes so she can buy birthday and Christmas presents for her daughter and granddaughter.\u003c/p>\n\u003cp>“Instead of being on the receiving end all the time, you know, give me, give me, give me,” she says, “I can give now.”\u003c/p>\n\u003cp>\u003cem>Additional reporting by \u003ca href=\"http://www.wnyc.org/people/fred-mogul/\">Fred Mogul\u003c/a> from WNYC.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>California Counts is a collaboration with four public media organizations in California to cover the 2016 election. This includes \u003ca href=\"http://www.scpr.org/\" target=\"_blank\">KPCC in Los Angeles\u003c/a>, \u003ca href=\"http://www.kqed.org/\" target=\"_blank\">KQED in San Francisco\u003c/a>, \u003ca href=\"http://www.capradio.org/\" target=\"_blank\">Capital Public Radio in Sacramento\u003c/a> and \u003ca href=\"http://www.kpbs.org/\" target=\"_blank\">KPBS in San Diego\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11097450/would-californias-proposed-tobacco-tax-hike-reduce-smoking-just-ask-new-yorkers","authors":["3205"],"programs":["news_6944","news_72"],"series":["news_19101"],"categories":["news_457","news_8","news_13"],"tags":["news_19217","news_19916","news_19960","news_423","news_17286","news_17041","news_2629","news_2561"],"featImg":"news_11097463","label":"news_72"},"news_10517494":{"type":"posts","id":"news_10517494","meta":{"index":"posts_1591205157","site":"news","id":"10517494","score":null,"sort":[1431068489000]},"guestAuthors":[],"slug":"2016-chess-moves-california-politics-podcast","title":"2016 Chess Moves: California Politics Podcast","publishDate":1431068489,"format":"audio","headTitle":"Election 2016 | FaultLines | KQED News","labelTerm":{"term":7051,"site":"news"},"content":"\u003cp>Political campaigns, especially those involving ballot initiatives in California, are often like a big chess board. You need to think about not just the move you're making now, but about what moves you might have to make toward the end.\u003c/p>\n\u003cp>This week's California Politics Podcast starts off with a look at three potentially explosive topics that could all appear on the November 2016 statewide ballot: A $2 per pack tobacco tax, an increase in the homeowner's property tax exemption, and a long debated and closely watched effort that could ask voters to tinker with the legendary Proposition 13.\u003c/p>\n\u003cp>We also look at the bitter fight to define what it means to be a Democrat in the East Bay's special state Senate election. And, with Gov. Jerry Brown's revised budget coming out next week, a quick look at what we'll be watching.\u003c/p>\n\u003cp>As always, I'm joined by Anthony York of the Grizzly Bear Project and Marisa Lagos of KQED News.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n","blocks":[],"excerpt":"This week: big initiatives headed to the 2016 ballot, Democratic infighting and a state budget preview.","status":"publish","parent":0,"modified":1453922245,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":6,"wordCount":168},"headData":{"title":"2016 Chess Moves: California Politics Podcast | KQED","description":"This week: big initiatives headed to the 2016 ballot, Democratic infighting and a state budget preview.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"10517494 http://ww2.kqed.org/news/?p=10517494","disqusUrl":"https://ww2.kqed.org/news/2015/05/08/2016-chess-moves-california-politics-podcast/","disqusTitle":"2016 Chess Moves: California Politics Podcast","audioUrl":"http://www.kqed.org/.stream/anon/radio/RDnews/2015/05/PoliticsPodcast050815.mp3","guestFields":"0","customPermalink":"2015/05/08/2016-chess-moves-california-politics-podcast/","nprStoryId":"464591087","path":"/news/10517494/2016-chess-moves-california-politics-podcast","audioDuration":null,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Political campaigns, especially those involving ballot initiatives in California, are often like a big chess board. You need to think about not just the move you're making now, but about what moves you might have to make toward the end.\u003c/p>\n\u003cp>This week's California Politics Podcast starts off with a look at three potentially explosive topics that could all appear on the November 2016 statewide ballot: A $2 per pack tobacco tax, an increase in the homeowner's property tax exemption, and a long debated and closely watched effort that could ask voters to tinker with the legendary Proposition 13.\u003c/p>\n\u003cp>We also look at the bitter fight to define what it means to be a Democrat in the East Bay's special state Senate election. And, with Gov. Jerry Brown's revised budget coming out next week, a quick look at what we'll be watching.