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Addressing TobaccoAddressing Tobacco Pricing PoliciesPricing Policies

A Toolkit for Tobacco Control Program ManagersA Toolkit for Tobacco Control Program Managers

Table of ContentsTable of Contents....................................................................................................ii

Introduction.............................................................................................................1Why New Tools?......................................................................................................................................1

Key to Success: Raise Awareness............................................................................................................1

How to Apply the Tools...........................................................................................................................1

Part I: Readiness Assessment Form......................................................................3Why Assess Readiness?...........................................................................................................................3

Readiness Assessment Components.........................................................................................................3Section 1: Prevalence of Tobacco Use.................................................................................................3Section 2: Cigarette Excise Taxes........................................................................................................3Section 3: Other Tobacco Products (OTP) Excise Taxes....................................................................4Section 4: Other Price-Based Policies.................................................................................................4Section 5: Non-Tax Price-Related Policy Options...............................................................................5Section 6: State Tobacco Control Program Funding...........................................................................5Section 7: Readiness for Pricing Strategy Change..............................................................................5Section 8: Other Considerations..........................................................................................................6

Readiness Assessment Form...................................................................................8

Part II: Communications Plan.............................................................................19Introduction...........................................................................................................................................19

Why Plan Communications Strategies?.................................................................................................19

Communications Plan Components.......................................................................................................20

Objective 1. Develop Key Messages......................................................................................................20

Objective 2. Raise Awareness among Internal Stakeholders.................................................................21

Objective 3. Becoming the "Go-To" Point for Tobacco Issues..............................................................22

Objective 4. Raise Awareness among External Stakeholders................................................................23

Objective 5. Build Strong Relationships with State and Local Partners................................................25

Objective 6. Expect the Unexpected: Rapid Response Plan..................................................................25

Model Communications Plan...............................................................................27

© 2011 Tobacco Technical Assistance Consortium | Pricing Strategies Toolkit Page ii

Communications Plan Template..........................................................................36

Part III: Checklist for Action...............................................................................45

Part IV: PowerPoint Presentation.......................................................................61

Part V: Essential Resources..................................................................................63What are the Essential Resources and What is their Relevance?..........................................................63

Section 1: Resources from State Campaigns.........................................................................................63

Section 2: Resources from Slides...........................................................................................................63Part 1: The Toll of Tobacco...............................................................................................................64Part 2: Raising the Price of Tobacco..................................................................................................64Part 3: Other Tobacco Pricing Policies..............................................................................................66

Section 3: Additional Resources............................................................................................................67General..............................................................................................................................................67Campaign for Tobacco-Free Kids Fact Sheets...................................................................................68Campaign for Tobacco-Free Kids Resources Available by Request Only.........................................70

Acknowledgements................................................................................................73

© 2011 Tobacco Technical Assistance Consortium | Pricing Strategies Toolkit Page iii

IntroductionWelcome to Addressing Tobacco Pricing Policies: A Toolkit for Tobacco Control Program Managers. The purpose of this toolkit is to address the needs of state, territorial, and tribal tobacco control program professionals who are working to reduce tobacco use by raising the cost of tobacco products. The evidence is clear: tobacco products’ price increases result in lower consumption, especially among youth and those demographic groups with high tobacco use prevalence.

Why New Tools?Over the last decade, policies to maximize the impact of price increases have become better defined and easier to implement. Yet many challenges remain for program managers who want to contribute significantly to the policy debate by raising awareness of the public health benefits of raising the price of tobacco products. This guide provides new tools to support program managers’ ability to promote and sustain social norm changes through pricing strategies, in accordance with the Centers for Disease Control and Prevention’s (CDC) recommendations.

Key to Success: Raise AwarenessWhile understanding that policy change is the most cost-efficient population-wide approach to reducing tobacco use, many program managers struggle with how to raise the profile of tobacco-related policy, both internally and with their external partners. Each of the 50 states, U.S. territories, tribes and the District of Columbia has its own unique political culture and environment. Each state, territorial and tribal health department has its own rules for how and when staff is authorized to work on policy issues in general and tobacco policy issues in particular. Some tobacco control program managers report directly to the top agency official—most likely the Commissioner of Health or Health Director—and others have several layers of agency managers on the way to the top.

How to Apply the ToolsThere are many ways to apply these tools. One approach for tobacco control program managers might be to begin with relatively small accomplishments that can result in larger victories over time. An example of a small accomplishment is increasing awareness internally in a health department, and raising the profile of cigarette and other tobacco product excise tax health benefits. That victory may be followed by a press release from the agency when a CDC-published Morbidity and Mortality Weekly Report (MMWR) is released on a price-related tobacco topic. While these may seem like minor successes, they can add up to become factors in the policy debate and eventually the policy decisions. Addressing Tobacco Pricing Policies: A Toolkit for Tobacco Control Program Managers was developed to help tobacco control program managers become involved in shaping pricing policy interventions in their states. The

© 2011 Tobacco Technical Assistance Consortium | Pricing Strategies Toolkit Page 1

kit contains five tools that help put the principles of effective tobacco pricing strategies into practice. They are:

Readiness Assessment Form Communications Plan Checklist for Action PowerPoint Presentation Essential Resources

Each tool provides practical information and applications for tobacco control program managers to become experts in, and better proponents of, pricing strategies that are appropriate for their state. With careful research, planning, communications, and outreach, all tobacco control programs can play a meaningful role in strengthening tobacco-related pricing policy.

For help using this toolkit or to request technical assistance on pricing policies, contact TTAC at 404-712-8474 or [email protected].


mailto:[email protected]

Part I: Readiness Assessment FormWhy Assess Readiness?Tobacco control programs seek to change community norms about tobacco use through evidence-based interventions recommended by the CDC: namely, by educating about the dangers of tobacco use in order to prevent young people from using tobacco products, encouraging and supporting tobacco users in

efforts to quit, and raising awareness of the dangers of secondhand smoke exposure. To do so, assessing the seriousness of the problem and the status of the recommended interventions is an essential first step. Working on a pricing strategy intervention is no different. Below is a brief description of each section of the Readiness Assessment Form, and how the information can be used in pricing policy

Readiness Assessment Components

Section 1: Prevalence of Tobacco Use

Smoking Rates, Other Tobacco Products Use Rates and MortalityData on the number of smokers and other tobacco users in the state (for both youth and adults), as well as information on the number of deaths attributed to tobacco use, help to clarify how many people are affected by tobacco. These numbers provide evidence that effective strategies to reduce tobacco use are necessary in each state.

Healthcare Costs per Pack SoldData on the healthcare costs attributed to the use of tobacco products helps expose the economic costs for state government (e.g., Medicaid), businesses (e.g., healthcare and lost productivity) and individuals (e.g., illness, sick time). The cost of tobacco use is not just calculated in lives lost and diminished quality of life for those afflicted with tobacco-related diseases, but also in economic terms. As pricing strategies are discussed in economic terms, the financial burden on individuals, businesses, government and the economy-as-a-whole are important to understand and include in the case for increasing the price of tobacco products. There are three excellent tools for determining economic costs listed in the charts.

Section 2: Cigarette Excise Taxes

Current Cigarette Excise Tax StatusThe assessment of pricing strategies begins with basic data on the current price of cigarettes and your state (and local, if any) cigarette excise taxes. One evidence-based pricing strategy proven to result in reliable, measurable reductions in smoking is increasing the cigarette excise tax. A local cigarette excise tax, when combined with the state tax, has created the highest cigarette taxes in the country in Chicago and New York City. Local taxes have also helped raise prices in


states with relatively low state excise taxes (e.g. Virginia). Data on current cigarette excise taxes, national rankings, and city and county excise taxes can be found using the links provided. The data reported on these websites are invaluable for assessing the status of the cigarette excises tax in any state.

Having information on current state and local cigarette excise taxes can help build a case for increasing taxes in states where the tax is below average or lower than the tax in neighboring states.

Appropriation of Cigarette Excise Tax RevenueIn addition to knowing your state and local cigarette excise taxes, it is important to know how the tax revenue is allocated. Evidence demonstrates that when even a small percentage of a cigarette excise tax is appropriated for tobacco control programs, the appropriation provides a sustainable source of funds for those programs. In addition, appropriating excise tax revenues to cessation interventions addresses the need to provide assistance to lower income smokers, who are more likely to quit as cigarette prices increase, and who are also more likely to need free or low-cost services and medications to help them quit smoking.

