By Tim Byers, MD, MPH, and Paul Bunn, MD
In 2004 Colorado voters overwhelmingly supported amending our state’s constitution by increasing the excise tax on tobacco by 60 cents per pack, dedicating the new funds for preventive health programs and services. Since then those funds have provided health care for children, supported community clinics, created innovative chronic disease prevention programs, and have led to substantial reductions in tobacco use across Colorado.
The widespread support by voters all across Colorado for Amendment 35 was due in large part to the investments for these new tax revenues which were written into the amendment itself. The idea that this was a constitutional amendment and legislators would not be able to redirect these monies to other purposes (as they had done in the past with the Master Settlement Agreement funds coming from the tobacco industry lawsuits) was very especially appealing to voters. Nonetheless, facing the current financial crisis, the Colorado state legislature now has its eyes on even these constitutionally prescribed funds. Last week the Joint Budget Committee proposed legislation to divert $20 million of the funding from tobacco control and chronic disease prevention programs. This would reduce these programs by about 40 percent.
We know times are hard in Colorado (as elsewhere), but we think redirecting Amendment 35 funds from tobacco control and chronic disease prevention would be short-sighted. The smart choice now is to sustain cost-effective efforts to reduce tobacco use and prevent the two leading causes of death (cancer and heart disease) in Colorado.
Due to Amendment 35 investments, tobacco use has been falling steeply in Colorado in recent years. This saves both lives and money spent on medical care in the future.
Chronic disease prevention programs supported by Amendment 35 are awarded by competitive grants that fund only the most effective ideas—those that are proven to reduce mortality rates. A good example is the Colorado Colorectal Screening Program, which has become a national model, already screening more than 7,000 Coloradans who are medically underserved and at high risk for colon cancer, and having already prevented 200 future cancers due to the identification and removal of advanced colon polyps. The future cost savings for not having to treat these cancers is substantially greater than the costs of the screening program. Thus, this program, just like the tobacco control program, is saving both lives and money.
If the legislature feels the need to override the expressed intent of Colorado voters to re-direct the uses of Amendment 35 funds, why would they consider targeting such steep reductions in effective and cost-saving programs such as these?
We know times are hard, but we think this choice is easy.
Tim Byers, MD, MPH, is interim director of the University of Colorado Cancer Center and associate dean of the Colorado School of Public Health.
Paul A. Bunn, Jr., MD, is the founding director of the Center, a lung cancer physician and researcher at the University of Colorado Denver and executive director of the International Association for the Study of Lung Cancer.