\u003c/p>\n\u003cp>As always, I'm joined by Anthony York of the Grizzly Bear Project and Marisa Lagos of KQED News.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/10517494/2016-chess-moves-california-politics-podcast","authors":["232"],"programs":["news_7051"],"series":["news_19101"],"categories":["news_13","news_17793"],"tags":["news_402","news_17599","news_30","news_725","news_19960","news_17810","news_17812","news_423","news_2629","news_2561"],"featImg":"news_10508407","label":"news_7051"},"news_68574":{"type":"posts","id":"news_68574","meta":{"index":"posts_1591205157","site":"news","id":"68574","score":null,"sort":[1340396081000]},"guestAuthors":[],"slug":"ap-tobacco-tax-fails-in-vote-count","title":"AP: Tobacco Tax Fails in Vote Count","publishDate":1340396081,"format":"aside","headTitle":"News Fix | KQED News","labelTerm":{"term":6944,"site":"news"},"content":"\u003cfigure id=\"attachment_68602\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2012/06/smokingban201205221.jpg\">\u003cimg src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2012/06/smokingban201205221-300x205.jpg\" alt=\"\" title=\"Tobacco Tax\" width=\"300\" height=\"205\" class=\"size-medium wp-image-68602\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Proposition 29 would have imposed a new tax on tobacco. (Sean Gallop/Getty Images))\u003c/figcaption>\u003c/figure>\n\u003cp>by Hannah Dreier\u003cbr>\nAssociated Press\u003c/p>\n\u003cp>SACRAMENTO, Calif. (AP) _ A closely-watched effort to impose a new tax on tobacco to pay for cancer research in the nation's most populous state has failed by six tenths of a percentage point.\u003c/p>\n\u003cp>The Associated Press determined Friday that California's Proposition 29, backed by cycling legend Lance Armstrong, had failed by about 27,000 votes out 5 million cast.\u003c/p>\n\u003cp>Through a barrage of campaign ads, tobacco companies were able to cut support for the $1-a-pack cigarette tax from a two-thirds majority in March to a dead heat on Election Day.\u003c/p>\n\u003cp>Opponents of the measure raised $47 million to fight it, dramatically outspending supporters, who raised $12 million.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Campaign ads sponsored by tobacco companies framed the tax as a government boondoggle and warned that some of the cancer research could be done outside California. \u003c/p>\n\n","blocks":[],"excerpt":null,"status":"publish","parent":0,"modified":1398475414,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":8,"wordCount":161},"headData":{"title":"AP: Tobacco Tax Fails in Vote Count | KQED","description":"by Hannah Dreier Associated Press SACRAMENTO, Calif. (AP) _ A closely-watched effort to impose a new tax on tobacco to pay for cancer research in the nation's most populous state has failed by six tenths of a percentage point. The Associated Press determined Friday that California's Proposition 29, backed by cycling legend Lance Armstrong, had","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"68574 http://ww2.kqed.org/news/?p=68574","disqusUrl":"https://ww2.kqed.org/news/2012/06/22/ap-tobacco-tax-fails-in-vote-count/","disqusTitle":"AP: Tobacco Tax Fails in Vote Count","path":"/news/68574/ap-tobacco-tax-fails-in-vote-count","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_68602\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2012/06/smokingban201205221.jpg\">\u003cimg src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2012/06/smokingban201205221-300x205.jpg\" alt=\"\" title=\"Tobacco Tax\" width=\"300\" height=\"205\" class=\"size-medium wp-image-68602\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Proposition 29 would have imposed a new tax on tobacco. (Sean Gallop/Getty Images))\u003c/figcaption>\u003c/figure>\n\u003cp>by Hannah Dreier\u003cbr>\nAssociated Press\u003c/p>\n\u003cp>SACRAMENTO, Calif. (AP) _ A closely-watched effort to impose a new tax on tobacco to pay for cancer research in the nation's most populous state has failed by six tenths of a percentage point.\u003c/p>\n\u003cp>The Associated Press determined Friday that California's Proposition 29, backed by cycling legend Lance Armstrong, had failed by about 27,000 votes out 5 million cast.\u003c/p>\n\u003cp>Through a barrage of campaign ads, tobacco companies were able to cut support for the $1-a-pack cigarette tax from a two-thirds majority in March to a dead heat on Election Day.\u003c/p>\n\u003cp>Opponents of the measure raised $47 million to fight it, dramatically outspending supporters, who raised $12 million.