One of the most reliable places to obtain information on how state cigarette excise tax revenue is appropriated is the American Lung Association on-line State Legislated Action on Tobacco Issues (SLATI) website, http://www.lungusa2.org/slati/. The interactive map provides state-by-state information on the details of excise tax statutes, including where the revenue is appropriated.

Section 3: Other Tobacco Products (OTP) Excise Taxes

As the price of cigarettes increases, some smokers turn to cheaper forms of tobacco such as snuff, roll-your-own tobacco or little cigars. One way to lessen the possibility of smokers switching from cigarettes to other tobacco products is to raise the excise taxes on other tobacco products whenever the cigarette tax rate increases. Another way is to tax little cigars and roll-your-own tobacco at the same rate as cigarettes. These other taxing approaches can help assure that the pricing strategy produces the maximum revenue and health benefits.

Section 4: Other Price-Based Policies

There are other measures to consider in addition to raising tobacco excise taxes that can strengthen current and future policies. These include policies that automatically increase excise taxes on other tobacco products (OTP) when cigarette taxes are raised, eliminate caps on tobacco taxes, establish a minimum percentage of wholesale price tax (rather than a weight-based tax) for OTP, and apply sales tax to tobacco products on top of excise tax.


http://www.lungusa2.org/slati/

Knowing the current policy on sales of tobacco products on adjacent Tribal lands needs to be considered when raising state tobacco excise taxes. Tobacco retailers operating on Tribal lands have the right to sell tobacco products to members of the same Tribe free of any state taxes. This right derives from Tribes’ unique sovereign nation status affirming self-governance. The reality is that both smokers and smugglers visit Tribal lands to purchase tobacco products in order to avoid paying state taxes. To address this issue, a growing number of states and Tribal Nations have successfully crafted new Tribal compacts that help to “level the playing field” between Tribal outlets and other tobacco retailers. In these agreements, Tribes agree to collect the state’s tobacco excise taxes (or a similar Tribal tax) on all cigarette and other tobacco product sales on the Tribe’s land, thereby making Tribal prices comparable to state prices while eliminating double taxation. This solution makes Tribal prices comparable to prices charged elsewhere in the state and eliminates a source for contraband cigarettes.

Section 5: Non-Tax Price-Related Policy Options

Several non-tax policy options are being implemented in states to raise the price of tobacco products and reduce tax evasion. These options include requiring a wholesale and/or retail license to sell tobacco products, increasing tobacco licensing fees, minimum pricing laws, high-tech tax stamps, and broadening the definition of “cigarette” in the tax codes to include little cigars and similar products.

Section 6: State Tobacco Control Program Funding

The 2007 CDC Best Practices for Comprehensive Tobacco Control Programs has state-by-state recommendations for funding levels needed to implement comprehensive, evidence-based tobacco control programs. Data on current funding levels compared to CDC-recommended funding are also available. These data help raise awareness about the need to increase funding for comprehensive tobacco control programs as part of an overall tobacco excise tax strategy.

Section 7: Readiness for Pricing Strategy Change

Previous AttemptsBefore taking action, it is helpful to know the history of tobacco pricing strategies in your state. What successes have already taken place? Have there been unsuccessful attempts in the past? Who were the champions among state and/or local decision-makers in the executive and legislative branches, opinion leaders, and the media? Was there a tobacco control coalition? If yes, how involved was the coalition and who were the key players? Who were other essential supporters who helped? What were the impediments? The answers to these questions come from shared wisdom of those who have been involved in past excise tax campaigns and other pricing strategy policy campaigns.


Internal Champions and Partners A mutual interest in improving the health of your state’s residents is shared by people in many different agencies within state and local governments. To maximize this commitment, a tobacco control program manager should take stock of everyone with whom s/he collaborates on health-related issues, including managers of other health department programs as well as colleagues in the Attorney General’s Office, Medicaid Office, Mental Health and Substance Abuse Agencies, Departments of Families and Children, etc. Program managers should also engage individuals and organizations that have grants and contracts at the community level to provide policy-related briefings and to raise awareness among their allies.

State Budget StatusIt is important to know the status of the current state budget before moving forward on tobacco pricing strategies. Since most states have balanced budget requirements, when a deficit is forecast, lawmakers need to find new revenue, make spending adjustments or some combination of the two. If unpopular taxes are being considered, increasing tobacco excise taxes may likely be a more popular alternative. Polling data indicate that cigarette and OTP tax increases are favored by more voters than any other taxes. The data also show that when a percentage of revenue is committed to preventing kids from using tobacco, support is even greater. When there is a budget deficit to offset, or an unpopular tax to replace, tobacco excise taxes are even more popular. Finally, it is useful to assess other external stakeholder resources that are committed to an excise tax increase or other pricing strategy change. Taking all these factors into account is essential to developing plans and realistic timelines for each state.

Section 8: Other Considerations

The State Policy TimetableBefore beginning to build public awareness regarding tobacco pricing strategies, it is essential to know well ahead of time the Governor’s timeline for writing the budget s/he will propose to the legislature as well as the legislative calendar and key benchmarks. It is equally important to plan ahead for the Governor’s budget and other key legislative addresses. It takes months of preparation before the stage is set for efforts to increase the cigarette excise tax or other pricing strategy. To plan ahead, the timetables and deadlines for policymakers must be known so that communications can be planned accordingly.

Tobacco Control Program Policy AgendaEvery state tobacco control program should have a policy agenda in accordance with the CDC recommendations that include strategies to increase the price of tobacco products, smoke-free air policies, and systems and incentives to increase cessation attempts. The agenda should take into consideration a thorough assessment of existing policies, as well as the internal and external policy environment. It should establish policy goals for the program to support with its


community programs and public awareness activities. Finally, the policy agenda should be updated annually to take into consideration changes in the policy environment.


Readiness Assessment FormInstructionsAnswer each question in the Readiness Assessment Form using the resources provided, or other applicable resources. Completing the Readiness Assessment Form will allow tobacco program managers to evaluate their state’s current environment and special circumstances—a jumping-off point for pricing strategy planning. Each question should be researched, carefully considered, and answered prior to continuing the process. When available, potential resources for finding the necessary information have been listed; however, some questions will require further research or the use of alternative resources.


PRICING STRATEGIES READINESS ASSESSMENT<STATE><DATE>

Readiness Assessment Form ContentsCigarette Excise Tax.................................................................................................................................................................................................... 11

Other Tobacco Product (OTP) Excise Taxes................................................................................................................................................................12

Other Price-Based Policies......................................................................................................................................................................................... 13

Non-Tax Price-Related Policy Options........................................................................................................................................................................14

State Tobacco Control Program Funding...................................................................................................................................................................15

Readiness for Pricing Strategy Change (observational and shared opinions).............................................................................................................16

Cigarette Excise TaxQuestion Answer Resources

What is your current state excise tax?

http://www.rwjf.org/publichealth/product.jsp?id=56548Use the tab “Cigarette Tax Rates” and click on your state.http://apps.nccd.cdc.gov/statesystem/InteractiveReport/InteractiveReports.aspx

What is the national ranking of your state excise tax?

http://www.tobaccofreekids.org/research/factsheets/pdf/0097.pdf

What is the amount and date of the most recent state excise tax increase?

http://www.rwjf.org/publichealth/product.jsp?id=56548Use the tab “Cigarette Tax Rates” and click on your state.

Does your state allocate any funds from the tax to tobacco control?

http://www.rwjf.org/publichealth/product.jsp?id=56548

http://slati.lungusa.org/

Does your state allow local or county excise taxes? If so, what are they?



What are your state’s healthcare costs per pack sold?

http://www.rwjf.org/publichealth/product.jsp?id=56548Use the tab “Cigarette Tax Rates” and click on your state.

Other Tobacco Product (OTP) Excise TaxesQuestion Answer Resources

What is the tax on snuff? Is it weight-based or a percentage of the wholesale price?


http://slati.lungusa.org

What is the tax on chewing (spit) tobacco? Is it weight-based or a percentage of the wholesale price?



