20 January 2011

Unhealthful News 20 - Just because someone tells you something does not mean it is true.

A recent report from of a Washington lobbyist/pundit company about taxes on tobacco products (see more about why I picked this topic and about that report below) was picked up in this news story last week.  The story began "A national study of state tobacco taxes, released Thursday, found that a lower rate on smokeless products could encourage users to switch from cigarettes."  In the middle of the article, the reporter wrote, "Analysts say that most tobacco taxes are geared toward recouping the cost to society of health-care expenses related to its use. However, some state-level politicians want to fill budget shortfalls with a larger tax on those products."  The trouble with both of these is that though someone was claiming them, they are wrong.

The second of these assertions is a common claim, but a bit of checking shows that it is not so.  Cigarette taxes have often been justified based on medical costs, though that traces back to a time when there was not even good evidence that the medical costs were positive (i.e., the increased costs of treating smoking caused diseases is offset by the decreased costs of not treating people who have died prematurely, and it took a while to get good measurements for both sides of that).  But the taxes (technical note: particularly if we include the "Master Settlement Agreement" payments which are widely portrayed as a liability award paid by cigarette companies but are actually a sales tax on smokers) are quite a bit higher than the net increase in medical costs.  Moreover, if we do not try to isolate medical care consumption as if it were special, but consider total effects on smokers' lifetime consumption (i.e., we consider that people who die earlier consume nothing, healthcare or otherwise), smoking saves resource costs (or pension / Social Security payments if  you prefer to think about money rather than resources).  Obviously this does not imply that people dying from smoking is good, but merely that it is disingenuous to claim that taxes on cigarettes can be justified because smokers impose higher costs on the rest of the community.

Moreover, taxes on smokeless tobacco, the subject of the story, could not possibly be justified based on this because smokeless tobacco causes risks that are so low that they cannot even be measured.  And anti-tobacco activists who demand even higher taxes have largely stopped making the claim about them being some kind of fair user fee, instead focusing almost exclusively on how the taxes support their political goal of trying to punish people who choose not to quit using tobacco, whether it is risky or not.

(Oh, and sorry, but saying "Analysts say..." does not excuse a reporter from following with something that just ain't so.  If you start with "Congressman Smith said..." then you are off the hook, but "Analysts say..." is just as much a way of saying "you, dear reader, should believe the following without question" as is just asserting the statement.)

As for the lead, the "study" that the story reports on did not, in fact, find that lower taxes on smokeless tobacco could reduce smoking by encouraging product switching, and therefore benefit public health.  The author of the study asserted that conclusion, and it is undoubtedly right (hundreds of others of us have said the same thing).  But it turns out nothing in the study actually supported the claim - it was pretty much disconnected from the analysis.  I wrote a few more details about that here if you are interested.  Indeed, the reason I wrote a brief post and about this topic today is that I used up all my blogging time for the day writing a long analysis of how tobacco harm reduction advocacy seems to be tending toward embracing bad analysis - anything that sounds like science and supports the cause - which I see as a serious threat to the cause (along with a couple of other forces I mention).

If you found your way to my writing because of my work on THR, you really should read that other piece.  If you are not interested, I will just leave you with today's message (reporters should not just believe assertions about what analyses tell us; the rest of us should not assume that the reporters have taken that advice) and an assurance that, thanks to regression toward the mean, tomorrow's post is likely to be more interesting.

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