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Campaign ads sponsored by tobacco companies framed the tax as a government boondoggle and warned that some of the cancer research could be done outside California. \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/68574/ap-tobacco-tax-fails-in-vote-count","authors":["237"],"programs":["news_6944"],"categories":["news_13"],"tags":["news_18543","news_2572","news_19960","news_423","news_2629","news_2561"],"label":"news_6944"},"news_67324":{"type":"posts","id":"news_67324","meta":{"index":"posts_1591205157","site":"news","id":"67324","score":null,"sort":[1339000338000]},"guestAuthors":[],"slug":"tobacco-tax-losing","title":"Tobacco Tax Losing by 63,000 Votes","publishDate":1339000338,"format":"aside","headTitle":"News Fix | KQED News","labelTerm":{"term":6944,"site":"news"},"content":"\u003cfigure id=\"attachment_67333\" class=\"wp-caption alignright\" style=\"max-width: 254px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2012/06/smoker-300x280.png\">\u003cimg class=\"size-full wp-image-67333\" title=\"smoker-300x280\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2012/06/smoker-300x280.png\" alt=\"\" width=\"254\" height=\"238\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Dr. Jauss/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"http://blogs.kqed.org/lowdown/2012/05/18/prop-29-should-smoking-in-california-be-more-expensive/\">Proposition 29\u003c/a>, the $1.00 per pack cigarette tax is currently losing by about 63,000 votes out of approximately 3,853,000 cast. That's a 1.6 percent margin. You can check out the latest vote tally at the \u003ca href=\"http://vote.sos.ca.gov/returns/ballot-measures/\">Secretary of State's ballot measure results page\u003c/a>.\u003c/p>\n\u003cp>Despite some media reports that the results are final, the election is still too close to call. A spokesperson for the California Secretary of State's Office says counties have 28 days from the election to turn in unprocessed and vote-by-mail ballots. The Secretary of State won't turn in an official \"statement of vote\" until 38 days after the election.\u003c/p>\n\u003cp>As Hannah Dreier of AP notes below, \"there typically are many late-arriving ballots from early and absentee voting not counted until after election day. These ballots typically comprise up to 20 percent of all votes, meaning potentially hundreds of thousands of votes were still to be counted statewide.\"\u003c/p>\n\u003cp>\u003cstrong>Update 9:50 a.m.\u003c/strong> From the \u003ca href=\"http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2012/06/06/BA8T1OTODR.DTL&tsp=1\">Chronicle\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Ricardo Quinto, a spokesman for the Yes on 29 campaign, said proponents were not conceding defeat. He said an estimated 200,000 ballots remain to be counted.\n\u003c/p>\u003c/blockquote>\n\u003cp>Full AP story:\u003c/p>\n\u003cblockquote>\u003cp>A California initiative to raise the tax on tobacco products was losing early Wednesday but the vote was still too close to call because hundreds of thousands of ballots potentially remained uncounted.\u003c/p>\n\u003cp>The day after Election Day, Proposition 29 was losing by just over 1 percent, or about 64,000 votes out of more than 3.8 million counted.\u003c/p>\n\u003cp>However, even with all precincts reporting, there typically are many late-arriving ballots from early and absentee voting not counted until after election day. These ballots typically comprise up to 20 percent of all votes, meaning potentially hundreds of thousands of votes were still to be counted statewide.\u003c/p>\n\u003cp>It could be days or longer before a winner is declared.\u003c/p>\n\u003cp>Cycling legend Lance Armstrong backed the measure to impose an additional $1-per-pack tax on cigarettes to fund cancer research. A $50 million opposition ad campaign was led by Big Tobacco.\u003c/p>\n\u003cp>In March, a statewide poll suggested the Proposition 29 would pass with two-thirds approval.\u003c/p>\n\u003cp>The situation reminded some of a 2006 California cigarette tax measure that was leading by wide margins until tobacco companies spent $66 million to defeat it.\u003c/p>\n\u003cp>The attempt to hike taxes on cigarettes and other tobacco products grew into a national fight last month with tobacco companies pouring in millions to quash the effort and celebrities including the New York City Mayor urging voters to support it.\u003c/p>\n\u003cp>As returns came in, both camps said they expected a close race but remained confident they would emerge the winner.\u003c/p>\n\u003cp>``We expected that as voters took a look at the measure, they would recognize the serious flaws, and as well intentioned as the measure is, they would realize it's not right for California,'' Beth Miller, spokeswoman for the No on 29 campaign said Wednesday.