What is the cigar tax?http://www.tobaccofreekids.org/research/factsheets/pdf/0169.pdf


Has your state raised the excise tax on all non-cigarette tobacco products (OTP)? How much? When?



Other Price-Related Policies

Question Answer ResourcesDoes your state have Tribal land? If so, does your state have a tobacco tax allocation system for the collection of tax revenues from tribal governments that sell tobacco products to non-members of the tribes?

Does your state automatically increase tax rates on OTP whenever the cigarette tax rate is increased?Has your state eliminated caps on tobacco tax rates or amounts?Has your state established a minimum tax for percentage-of-price OTP taxes?Does your state apply sales tax to the full price of all tobacco products, including excise taxes?

Non-Tax Price-Related Policy OptionsQuestion Answer Resources

Has your state established licensing, permit, and registration fees for wholesalers and retailers who sell tobacco products? If so, what are they? Do the fees go to enforcement efforts?


Has your state established fees for manufacturers, and distributors of tobacco products? If so, what are they? Do the fees go to enforcement efforts?


Does your state have a minimum pricing law? When was it established?

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5913a2.htm#tab2

Does your state have plans to use or already use high-tech tax stamps?Where in your legal code is “cigarette” defined? Does the definition include small cigars, cigarillos and other non-cigarette smoked tobacco products?

State Tobacco Control Program FundingQuestion Answer Resources

What is the total funding for the state tobacco control program?


http://www.rwjf.org/publichealth/product.jsp?id=56548Use the tab “Tobacco Spending” and click on your state.

What is the state tobacco control program spending as a percentage of CDC recommended spending?

http://www.rwjf.org/publichealth/product.jsp?id=56548Use the tab “Tobacco Spending” and click on your state.

Readiness for Pricing Strategy Change (observational and shared opinions)Question Answer Resources

What previous attempts were made to address the issue, including legislative and regulatory proposals and public information campaigns?Identify key champions or partners, including those within your department, other decision-makers, advocacy groups and other coalition members (Governor? Legislature?)Is the media reporting interest in increasing tobacco excise taxes?What is the state’s current budget situation?Is the Legislature considering raising any unpopular taxes?What resources (human and financial) are available to commit to this issue?

Other ConsiderationsQuestion Answer Resources

When does your state legislature meet? When is the Governor’s state-of-the-state address? Budget address? Other key addresses to the Legislature?

Alabama (H, S) · Alaska (H, S) · Arizona (H, S) · Arkansas (H, S) · California (A, S) · Colorado (H, S) · Connecticut (H, S) · Delaware (H, S) · Florida (H, S) · Georgia (H, S) · Hawaii (H, S) · Idaho (H, S) · Illinois (H, S) · Indiana (H, S) · Iowa (H, S) · Kansas (H, S) · Kentucky (H, S) · Louisiana (H, S) · Maine (H, S) · Maryland (H, S) · Massachusetts (H, S) · Michigan (H, S) · Minnesota (H, S) · Mississippi (H, S) · Missouri (H, S) · Montana (H, S) · Nebraska · Nevada (A, S) · New Hampshire (H, S) · New Jersey (GA, S) · New Mexico (H, S) · New York (A, S) · North Carolina (H, S) · North Dakota (H, S) · Ohio (H, S) · Oklahoma (H, S) · Oregon (H, S) · Pennsylvania (H, S) · Rhode Island (H, S) · South Carolina (H, S) · South Dakota (H, S) · Tennessee (H, S) · Texas (H, S) · Utah (H, S) · Vermont (H, S) · Virginia (H, S) · Washington (H, S) · West Virginia (H, S) · Wisconsin (A, S) · Wyoming (H, S)Also, Google Individual State Government homepages

When does your department provide annual policy recommendations to your Governor?When does your program provide annual policy recommendations to the Commissioner/Health Director?

http://ballotpedia.org/wiki/index.php/Utah

Does your tobacco control program have a policy agenda?

Part II: Communications PlanIntroduction The Model Communications Plan in the toolkit offers suggestions for objectives and activities that state tobacco control program managers have successfully employed to support pricing strategies. After reviewing the Model Communications Plan, a collaborative process can be used to develop a plan

tailored to each state’s needs. The blank template uses a commonly accepted format for managers who are developing their own communications plan.

Why Plan Communications Strategies?Simply stating the facts about tobacco use is not enough to stop young people from using tobacco or provide enough incentive for most tobacco users to quit. For tobacco control programs, the art of communications involves careful, strategic planning to educate stakeholders and the public in order to gain support for CDC-recommended program and policy interventions. The evidence presented in CDC’s Best Practices shows a dose-response relationship in every program’s health communications interventions; that is, there is a threshold for the number of times a message needs to be repeated in order to incur the intended response among its audience.

Tobacco control managers can benefit from planning strategic communication strategies that raise awareness within their agencies, among external stakeholders, and with the public at-large of the dangers of tobacco use and the CDC-recommended interventions that the evidence demonstrates will reduce tobacco use. Ideally, there will be an 18 month to 2 year timeframe to build support for tobacco pricing policy interventions before their consideration by legislative bodies. During that time, a systematic approach to communicating key messages can build support among the public and policymakers. However, there are times when tobacco pricing policy issues unexpectedly appear and move through legislative bodies. Remember that strategic communications planning is also as essential in less than ideal circumstances to communicate key messages to support, and in some instances oppose, proposed tobacco pricing policy interventions.

Tobacco control program managers can increase the internal and external demand and support for policy interventions when they develop and implement an integrated, coordinated communications plan. Every communications plan must take into account the internal forces within state government that need to be addressed to create a knowledgeable, supportive environment for CDC-recommended pricing strategies. Also, the communications plan will address the need to create a consistent, authoritative voice as the “go-to” place for state and community partner organizations and the public-at-large. Finally,


although the plan will help keep all planned communications strategies on track, there will always be unpredictable circumstances that need to be addressed by a quick response mechanism—another essential component of a strategic communications plan.

Communications Plan ComponentsThe goal of the state (or local) pricing strategy communications plan is to raise awareness of how pricing strategies reduce tobacco use and the death and disease it causes, as well as the economic benefits that result. The Model Communications Plan recommends six objectives and many activities that can be tailored to a state’s media culture and political environment to achieve this goal.

Each of these objectives can be achieved by implementing elements of the following activities: Schedule (monthly, quarterly, annually): How often is enough for your communications

to break through the clutter of competing messages to be heard without losing audience interest?

Communication Type (bulletin, scientific report, confidential memo, etc.): A variety of communications types should be considered to keep the communications compelling and relevant.

Audience: Who are the various audiences that you want to educate? Are they sufficiently targeted in the plan?

Method (listservs, e-mails, social networking, press alerts, mailings, face-to-face meetings, teleconferences, paid and unpaid media): Using a variety of communications media and methods can be effective.

Objective 1. Develop Key Messages

Rationale: One of the lessons learned in states and localities that successfully achieved increasing tobacco excise taxes and other policies that raise the price of tobacco products is the importance of consistent, concise messages that speak to decisions-makers, opinion leaders and the public.

Activity 1: Develop 3-4 universal messages that can be incorporated in all communications regarding pricing strategies

An example of messages that have been successfully used are the “Win-Win-Win” messages — a BUDGET WIN that will raise millions in revenue and help preserve essential services such as tobacco control, healthcare and education; a HEALTH WIN that will prevent kids from smoking and save lives; and a POLITICAL WIN that is popular with voters. These messages can be adapted to any state’s unique circumstances.


Activity 2: Develop a one-page summary of key messages.

The set of key messages should be supported by science, and appeal to the audience of decision-makers, opinion leaders and the public. It is advisable to consult national and state partners to create messages that are in sync with the highest scientific standards and complement the prevailing messages of leading health organizations.

Activity 3: Use these key messages whenever possible when communicating to internal and external audiences.

Once the messages are established, the remainder of the pricing strategies communications plan can consistently amplify the case for pricing strategies through appropriate media and spokespeople. The form of the communication will depend on who the audience is, what the messenger‘s relationship is to the audience, and how the information is being communicated.

