Letters to the Editor

Readers write about "sin taxes" and healthcare in New Orleans.

More taxes on cigarettes

Regarding the May 14 Opinion piece, "The tyranny of taxing sin": This commentary was misleading about tobacco taxes. In fact, smoking-related costs in the United States far exceed total cigarette tax revenues. For example, the US Centers for Disease Control and Prevention (CDC) estimates that smoking-caused healthcare costs and narrowly defined productivity losses total $10.28 per pack sold in the US. But the average federal, state, and local cigarette tax on a pack is less than $2.40.

It is also bizarre for author Patrick Fleenor to claim that productivity losses and healthcare costs from smoking are borne primarily by smokers themselves – ignoring the enormous detrimental impact on employers and our economy.

Similarly, Mr. Fleenor ignores the tens of thousands of nonsmoker deaths each year caused by secondhand smoke in his odd assertion that smokers pay their own way. He also fails to consider the substantial health risks to innocent children from parental and other household smoking. Nor does he mention the large number of spontaneous abortions and stillborn births caused by smoking and secondhand smoke exposure during pregnancy.

Some of that might be excused by Fleenor focusing only on monetary costs and not on unnecessary harm done to innocents. But any evaluation of tobacco tax increases (or other so-called sin taxes) must look beyond just money and consider other impacts.

In the case of tobacco tax increases, the evidence is clear. They raise government revenues, prevent kids from starting to smoke, and prompt existing users to quit. Accordingly, tobacco tax increases also work effectively to reduce the still enormous number of harmful costs and deaths caused by smoking and other tobacco use.

Thankfully, one of the beneficial side effects of state and local governments raising their tobacco tax rates to address current budget deficits will be a less smoky and more healthy and productive society.

Eric Lindblom

Director for policy research,

Campaign for Tobacco-Free Kids

Washington, D.C.

How to jump-start healthcare in New Orleans

Regarding the May 13 article, "New Orleans' 'Katrina Generation' struggles with drugs and depression": This article highlights the continuing challenges that New Orleans residents have accessing healthcare and mental-health care since hurricane Katrina.

Fortunately for some communities, school-based health centers (SBHC), which are like a doctor's office located in a school, offer students in the New Orleans area access to physical-, mental- and oral-health care services. There are currently three SBHCs in New Orleans with five more slated to open through the next school year. St. Bernard Parish opened its first SBHC in 2007, and Jefferson Parish has opened three new SBHCs in the past two years, with one of these sites under renovation and a fourth in the planning phase. There are also three school-linked community health centers in the New Orleans area that serve both students and community residents.

SBHCs have been providing quality healthcare in our nation for 30 years and are a proven healthcare safety net model for children and teens. Because SBHCs are located on school campuses, medical staff are familiar with the students and can identify problems early, while providing a mechanism for follow-up for chronic medical issues that often prevent students from attending school. In the New Orleans area, with many students still dealing with deep psychological wounds from the storms, mental health and substance-abuse issues are also routinely diagnosed and addressed at the SBHCs.

While we work to rebuild healthcare service capacity in New Orleans and across the nation, let's be sure to invest in SBHCs as an effective model to provide vital healthcare services to students where they have the highest likelihood of accessing it – right in their schools.

Marsha Broussard, MPH

Director, School Health Connection

New Orleans

The Monitor welcomes your letters. All submissions are subject to editing. Letters must include your full name; your city, state, and country; and your telephone number. Any letter accepted may appear on our website, www.CSMonitor.com. E-mail letters to oped@csps.com. Or mail letters to Readers Write, 210 Massachusetts Avenue, Boston, MA 02115.

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