\u003c/p>\n\u003cp>Tobacco taxes have been proven to reduce smoking. But opponents said the initiative would create an unaccountable bureaucracy in charge of doling out the tax revenue, which is expected to start at $735 million a year.\u003c/p>\n\u003cp>An extra tax in the nation's most populous state also could mean major losses for tobacco companies, and Proposition 29 supporters said industry heavyweights were inventing arguments to obscure their true motive _ safeguarding profits.\u003c/p>\n\u003cp>``I think the public health message has gotten through the smoke screen of the tobacco companies' nearly $50 million misinformation campaign,'' Jim Knox of the American Cancer Society said Tuesday.\u003c/p>\n\u003cp>Armstrong and a coalition of anti-smoking groups raised about $18 million to bolster the measure. New York City Mayor Michael Bloomberg gave $500,000 to the campaign to help offset the industry donations.\u003c/p>\n\u003cp>Majorities in the Democratic-leaning counties along the Northern California coast favored the tax, while majorities in most other regions others opposed it. Voters on both sides expressed strong convictions as they cast their ballots.\u003c/p>\n\u003cp>``I think that we should aggressively discourage smoking _ make it less convenient, make it more expensive,'' said Susan Hyman of Long Beach.\u003c/p>\n\u003cp>In nearby Glendale, Craig Jerpseth, a 43 year-old nurse, was equally certain about voting the measure down.\u003c/p>\n\u003cp>``I hope we don't get any more taxes. That's pretty much it,'' he said.\u003c/p>\n\u003cp>A slew of newspapers, including the Los Angeles Times, opposed the measure while proclaiming their reluctance to side with tobacco companies. They argued that the revenue should go to the state, which Gov. Jerry Brown announced last month now faces a deficit of $16 billion.\u003c/p>\n\u003cp>With a smoking rate of 12.1 percent, California has not raised these taxes since 2000. If the measure passes, California would still have only the 16th highest tax rate in the nation.\u003c/p>\u003c/blockquote>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n","blocks":[],"excerpt":null,"status":"publish","parent":0,"modified":1398475419,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":28,"wordCount":807},"headData":{"title":"Tobacco Tax Losing by 63,000 Votes | KQED","description":"Proposition 29, the $1.00 per pack cigarette tax is currently losing by about 63,000 votes out of approximately 3,853,000 cast. That's a 1.6 percent margin. You can check out the latest vote tally at the Secretary of State's ballot measure results page. Despite some media reports that the results are final, the election is still","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"67324 http://ww2.kqed.org/news/?p=67324","disqusUrl":"https://ww2.kqed.org/news/2012/06/06/tobacco-tax-losing/","disqusTitle":"Tobacco Tax Losing by 63,000 Votes","path":"/news/67324/tobacco-tax-losing","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_67333\" class=\"wp-caption alignright\" style=\"max-width: 254px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2012/06/smoker-300x280.png\">\u003cimg class=\"size-full wp-image-67333\" title=\"smoker-300x280\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2012/06/smoker-300x280.png\" alt=\"\" width=\"254\" height=\"238\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Dr. Jauss/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"http://blogs.kqed.org/lowdown/2012/05/18/prop-29-should-smoking-in-california-be-more-expensive/\">Proposition 29\u003c/a>, the $1.00 per pack cigarette tax is currently losing by about 63,000 votes out of approximately 3,853,000 cast. That's a 1.6 percent margin. You can check out the latest vote tally at the \u003ca href=\"http://vote.sos.ca.gov/returns/ballot-measures/\">Secretary of State's ballot measure results page\u003c/a>.\u003c/p>\n\u003cp>Despite some media reports that the results are final, the election is still too close to call. A spokesperson for the California Secretary of State's Office says counties have 28 days from the election to turn in unprocessed and vote-by-mail ballots. The Secretary of State won't turn in an official \"statement of vote\" until 38 days after the election.\u003c/p>\n\u003cp>As Hannah Dreier of AP notes below, \"there typically are many late-arriving ballots from early and absentee voting not counted until after election day. These ballots typically comprise up to 20 percent of all votes, meaning potentially hundreds of thousands of votes were still to be counted statewide.\"\u003c/p>\n\u003cp>\u003cstrong>Update 9:50 a.m.