Objective 2. Raise Awareness among Internal Stakeholders

Rationale: Tobacco control program managers can serve their department well by initiating a set of communications briefings that will build support among public health and other governmental colleagues. Support for the pricing strategies may very well not exist prior to the initiation of these communications briefings. However, through repeated small steps, the awareness can increase, support can be built, and readiness for action can improve.

Activity 1: Send monthly bulletin to internal stakeholders.

Monthly bulletins can be planned well in advance, with each one addressing a specific topic and can include graphs, maps, or other visually interesting illustrations that will help raise awareness among agency leadership, other program managers, program grantees and other state government stakeholders. Topics may include: toll of tobacco, impact of tobacco price increases on youth, impact of price increases on pregnant smokers, CDC-recommended funding for tobacco control in your state and the evidence behind the recommendation, tobacco excise tax increases as reliable revenue source, and your state’s tobacco excise taxes in comparison to other states. However, program managers should adjust the bulletin’s content to reflect current events and news.

Social marketing tools such as Twitter and Facebook can improve the department’s visibility and policy agenda. Tobacco control program managers should consider whether to use social marketing tools to raise awareness of key messages.


Activity 2: Present the tobacco control program’s tobacco pricing policy agenda to appropriate department leader (e.g. Commissioner, division director, legislative liaison) for incorporation in health department policy agenda or statement.

No matter the extent a tobacco control program is authorized by department leadership to work directly on pricing strategies, a tobacco control program manager should have an up-to-date evidence-based fact sheet on pricing strategies that addresses 1) the health problems being addressed, 2) a description of the pricing strategy, and 3) the health and economic benefits of the pricing strategy. Note that fact sheets for increasing cigarette or OTP excise taxes should include CDC recommendations to optimize health benefits of a tax increase, including allocation of a portion of the excise tax increase to tobacco prevention and control and cessation services and medications. The pricing strategy fact sheet could be part of a policy agenda that includes other CDC-recommended policy interventions, such as smoke-free air policy.

Tobacco control program managers should know the process used to determine the Governor’s proposed budget and the content of his/her key legislative addresses. Also, it is important to know how the health department provides input into that process as well as the internal process for becoming a part of the health department’s proposed legislative agenda, so that all steps are taken well in advance to have the case for tobacco pricing strategies included first in the department’s recommendations and then in the Governor’s.

Objective 3. Becoming the "Go-To" Point for Tobacco Issues

Rationale: Tobacco control program managers have more knowledge and resources at their fingertips than most of their internal and external colleagues realize. The strategic communications plan will hold program managers accountable for sharing relevant information so that when a pricing strategy is proposed, the agency hierarchy can be ready to respond positively. There are three suggested activities to establish the tobacco control program as the “go-to” place.

Activity 1: Keep internal stakeholders informed about what is happening around pricing strategy efforts from early discussions to introduction of pricing strategy legislation and throughout the legislative process.

One of the roles of a “go-to” authority on pricing strategies is to track and report changes in proposed price policy legislation to internal stakeholders. By alerting them to ongoing changes in legislative activity and support for a proposed policy, colleagues will learn as soon as possible what opportunities they have to take action, such as issuing a position


statement, providing research and expertise to legislative staff, or raising specific issues with other internal stakeholders.

Activity 2: Create news briefs to inform internal stakeholders of media coverage relating to tobacco pricing issues in the state, such as news of proposed changes in other taxes, changes in the political environment and statements from key decision-makers, etc.

Tobacco control program managers have access to up-to-the-minute information on pricing strategies from federal government sources (CDC, MMWR , Institute of Medicine, etc.), external partners, and media listservs, to keep their colleagues informed. Also, it is very important to monitor local media coverage to alert internal stakeholders of changes in the local political landscape or news that may have an impact on the pricing policy. The audience for these brief notes include: 1) the health department leadership, 2) other health department program managers (e.g., chronic disease, maternal child heath, public affairs), and 3) other state government stakeholders and program grantees.

The news briefs may describe what is happening within the state, and, equally important, noteworthy breakthroughs in neighboring states and across the country.

Activity 3: Maintain a briefing book of relevant state and local tobacco-related facts.

A briefing book or online library is an excellent tool if it is kept up-to-date with current resources and ready-to-use messages. New material is distributed by the CDC, Campaign for Tobacco-Free Kids and other leading authorities every week. This information can be kept as is, or localized and distributed in a bulletin or briefing document. Creating new messages and materials for every occasion is time consuming and unnecessary; by keeping the briefing book up-to-date, everything will be ready when needed.

Objective 4. Raise Awareness among External Stakeholders

Rationale: As the state government health authority on tobacco, tobacco control program managers disseminate and promote CDC recommendations and other data and research. Possessing these rich, evidence-based resources is not only beneficial to colleagues and leadership in state government, but these resources also lend authority to actions taken by external partners. There are several recommendations for communicating with external partners to advance CDC-recommended policy strategies.

Activity 1: Maintain a website with pertinent information on pricing strategies (maps, graphs, MMWR, polling, etc.).


Several states have price-related links on their tobacco control program’s homepage to retrieve valuable reports, news, and other resources. These website postings of pricing strategy information not only provide easy access to valuable data and reports for internal and external stakeholders, they establish the department as informed and relevant. There are many reports and surveys from government sources, peer-reviewed scientific journals, and other leading experts to help inform the debate over pricing strategies without taking a position on any policy under consideration by lawmakers.

Activity 2: Organize events (youth and others) and other media opportunities to raise awareness of tobacco industry marketing practices to make the case for deterrents to tobacco use such as raising the price of tobacco products.

Events that generate public interest in reducing tobacco use by dramatizing the loss of life or tobacco industry marketing practices to attract young smokers draw attention to the need for action. These events need not directly address a pricing strategy nor advocate for policy change. However, they raise awareness of the power of the tobacco industry and the illness and death caused by tobacco products, thereby setting the stage for policy solutions.

Some states award community grants for youth events that are developed by young people themselves that put a spotlight on the tobacco industry’s marketing tactics. One example is the creation of a “memorial wall” in a public place that contains collected pictures and memories of relatives and friends who died as a result of tobacco use. The testimonials of young people who have personally lost loved ones can raise awareness of the human loss, which is so much greater than data and economics can illustrate.

Activity 3: Issue state reports (evaluation, surveys, quit line data, prevalence data).

As the “go-to” authority on tobacco issues, tobacco control programs provide the scientific credibility to reports that show evidence supporting the need to reduce tobacco use, and the effectiveness of pricing strategies in accomplishing a reduction. A good example of this activity took place in New York. The state health department published the tobacco control program’s independent evaluator’s report that showed the program’s successes as well as many unmet needs that could be addressed with increased funding at CDC-recommended levels. Subsequently, a significant excise tax increase was passed by the legislature. Other states have reported on the association between tobacco price increases and increased quit line use to show the need for providing adequate funding for the quit line and other cessation services and medications when tobacco excise taxes are raised. These reports are intended to guide internal program decisions, but can also be used effectively by outside organizations to advocate for raising the cost of tobacco products and sustaining or increasing program funding.


Objective 5. Build Strong Relationships with State and Local Partners

Rationale: State tobacco control managers play an important role in diverse coalitions that have evolved over the past few decades to become the engine that drives tobacco policy change at the state and local levels. While government employees need to avoid lobbying as well as any perception of lobbying for a policy initiative, their involvement as a knowledgeable, resourceful coalition member is invaluable. Ideally, a program manager’s role regarding pricing policy is just an extension of ongoing partnerships and planning around local and state tobacco policy.

Activity 1: Communicate with state partners on pricing related issues (MMWR and other CDC reports, state government activity).

The state tobacco control program can disseminate CDC recommendations by participating on listservs, coalition meetings, and other partnership discussions. The CDC strongly encourages the use of pricing strategies and regularly issues reports, MMWR findings, media announcements, and statements that focus on pricing-related policy. Health department staff will know about these publications before their colleagues outside government, giving them the lead time to spread the information to opinion leaders and key decision-makers.

Activity 2: Attend coalition meetings to contribute the public health perspective to discussions related to pricing strategies, without participating in any lobbying (or the perception of lobbying) activities (e.g. not voting on policy decisions, etc.).

