The high cost of spending less in Indiana


South Bend Tribune

Directives announced last week from Indiana Gov. Eric Holcomb are aimed at improving access to tobacco cessation products for Hoosiers.

That’s good. But it’s reasonable to expect even more from leaders in a state with one of the highest smoking rates in the nation.

Acting on Holcomb’s direction, State Health Commissioner Dr. Kristina Box issued a standing order, effective Aug. 1, allowing Indiana residents to purchase tobacco cessation products at pharmacies in the state without having to obtain an individual prescription. She also announced that Indiana Medicaid will remove co-payments for tobacco cessation products for pregnant women or members up to one year postpartum.

Box, who recently called smoking “the single most preventable cause of death and disease,” explained that the priority is reducing the state’s dreadful smoking rate for expectant mothers.

That’s a worthy goal, given the grim reality that nearly 25 percent of expectant Hoosier mothers on Medicaid smoke during pregnancy. That’s compared to 8 percent of all expectant mothers nationally. And women who smoke are at least twice as likely to have a preterm birth — the leading cause of infant mortality in Indiana.

Even while acknowledging the value of such small but positive steps, it’s hard to ignore the elephant in the room: Indiana, once a leader in tobacco prevention funding, has repeatedly slashed money specifically intended for such purposes.

As a recent Indianapolis Star story points out, Indiana was once one of only six states to match budget recommendations on tobacco control from the Centers for Disease Control and Prevention. Today, the state spends around one-tenth of what the CDC recommends.

The funding for the Tobacco Prevention and Cessation Commission comes from a settlement between the attorneys general of 46 states, five U.S. territories and the District of Columbia.

We don’t think that it’s a coincidence that Indiana today has the seventh-highest smoking rate in the country.

The price of such a statistic is staggering, measured in human lives, with annual costs of $3 billion in health care costs and more than 10,000 lives.

The state could save lives and millions of dollars by investing more in keeping people off of tobacco products — which could stop common diseases before they start, says John Schachter from the Campaign for Tobacco-Free Kids. “It’s a lot harder to treat symptoms than it is to prevent them in the first place, “ he says.

States that spend way below CDC recommendations are being “penny-wise and pound-foolish,” he says.

And with the consequences of smoking taking a huge toll in Indiana, this is no time to skimp on investing in tobacco prevention and cessation.

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