\u003c/strong> From the \u003ca href=\"http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2012/06/06/BA8T1OTODR.DTL&tsp=1\">Chronicle\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Ricardo Quinto, a spokesman for the Yes on 29 campaign, said proponents were not conceding defeat. He said an estimated 200,000 ballots remain to be counted.\n\u003c/p>\u003c/blockquote>\n\u003cp>Full AP story:\u003c/p>\n\u003cblockquote>\u003cp>A California initiative to raise the tax on tobacco products was losing early Wednesday but the vote was still too close to call because hundreds of thousands of ballots potentially remained uncounted.\u003c/p>\n\u003cp>The day after Election Day, Proposition 29 was losing by just over 1 percent, or about 64,000 votes out of more than 3.8 million counted.\u003c/p>\n\u003cp>However, even with all precincts reporting, there typically are many late-arriving ballots from early and absentee voting not counted until after election day. These ballots typically comprise up to 20 percent of all votes, meaning potentially hundreds of thousands of votes were still to be counted statewide.\u003c/p>\n\u003cp>It could be days or longer before a winner is declared.\u003c/p>\n\u003cp>Cycling legend Lance Armstrong backed the measure to impose an additional $1-per-pack tax on cigarettes to fund cancer research. A $50 million opposition ad campaign was led by Big Tobacco.\u003c/p>\n\u003cp>In March, a statewide poll suggested the Proposition 29 would pass with two-thirds approval.\u003c/p>\n\u003cp>The situation reminded some of a 2006 California cigarette tax measure that was leading by wide margins until tobacco companies spent $66 million to defeat it.\u003c/p>\n\u003cp>The attempt to hike taxes on cigarettes and other tobacco products grew into a national fight last month with tobacco companies pouring in millions to quash the effort and celebrities including the New York City Mayor urging voters to support it.\u003c/p>\n\u003cp>As returns came in, both camps said they expected a close race but remained confident they would emerge the winner.\u003c/p>\n\u003cp>``We expected that as voters took a look at the measure, they would recognize the serious flaws, and as well intentioned as the measure is, they would realize it's not right for California,'' Beth Miller, spokeswoman for the No on 29 campaign said Wednesday.\u003c/p>\n\u003cp>Tobacco taxes have been proven to reduce smoking. But opponents said the initiative would create an unaccountable bureaucracy in charge of doling out the tax revenue, which is expected to start at $735 million a year.\u003c/p>\n\u003cp>An extra tax in the nation's most populous state also could mean major losses for tobacco companies, and Proposition 29 supporters said industry heavyweights were inventing arguments to obscure their true motive _ safeguarding profits.\u003c/p>\n\u003cp>``I think the public health message has gotten through the smoke screen of the tobacco companies' nearly $50 million misinformation campaign,'' Jim Knox of the American Cancer Society said Tuesday.\u003c/p>\n\u003cp>Armstrong and a coalition of anti-smoking groups raised about $18 million to bolster the measure. New York City Mayor Michael Bloomberg gave $500,000 to the campaign to help offset the industry donations.\u003c/p>\n\u003cp>Majorities in the Democratic-leaning counties along the Northern California coast favored the tax, while majorities in most other regions others opposed it. Voters on both sides expressed strong convictions as they cast their ballots.\u003c/p>\n\u003cp>``I think that we should aggressively discourage smoking _ make it less convenient, make it more expensive,'' said Susan Hyman of Long Beach.\u003c/p>\n\u003cp>In nearby Glendale, Craig Jerpseth, a 43 year-old nurse, was equally certain about voting the measure down.\u003c/p>\n\u003cp>``I hope we don't get any more taxes. That's pretty much it,'' he said.\u003c/p>\n\u003cp>A slew of newspapers, including the Los Angeles Times, opposed the measure while proclaiming their reluctance to side with tobacco companies. They argued that the revenue should go to the state, which Gov. Jerry Brown announced last month now faces a deficit of $16 billion.\u003c/p>\n\u003cp>With a smoking rate of 12.1 percent, California has not raised these taxes since 2000. If the measure passes, California would still have only the 16th highest tax rate in the nation.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/67324/tobacco-tax-losing","authors":["80"],"programs":["news_6944"],"categories":["news_1758","news_13"],"tags":["news_18543","news_19960","news_71","news_423","news_2629","news_2561"],"label":"news_6944"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. 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Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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