There is no way to overemphasize the value of collaborating with partners with diverse backgrounds, experiences and perspectives. They may represent a specific constituency group, such as youth, elderly, LGBT, racial and ethnic minorities, or distinct disease categories such as cancer, diabetes, asthma or cardiovascular disease. Because tobacco control programs address the needs of all population groups, it is important to work closely with diverse individuals and organizations. Though tobacco control program managers are limited to when they can vote, and what discussions they can engage in, they can always provide the CDC’s perspective and evidence-based data to help focus the coalition on proven policy interventions.

Objective 6. Expect the Unexpected: Rapid Response Plan

Rationale: Despite the best efforts to be prepared with all of the sound, scientific evidence to support all communications and actions, there may be unforeseen developments among


stakeholders, or challenges from the tobacco industry that will require deliberations at the highest levels. The time spent preparing in advance for unexpected challenges will pay off tremendously when a sensitive situation occurs.

Activity 1: Create a rapid internal response plan.

Sometimes referred to as a “crisis communications plan,” the rapid response plan is utilized when trouble occurs. Therefore, it is important to work with program supervisors and other internal colleagues to recruit a team that can quickly assess the situation and create key messages for the designated spokesperson. Tobacco program managers may not be the target of a negative incident, but will want to protect their agency and other state government leaders from any possible misunderstanding. It may be wise to include legal counsel on the team to identify potential risks and liabilities and review all statements.

After being informed of a potentially harmful or positive development, time is needed to gather all of the information about potential consequences and then draft messages that address what the health department wants the public to know. Another important step is to inform the designated team of any potential difficulties and/or benefits and convene a session to answer all questions and address concerns. Finally, the chosen spokesperson should consult with designated leadership before releasing any statements. The plan should provide assurances to all concerned that interested parties will be kept informed and engaged to avoid potential problems.

Though invaluable to address crises, should they occur, there are other times when the rapid response plan can be used for unexpected good news. Some states have activated a rapid response plan, for example, when a neighboring state increased its cigarette excise tax, or a new research article that supports pricing strategies is published.


Model Communications Plan


PRICING STRATEGIES COMMUNICATIONS PLAN<STATE><DATE>

Model Communications Plan Contents Goal: Raise awareness of the impact of pricing strategies to reduce tobacco use....................................................................................................30

Objective 1: Communicate messages that will move internal and external audiences to support your policy agenda. .........................................30

Objective 2: Raise awareness among key health department decision-makers and stakeholders (chronic disease director, legislative lliaison, commissioner of health, program grantees, itc), and leaders in other related state-level agencies (Medicaid, mental health, etc).....................31

Objective 3: Establish the Tobacco Control Program as the “go to” place in state government on anything related to tobacco control in general, and pricing strategies in particular........................................................................................................................................................................32

Objective 4: Raise public awareness (outside state government) of the impact of tobacco pricing strategies to reduce tobacco use and raise revenue.................................................................................................................................................................................................................. 33

Objective 5: Build and maintain communications with state partners (organizations and individuals) in the state coalition ................................34

Objective 6: Expect the unexpected: Be prepared to quickly respond to surprises.................................................................................................35

Goal: Raise awareness of the impact of pricing strategies to reduce tobacco use.Objective 1: Communicate messages that will move internal and external audiences to support the pricing strategy

Activity Timeline Communication Type Audience Method

Develop 3-4 universal messages that can be incorporated in all communications regarding pricing strategies

As soon as position is determined

Adaptable to all communications pieces

All potentially interested parties: Internal health department

leadership, other related state level agencies and program grantees as well as external

decision makers, opinion leaders and the public

Apply these messages in all

communications

Develop a one-page summary of key messages

As soon as position is determined One-page document




Prominent downloadable

posting on program website; use as

needed

Use these key messages whenever possible when communicating to internal and external audiences

Frequently repeat these messages

whenever possibleAdaptable to audience




Adaptable to audience as either

hand-out material, e-mail, or web-based

Objective 2: Raise awareness among key health department decision-makers and stakeholders (chronic disease director, legislative liaison, commissioner of health, program grantees, etc) and other related state agencies by distributing monthly bulletins and annual policy agenda.


Send monthly bulletin from a prepared list of topics, including toll of tobacco, impact of price increase on youth smokers, impact of price increase on pregnant smokers, popularity of excise tax increases with the voting public, CDC recommended funding for tobacco control program linked to increased revenue; reliability of excise tax as revenue source; excise tax increases in other states as they occur; current activity by tobacco industry that targets vulnerable populations; research reports; polling other related public opinion studies.

Same time every month

One page with clear take-away message(s)

Internal health department leadership (the chain of command

to the commissioner), other related state level agencies and

program grantees

E-mail; internal bulletins; website

Present the tobacco control program’s tobacco pricing policy agenda to appropriate agency representative (Commissioner, legislative liaison) for incorporation in health department policy agenda or statement)

While Commissioner is preparing policy

agenda for submission to the Governor’s office

One page policy agenda with appended fact sheets

and references

Internal health department leadership at highest level

possibleBriefing in person

Objective 3: Establish the Tobacco Control Program as the “go-to” place in state government on anything related to tobacco control in general, and pricing strategies in particular.


Keep internal stakeholders informed about what is happening around pricing strategy efforts from early discussions to introduction of pricing strategy legislation and throughout the legislative process.

When there is any progress or setbacks that impact pricing strategies , send a

“briefing.”

One paragraph briefing that reports the event and

implications for pricing strategy legislation



program grantees

E-mail news brief

Create news briefs to inform internal stakeholders of media coverage relating to tobacco pricing issues in the state, such as news of other taxes, changes in the political environment or statements from key decision-makers, etc..

When happens

Forward links or forward “alerts” with a brief

statement of its implications.



program grantees

E-mail

Maintain a briefing book of relevant state and local tobacco-related facts

Keep up-to-date with new material

from CDC, Campaign for Tobacco-Free

Kids, state partners

Binder and on-line file for internal use only Tobacco Control Program Staff Use as needed

Objective 4: Raise awareness of the impact of tobacco pricing strategies to external audiences.


Maintain a website with pertinent information on pricing strategies (Maps, graphs, MMWR reports , polling, etc.)

Begin well before pricing strategy

legislation is introduced (18

months)

On-line Internal and External Prominent posting on program website

Organize events (youth and others) and other media opportunities to raise awareness of tobacco industry marketing practices to make the case for deterrents to tobacco use such as raising the price of tobacco products.

Periodically Earned media Press and public Public event with invited press

Issue state reports (evaluation, surveys, quitline data, prevalence data)

When available and often enough to

build interest in the information

Formal report from state agency Press and public

Press release, broad distribution of link to information; website

posting

Objective 5: Build and maintain communications with state and local coalition partners (organizations and individuals)


Communicate with state partners on pricing related issues (MMWR and other CDC Reports, state government activity)

Whenever there is an opportunity

E-mail, telephone and in-person

Voluntary health agencies, community organizations, local

coalitions, other external stakeholders

Whatever is most direct and fosters good relationships

Attend coalition meetings to contribute the public health perspective to discussions related to pricing strategies, without participating in any lobbying (or the perception of lobbying) activities (e.g., not voting on policy decisions, etc.).

Whenever coalition meetings or

conference calls take place

In-person or by telephone, depending on how coalition

meetings are conductedCoalition members Personal interaction

Objective 6: Expect the unexpected: Be prepared to quickly respond to surprises.


Create a Rapid Internal Response Plan As soon as policy

position is determined

Internal N/A E-mail and telephone

Communications Plan Template


COMMUNICATIONS PLAN<STATE><Date>

Communications Plan Template Contents Goal: Fill in the Blank................................................................................................................................................................................................. 39

Objective 1:............................................................................................................................................................................................................ 39

Objective 2:............................................................................................................................................................................................................ 40

Objective 3:............................................................................................................................................................................................................ 41

Objective 4:............................................................................................................................................................................................................ 42

Objective 5:............................................................................................................................................................................................................ 43

Objective 6:............................................................................................................................................................................................................ 44

Goal: Fill in the BlankObjective 1:


Objective 2:


Objective 3:


Objective 4:


Objective 5:


Objective 6:


Part III: Checklist for ActionAnother tool for success is a Checklist to track the progress of all the recommended activities on a timeline. The recommended activities on the checklist have been suggested by tobacco control program managers around the country who have played a role in efforts to raise tobacco excise taxes in their

states. These recommended activities can be adapted to any state’s policy environment to optimize a tobacco control program’s contribution to statewide efforts to reduce tobacco use by raising the price of tobacco products. There are also blank spaces throughout the timeline for additional activities to be added and described.


