¶ … trick-or-treating on Halloween unsupervised with my friends for the first time. I came back with the usual pillowcase full of candy, which my parents immediately appropriated, looking for apples with razor blades, drug-laced baked goods or any other of the dangers the media scared them about that year. One of the treats that was taken away was a red and white, cellophane-wrapped box I hadn't really paid attention to and so didn't really miss. My friend's pack however, had slipped under the parental radar, and the next day we stood around pretending to smoke our candy cigarettes in front of the mirror like movie stars. It was fun. We looked cool, like the high-school kids. Demonstrate Existence Of A Problem

Is tobacco use a problem? One AP writer argues early death by smokers saves us all money (Werner 2009). Congress seems to think smoking is a problem, if the scathing language in Section 2 ("Findings") of the Family Smoking Prevention and Control Act (2009) is true. I argue we should use market forces to encourage production of other products besides tobacco, because of externalities, or costs to public health not paid for directly by tobacco consumers or producers. While the total social cost of the problem is probably more than all of us expect if we consider how this money could be invested in more socially profitable output, this is enough to demonstrate the existence of a problem we can document and analyze in a number of ways. Likewise the black market for tobacco products is real, even if more of a problem outside the U.S. As yet (World Health Organization 2004, p. 16). These will become a component of our solutions below.

Analysis and Documentation

In the U.S., cost of mortality (death), "morbidity" from tobacco use, or disease attributed to or influenced by tobacco usage, and lost productivity runs to about $200 billion per year (U.S. Center for Disease Control and Prevention, 2010, n. pag.). Some of this cost is borne by the taxpayer and all other health care consumers, rather than by the people who incurred a disease they spent their earnings to acquire (Armour, Finkelstein and Fiebelkorn, 2009 n. pag.). Uncollectables lower private health care profits, generate unnecessary operating costs, and raise cost of final health care and insurance products for all consumers, caused by the minority who chooses to smoke (Ong, 2011, slide 13).

Opponents will argue that that money drives the American economy, creating jobs in the health care sector (I include insurance in 'health care' from now on), generating equity for shareholders, interest on loans, and credit that increases wealth and consumption, which ultimately flow back to the government as the very income tax we spend on health care for those who can't afford to pay ("indigent cost"). If we take this argument seriously, the conclusion that we could therefore increase employment and wealth by generating more unnecessary costs or even whole harmful unnecessary industries, is not an ad absurdum or slippery slope fallacy if we limit the growth to say one percent per year. If this kind of growth is good, we should create more sick people, not less, this argument asserts. Either way, the expense demonstrates the scope of the problem.

Even if our estimates do not include all those costs, verifiable dollars spent are convincing enough that the problem exists, although estimating human cost of disease and death will always remain controversial. Returns to shareholders are fairly transparent and direct tax expenditure on tobacco-related medical conditions are scrutinized by regulators, investors and analysts across the globe. The question becomes, is the tax revenue from regulation more than the health care externality cost to taxpayers and consumers? Philip Morris International. brought in $67.7 billion in net revenue in 2010, paid $40 billion in excise taxes, and made $17.5 billion in profit, all from sales outside the U.S. (Philip Morris International 2011, p. 45) Parent company Altria sold another $21.6 billion in cigarettes alone over 2010 on top of that (Altria 2011, Table 4). These revenues could add up to the health care cost or much of it, considering this is the biggest, but not the only producer.

Criteria Defining Scope of Possible Solutions

Solutions must be viable and fair. Viability includes several required and measurable criteria. Solutions...

'revenue neutral' or better, and enforceable. This implies they must be legal. Fairness is defined as treating people the same under law. This usually involves the Supreme Court, so we can measure rulings, sometimes also by their economic effects. This may be a requirement of the viability criterion 'legality,' i.e. viability may include the fairness category. This does not preclude implementation. We can define fairness as not discriminating between groups of individuals from examples like the Civil Rights Act or the Constitution. If unfair, the Courts will overrule solutions that get through Congress, which will be the unit of fairness measurement, yes or no. This is not an innovation but how new laws are normally made.
Possible Solutions that Satisfy Criteria; Research Supports the Best Solution

Outright tobacco prohibition may not satisfy viability criteria, as suggested by the U.S. experience with alcohol and illegal drug prohibition. One of the main lessons we learned from the U.S. Prohibition experiment was that enforceability was expensive and difficult, apparently impossible given the resources at the time. The persistence of a modern black market for marijuana, and apparently tobacco, both by organized crime and through sales to minors (World Health Organization, 2004, p. 16), support an argument that prohibition of tobacco would just expand existing black markets for that as well, especially considering products' physical similarity and a history of tobacco smuggling that predates the United States (Smith, 1937, p. 157).

Simply increasing taxes on these products at the cash register the way we do now reduces consumption (Ong, 2011, slide 16) but violates the fairness and viability criteria in that such taxes are regressive if smokers don't quit. Ong argues higher-income smokers pay more share of the absolute value of tobacco tax based on the assumption that they buy more expensive brands and also that more low-income smokers quit (2011); I consider a different measurement, share of total income, and reject point of sales tax increases as violating both super- and subordinate criteria. If lower-income consumers can't quit smoking after tax increases, then point of sale tax represents a higher percentage of their incomes than would taxing the profits and equity shareholders enjoy, who must have enough savings to invest in tobacco company stocks in the first place. Increasing point-of-sales taxes may also stimulate avoidance, i.e. smuggling (Farrelly, Nimsch and James, 2003 p. 6), and thus violate revenue neutrality by raising enforcement costs.

In fact the marijuana prohibition experience provides a valuable modern analogy but also a potential revenue stream, were that tax expense freed up through decriminalization. If marijuana was regulated the same way as tobacco is now, the tax revenue and enforcement savings could be transferred to covering tobacco health care costs, increasing fairness for insurance and medical consumers who don't smoke either one. On the other hand, states that have decriminalized medical marijuana also serve as a precedent for tobacco licensing programs, because if we can permit and regulate marijuana production as a growing number of examples demonstrate, we could likely regulate tobacco the same way. The two parallels demonstrate perfectly symmetrical solutions in that one is illegal and regulated, and the other is legal but less (medically) regulated than the illegal one.

Marijuana licensure requires medical treatment, which would satisfy the enforceability criterion for tobacco cessation programs and enforcement, cutting down the public health care cost even more. If people were caught furnishing tobacco to unlicensed consumers, they could be punished the exact same way illegal medical marijuana sales are now, with the cost borne by those who commit the crime, i.e. revenue neutral in theory. Tobacco licensure could help equalize its social cost the same we attempt to internalize carbon emissions through cap-and-trade programs for industrial polluters, with the goal to be pushing costs back onto those who profit from them under identical justifications. The revenue could even be used to subsidize transition to other commodities by erstwhile tobacco producers over a finite period, with retraining for workers displaced from a shrinking tobacco industry.

The savings to consumers would stimulate employment and savings the same way returns to tobacco investors do now. These returns to investors represent a leakage, if increased health care costs paid by all consumers and taxpayers generate profit for those with enough savings to invest in tobacco company stocks. This is a revenue stream that to my knowledge goes untaxed separately from other sources of income. The real solution to the fairness problem is to break this transfer cycle to the investors, from the low-income tobacco consumer, from indigent care paid by the entire health care consumer sector, and then ultimately from the taxpayer. The same applies to alcohol profits where indigent drunk drivers cannot pay for the damage they cause at the…