PRICING STRATEGIES

TIMELINE & BENCHMARKS<STATE><DATE>

Checklist for Action ContentsTwo Years to Eighteen Months Prior to Official Pricing Strategies Campaign............................................................................................................55

Research, assessment, planning.............................................................................................................................................................................55

Eighteen Months Prior to Official Pricing Strategies Campaign..................................................................................................................................56

Implement Communications Plan..........................................................................................................................................................................56

Seventeen Months Prior to Official Pricing Strategies Campaign...............................................................................................................................58

Sixteen Months Prior to Official Pricing Strategies Campaign....................................................................................................................................58

Theme.................................................................................................................................................................................................................... 58

Fifteen Months Prior to Official Pricing Strategies Campaign....................................................................................................................................59

Theme.................................................................................................................................................................................................................... 59

Fourteen Months Prior to Official Pricing Strategies Campaign.................................................................................................................................59

Theme.................................................................................................................................................................................................................... 59

Thirteen Months Prior to Official Pricing Strategies Campaign..................................................................................................................................60

Theme.................................................................................................................................................................................................................... 60

One Year Prior to Official Pricing Strategies Campaign..............................................................................................................................................60

Theme.................................................................................................................................................................................................................... 60

Eleven Months Prior to Official Pricing Strategies Campaign.....................................................................................................................................61

Theme.................................................................................................................................................................................................................... 61

Ten Months Prior to Official Pricing Strategies Campaign..........................................................................................................................................61

Theme.................................................................................................................................................................................................................... 61

Nine Months Prior to Official Pricing Strategies Campaign........................................................................................................................................62

Theme.................................................................................................................................................................................................................... 62

Eight Months Prior to Official Pricing Strategies Campaign.......................................................................................................................................62

Theme.................................................................................................................................................................................................................... 62

Seven Months Prior to Official Pricing Strategies Campaign......................................................................................................................................63

Theme.................................................................................................................................................................................................................... 63

Six Months Prior to Official Pricing Strategies Campaign...........................................................................................................................................63

Theme.................................................................................................................................................................................................................... 63

Five Months Prior to Official Pricing Strategies Campaign.........................................................................................................................................64

Theme.................................................................................................................................................................................................................... 64

Four Months Prior to Official Pricing Strategies Campaign........................................................................................................................................64

Theme.................................................................................................................................................................................................................... 64

Three Months Prior to Official Pricing Strategies Campaign......................................................................................................................................65

Theme.................................................................................................................................................................................................................... 65

Two Months Prior to Official Pricing Strategies Campaign.........................................................................................................................................65

Theme.................................................................................................................................................................................................................... 65

One Months Prior to Official Pricing Strategies Campaign.........................................................................................................................................66

Theme.................................................................................................................................................................................................................... 66

18-24 Months Prior to Official Pricing Strategies CampaignResearch, assessment, planning

ObjectiveComplete

Present the “Addressing Tobacco Pricing Policies: A Toolkit for Tobacco Control Program Managers” PowerPoint internally to tobacco control program staff.

Review list of Essential Resources.

Conduct Readiness Assessment, including analysis of current policy, key stakeholders, and general readiness.

Draft Policy Agenda (for internal purposes only).

Create Communications Plan.

18 Months Prior to Official Pricing Strategies CampaignImplement Communications Plan

Objective SpecificsComplete

Raise awareness internally about pricing strategies (CDC recommendations)Establish routine of scheduled bulletins

Develop policy agenda and key messages

Establish program as indispensible resource by creating a Briefing Book, using graphs and charts to show:

At-A-Glance Overview of Cigarette Excise Tax Information: Tool of Tobacco (http://www.tobaccofreekids.org/reports/state_tax_report/downloads/Natl%20&%20State%20Benefits%20pages%20all.pdf)Current tobacco excise taxes and ranking among statesGraph of how revenue increased in states that increased taxes (Slide 21 in Toolkit)

Impact of price increase on youth smokers

Impact of price increase on pregnant smokers

Graph showing popularity of excise tax increases among voters (if available survey data)Utilization of Quit Line, broken down by socioeconomic statusCDC-recommended funding for state tobacco control program

Charts and graphs from advocacy organizations

MMWR Reports related to tobacco and pricing strategies, etc.

Establish program as indispensible resource with internal stakeholders Inform internal stakeholders about progress in-state and around the country

Raise public awareness of impact of pricing strategies

Provide pricing strategy information on website

Organize events/media opportunities

Publish state data/reports

Encourage collaboration among external partners Communicate with internal state agency partnersCommunicate with external partners

Attend coalition meetings

Be prepared for the unexpected Organize Rapid Response Mechanism

Create month-by-month timeline to follow Complete Timeline Benchmarks Template

17 Months Prior to Official Pricing Strategies CampaignTheme


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1 Month Prior to Official Pricing Strategies CampaignTheme


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Part IV: PowerPoint Presentation The “Addressing Tobacco Pricing Policy” PowerPoint presentation provides slides and resources that tobacco control program managers can use to educate internal and external colleagues about the basics of pricing strategies. These slides can be adapted to local needs to help raise awareness of the presenter’s

positions on pricing strategies and deepen understanding among colleagues and stakeholders.

The presentation is divided into three sections:

1. The Toll of TobaccoThis section covers the very basic information of the human and economic toll that tobacco takes on our society. It provides an overview of the health and economic problems associated with tobacco use state by state and nationwide.

2. The Case for Raising the Price of Tobacco ProductsThis section presents the case for raising the price of tobacco products, including the public health benefits, associated revenue increases, and public popularity. Because most of the progress and evidence supporting price increases come from cigarette excise tax increases, much of the focus is on raising the price of cigarettes only.

3. The Case for Taxing Other Tobacco Products and Other Pricing StrategiesCigarette excise taxes alone are not sufficient deterrents to tobacco use. In fact, as the


cost of cigarettes increases, public health authorities are concerned about data that show smokers become more attracted to cheaper tobacco products such as snuff, snus, or cigars. In addition, cigarette tax avoidance increases as prices increase. These and other price-related concerns are covered in this section.

To download all of the PowerPoint slides and speaker’s notes, visit the TTAC Pricing Strategies Toolkit online at http://www.ttac.org/services/pricing_strategies/presentation.html.


http://www.ttac.org/services/pricing_strategies/presentation.html

Part V: Essential Resources This section provides easily accessible data and information related to

effective pricing strategies in the U.S. Every tobacco control program manager who wants to be the “go-to” resource on tobacco pricing strategies should become familiar with these websites, tools, and organizations, and use them to

stay current on the science related to pricing strategies.

Many of the Essential Resources will be used while conducting the Readiness Assessment. These resources are also recommended to gather data needed to create a state pricing strategies briefing book. To establish their programs as the “go-to” center for information related to tobacco control pricing strategies, many managers have kept an up-to-date briefing book that contains much of this information in easy to understand graphs, charts, and key findings on pricing strategies.

What are the Essential Resources and What is their Relevance?Every month, there is news related to changes in tobacco prices such as increases in the excise tax on cigarettes and/or other tobacco products, the enactment of laws requiring high-tech tax stamps to reduce smuggling of untaxed or lower taxed cigarettes, or bans on internet sales of tobacco products. Whether you are new to pricing strategies or need a little brushing up on the topic, there are abundant web-based resources that are updated regularly to deliver the most current, comprehensive information on the status of price-related policies. Additional resources provide evidence that price-related strategies are the single most effective intervention to reduce tobacco use throughout the population, whether in a community, state, tribe or nation.

There are three sections to the Essential Resources: Section 1: Resources from the “Addressing Tobacco Pricing Policy” PowerPoint Slides Section 2: Additional Resources Section 3: Resources from State Campaigns

Section 1: Resources from State Campaigns

Many states have contributed resource materials to the toolkit to serve as examples for other states. Although every state has its own unique challenges and opportunities, there are many commonalities as well. These resources apply the principles outlined in this toolkit, leading to successful policy. To view a full listing of these materials and download them, visit the TTAC Pricing Strategies Toolkit online at http://www.ttac.org/services/pricing_strategies/index.html.

Section 2: Resources from Slides

The first set of resources listed includes all documents referred to or used to compose the


http://www.ttac.org/services/pricing_strategies/index.html

“Addressing Tobacco Pricing Policy” PowerPoint slides provided in the toolkit. Each resource is listed along with its source, a link to the document, and which slides pertain to it. Resources are listed in the order of the slides, and are broken down into the three main parts of the presentation: The Toll of Tobacco, Raising the Price of Tobacco Products, and Taxing Other Tobacco Products and Other Tobacco Pricing Policies.

Many of the resources were developed by the Campaign for Tobacco-Free Kids because these easily accessible materials translate well researched data into language that non-experts can understand and trust. Their primary resources and methods for interpreting the data, is available in the document entitled, “Explanations and Sources for TFK’s Projections of New Revenues & Benefits from State Cigarette Tax Increases,” http://www.tobaccofreekids.org/research/factsheets/pdf/0281.pdf.

Part 1: The Toll of Tobacco

Toll of Tobacco in the United States of AmericaCampaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0072.pdfSlides 6, 7

Health Harms from Smoking and Other Tobacco UseCampaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0194.pdfSlide 6

The Daily Toll of Tobacco Use in the USACampaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0300.pdfSlide 7

Tobacco Use Among YouthCampaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0002.pdfSlide 7

Key State-Specific Tobacco-Related Data & RankingsCampaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0176.pdfSlides 8, 9

Part 2: Raising the Price of Tobacco

Taking Action to Reduce Tobacco UseInstitute of Medicine and Commission on Life Sciences, National Research Council








Citation: IOM, Taking Action to Reduce Tobacco Use, Washington, DC: National Academy Press, 1998. http://www.nap.edu/openbook.php?record_id=6060&page=R1 Slide 12

Tobacco Taxes: A WIN-WIN-WIN for Cash-Strapped StatesCampaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/what_we_do/state_local/taxes/state_tax_reportSlides 14, 24

Raising Cigarette Taxes Reduces Smoking, Especially among Kids (And the Cigarette Companies Know It)Campaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0146.pdfSlide 17

Pregnancy-Related Benefits and Cost Savings from Raising Cigarette TaxesCampaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0158.pdfSlide 17

State Cigarette Tax Increases Benefit Lower-Income Smokers and FamiliesCampaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0147.pdfSlides 17, 32

State Benefits from a $1 Cigarette Tax IncreaseCampaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/what_we_do/state_local/taxes/state_tax_report/Slide 18

Tobacco Tax Increases Are a Reliable Source of Substantial New State Revenue Campaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0303.pdfSlides 23, 26

Voters in All States Support Significant Increases in State Cigarette Taxes Campaign for Tobacco-Free Kidshttp://tobaccofreekids.org/research/factsheets/pdf/0309.pdfSlide 24

Map of Cigarette Tax RatesCampaign for Tobacco-Free Kidshttp://tobaccofreekids.org/research/factsheets/pdf/0222.pdfSlide 25


http://tobaccofreekids.org/research/factsheets/pdf/0222.pdf



http://www.tobaccofreekids.org/what_we_do/state_local/taxes/state_tax_report/




http://www.tobaccofreekids.org/what_we_do/state_local/taxes/state_tax_report

http://www.nap.edu/openbook.php?record_id=6060&page=R1

Responses to Misleading and Inaccurate Cigarette Company Arguments Against State Cigarette Tax Increases Campaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0227.pdfSlides 26-33

The Case for High-Tech Cigarette Tax Stamp Campaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0310.pdfSlide 28

State Cigarette Tax Increases, Retailers, and Jobs Campaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0330.pdfSlide 31

Part 3: Other Tobacco Pricing Policies

State Benefits from Increasing Smokeless Tobacco Tax RatesCampaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0180.pdfSlide 36

How to Make State Cigar Tax Rates Fair and EffectiveCampaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0335.pdfSlide 36

Taxation of Smokeless Tobacco: Percentage of Price vs. Net WeightAmerican Lung Associationhttp://www.tobaccofreekids.org/research/factsheets/pdf/0175.pdfSlide 37

Internet Sales of Tobacco Products – Reaching Kids & Evading TaxesCampaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0213.pdf Slide 41

The PACT Act: Preventing Illegal Internet Sales of Cigarettes & Smokeless TobaccoCampaign for Tobacco-Free Kidshttp://www.tobaccofreekids.org/research/factsheets/pdf/0361.pdf Slide 41










Section 3: Additional Resources

These additional resources were not included in the PowerPoint, but are also useful in learning about pricing strategies.

GeneralBest Practices for Comprehensive Tobacco Control Programs, Section C: Budgets by StateThe one-page per state summary of the 2007 CDC Best Practices Recommendations for Funding is an essential briefing document. Even a small percentage of a tobacco excise tax increase can provide the much needed resources to sustain cessation and public awareness programs. By allocating resources to tobacco control programs, the pricing strategy helps smokers who are cutting back or want to quit as the result of the excise tax increase—those who often can least afford the cost of tobacco or the cost of the illnesses it causes.

Best Practices User Guide: Tobacco Pricing Policies (TBA) Centers for Disease Control and Prevention

Centers for Disease Control State Tobacco Activities Tracking and Evaluation (STATE) System Interactive MapThe interactive map provides state-by-state trends on cigarette excise taxes, beginning in 1995, as well as other valuable tobacco-related policies and data. The website is one of the most informative resources available to the public.

Interactive State-by-State Cigarette Excise Tax Map of the United StatesThe Robert Wood Johnson Foundation’s on-line interactive tobacco policy map provides up-to-date information not only on state cigarette excise tax rates (latest increase and when), but also current tax rates on snuff, chewing tobacco, and cigars for every state. The map is user-friendly. It provides every state’s tax policies so that comparisons with neighboring states are easily accessible. If one state’s taxes are much lower than its neighbors, it may help the lower taxed state’s case for increased taxes.

Saving Lives, Saving Money: A State-By-State Report on the Health and Economic Impact of Tobacco TaxesThis report from the American Cancer Society Cancer Action Network (ACS CAN) measures the dramatic health and economic benefits of implementing increased tobacco taxes in the states. The results provide evidence that increased tobacco taxes have the potential to save hundreds of thousands of lives and billions of dollars in health care costs.

State Legislated Action on Tobacco Issue (SLATI)The American Lung Association provides extensive information in non-technical language, covering every state’s tobacco policies, including current pricing law history and current excise tax revenue.


Campaign for Tobacco-Free Kids Fact Sheets Most of the Campaign’s Tobacco Tax Factsheets and materials are on the Campaign website at:http://www.tobaccofreekids.org/facts_issues/fact_sheets/policies/tax/. This is an excellent place to gather information for an assessment of national and state data regarding the toll of tobacco, as well as the status and impact of pricing strategies in every state. The well-researched fact sheets cover the gamut of pricing strategy issues.

In addition, on request, the Campaign will create fact sheets with state and local data that are relevant to state and local community leaders and policy makers or model legislation documents on a variety of pricing strategy topics (see page 76).

General Information and Arguments for Raising the Price of Tobacco

The Many Ways States Can Raise Revenue While Also Reducing Tobacco Use and Its Many Harms & Costs http://www.tobaccofreekids.org/research/factsheets/pdf/0357.pdf

Raising State Cigarette Taxes Always Increases State Revenues and Always Reduces Smoking http://www.tobaccofreekids.org/research/factsheets/pdf/0098.pdf

Cigarette Tax Increases vs. Cigarette Company Price Increases (Compared to Avg Retail Prices 1993-2008)http://www.tobaccofreekids.org/research/factsheets/pdf/0210.pdfExplanations & Sources for TFK Projections of New Revenues & Benefits from State Cigarette Tax Increaseshttp://www.tobaccofreekids.org/research/factsheets/pdf/0281.pdf Effect of State Tobacco-Tax Increases on MSA and Phase II Payments to the States http://www.tobaccofreekids.org/research/factsheets/pdf/0197.pdf

State Cigarette Tax Increases and State Tobacco Settlement Revenueshttp://www.tobaccofreekids.org/research/factsheets/pdf/0157.pdf State Options to Prevent and Reduce Cigarette Smuggling and to Block Other Illegal State Tobacco Tax Evasion http://tobaccofreekids.org/research/factsheets/pdf/0274.pdf

Tobacco Tax Increases for Health Care and Tobacco Prevention

Using Tobacco Tax Increases to Fund Comprehensive Tobacco Prevention Programshttp://www.tobaccofreekids.org/research/factsheets/pdf/0295.pdf

Tax Increases Are Not Enough - States Must Also Invest in Tobacco Prevention Programs http://www.tobaccofreekids.org/research/factsheets/pdf/0221.pdf











http://www.tobaccofreekids.org/facts_issues/fact_sheets/policies/tax/

Using State Cigarette Tax Increases to Replace Any Reduced or Delayed Settlement Payments http://www.tobaccofreekids.org/research/factsheets/pdf/0067.pdf

State and Local Tax Rates

State Cigarette Excise Tax Rates & Rankingshttp://www.tobaccofreekids.org/research/factsheets/pdf/0097.pdf Map Showing State Cigarette Tax Rateshttp://www.tobaccofreekids.org/research/factsheets/pdf/0222.pdf Top Combined State-Local Cigarette Tax Rates (State plus County plus City)http://www.tobaccofreekids.org/research/factsheets/pdf/0267.pdf Local Government Cigarette Tax Rateshttp://www.tobaccofreekids.org/research/factsheets/pdf/0304.pdf Cigarette Tax Increases by State per Year 2000-2010http://www.tobaccofreekids.org/research/factsheets/pdf/0275.pdf

State Cigarette Tax Increases (& Recessions) Since 1980http://www.tobaccofreekids.org/research/factsheets/pdf/0212.pdf State Cigarette Tax Increases since January 1, 2002, With Political Party of Sitting Governor & Legislaturehttp://www.tobaccofreekids.org/research/factsheets/pdf/0239.pdf State Cigarette Tax Rates & Rank, Date of Last Increase, Annual Pack Sales & Revenues, and Related Datahttp://www.tobaccofreekids.org/research/factsheets/pdf/0099.pdf State Excise & Sales Taxes per Pack of Cigarettes - Total Amounts and State Rankingshttp://www.tobaccofreekids.org/research/factsheets/pdf/0202.pdf

Trends in Average State Cigarette Tax Rateshttp://www.tobaccofreekids.org/research/factsheets/pdf/0211.pdf State Tobacco Tax Hikes to Replace MSA Fundshttp://www.tobaccofreekids.org/research/factsheets/pdf/0100.pdf

Impact of Raising Taxes on Specific Populations














State Cigarette Tax Increases Will Not Hurt U.S. Tobacco Growers or Cigarette Factory Workershttp://www.tobaccofreekids.org/research/factsheets/pdf/0150.pdf

Case Studies

The New York City Experience: New Revenues from a $1.42 per Pack Cigarette Tax Increase http://www.tobaccofreekids.org/research/factsheets/pdf/0307.pdf

The Michigan Story: Cigarette Tax Increases, New Revenues, and the Value of Tax Stamps http://www.tobaccofreekids.org/research/factsheets/pdf/0279.pdf

Other Tobacco Products

The Best Way to Tax Smokeless Tobaccohttp://www.tobaccofreekids.org/research/factsheets/pdf/0282.pdf Closing Weight-Based Tax Loopholes for the New Generation of Low Weight Moist Snuff Smokeless Tobacco Productshttp://www.tobaccofreekids.org/research/factsheets/pdf/0355.pdf

State Excise Tax Rates for Non-Cigarette Tobacco Productshttp://www.tobaccofreekids.org/research/factsheets/pdf/0169.pdf

The Problem with Roll-Your-Own (RYO) Tobacco http://www.tobaccofreekids.org/research/factsheets/pdf/0336.pdf

The Rise of Cigars and Cigar-Smoking Harms http://www.tobaccofreekids.org/research/factsheets/pdf/0333.pdf

Campaign for Tobacco-Free Kids Resources Available by Request OnlyOn request, the Campaign will create fact sheets with state and local data that are relevant to state and local community leaders and policy makers or model legislation documents on a variety of pricing strategy topics. Please contact Ann Boonn at [email protected] for more information.

State-Specific Tobacco Tax Factsheets

Benefits from a Cigarette Tax Increase of ___ Cents Per Pack in [State] Projected Medicaid Program Savings in [State] From A ___-Cent Cigarette Tax Increase A State Cigarette Tax Increase Will Not Harm [State’s] Tobacco Farmers Benefits to [State] from Adjusting its Tax Rates for Other Tobacco Products to Match the State’s

Tax Rate for Cigarettes


mailto:[email protected]









Tobacco Tax Equity Memo Factsheets with tables showing benefits and revenues from range of different tax increase

amounts Factsheets comparing projected revenues and benefits from competing proposed amounts Factsheets comparing projected benefits from a one-time increase instead of multi-year increase State-specific memo on creating tax equity for all tobacco products

General Resources to Support Tobacco Tax Increases and Related Legislative Efforts:

Checklist of key items and issues to consider whenever cigarette tax increases are proposed Model letter to state fiscal office re revenue projections for any state tobacco tax increase

proposals (request) Model legislation re annual public state reports on revenues and benefits from state taxes on

different types of tobacco products Help with analysis of specific legislative proposals or with drafting legislation Model tax-equity legislation to set all OTP tax rates so they parallel state cigarette tax and rise

with it Model legislation to establish minimum legal prices for all tobacco products

Resources on Smokeless Tobacco Taxes and the Weight-Based vs. Percentage-of-Price Issue:

The Best Way to Tax Smokeless Tobacco, http://www.tobaccofreekids.org/research/factsheets/pdf/0282.pdf

Guidance sheet with model legislative text on improving state tax systems for smokeless or all OTPs (request)

Guidance on improving smokeless, moist snuff, or OTP definitions (request) Graph showing revenue losses from weight-based taxes – and how to fix them (request) Graph showing different state revenues from different moist snuff tax systems (request) Model letter to state fiscal office re revenue projections for weight-based change proposals

(request) Graphic showing different types of “moist snuff” with vastly different weights per dose (request) Model legislation to place state NPM fee on smokeless companies that do not join the Smokeless

MSA (request)

Resources on Other Tobacco Products:

Model legislation on improving cigarette, roll-your-own tobacco, and other tobacco product definitions

Model legislation on improving cigarette and cigar definitions

High-Tech Tax Stamps


Model legislation for establishing a high-tech tax stamp

Tobacco Tax Increases for Health Care and Tobacco Prevention:

Model legislation for stabilizing state tobacco revenues [via automatic tax increases] and directing surplus payments to tobacco prevention


AcknowledgementsThe Tobacco Technical Assistance Consortium (TTAC) gratefully acknowledges the many individuals who have contributed to this project. This project would not have been possible without their support and contributions. Tobacco Control State Program AdvisorsSharon Biggers, MPH, CHES, South Carolina Division of Tobacco Prevention and ControlLarry Elmore, New Mexico Tobacco Use Prevention and ControlSally Herndon, MPH, North Carolina, Tobacco Prevention and Control Branch Bonnie Mapes, Iowa Division of Tobacco Use Prevention and ControlJudy Martin, MA, Tobacco Free NebraskaKenneth Ray, MPH, Georgia Tobacco Use Prevention ProgramTerry R. Reid, MSW, Washington, Chronic Disease PreventionKarla Sneegas, MPH Indiana Tobacco Prevention and CessationJeffrey G. Willett, PhD, New York Tobacco Control Program National PartnersJudy Stephany Ahearn, Consultant, CDC/OSHAmy Barkley, Campaign for Tobacco-Free KidsMonica Eischen, MPH, CDC Office on Smoking and Health TTAC StaffSarah Anderson, MPHCarissa Beatty, MPHLaira KolkinRachel Lawley, MPHJanet Love, MPHDebra Morris, MPHPamela Redmon, RN, MPHAlison Sipler, MPHChelsea Williams

Madeleine Solomon, MPH, project lead and primary author


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