Smoking is on the minds of our legislators. Both tobacco and marijuana have been the subjects of spirited discussion and hearings the past few weeks and NHMS has been present bringing the voice of science, reason, and our patients. In regards to tobacco, NHMS has prepared a policy analysis (see report) that looks at the impact of a tobacco tax increase, taking into consideration the following:

• Smoking costs an average of $2,784 in direct medical expenses per smoker per year;
• Tobacco price increases of 10% consistently yield a 4% decrease in adult smoking and a 7% decrease in youth smoking;
• People of low socio-economic status have much higher smoking rates and poorer health outcomes; and
• The smoking rate among Medicaid beneficiaries is 57% compared to the overall NH of 19%.

Our analysis used evidence and data to find the right amount of price increase that would both maximize health benefit and revenue, and minimize impact on small grocers with cross border sales -- we believe that a $0.68 increase will achieve these goals. Our analysis shows this $0.68 increase results in the following:

• 9,807 NH resident will quit smoking;
• $2.4 million in savings to state healthcare spending;
• $24.9 million savings in private sector healthcare spending;
• $61.6 million in new revenue for NH; and
• We expect a 4% reduction on in-state cigarette sales and minimal impact on cross border sales.

Take a look at our report and let us know what you think. NHMS will likely need your help in advocating for this increase in the coming weeks.

In regards to marijuana, Dr. Seddon Savage recently represented NHMS in her well-researched testimony against the so-called "Medical Marijuana Bill." (You may read Dr. Savage's report by clicking here.) I've summarized the reasoning below:

• Medical grade marijuana that is regulated for safety and efficacy does not currently exist, this bill addresses herbal marijuana that is outside the realm of FDA approval and surveillance;
• The list of certifying diagnoses is significantly broad and would result in widespread use of marijuana and not be limited to those very few patients whose pain or other symptoms cannot be well controlled with thoughtful medical care using medications or procedures currently approved for use in the United States;
• Youth recreational use would likely increase dramatically; and
• Marijuana is second only to alcohol, as a drug for which individuals seek addiction treatment in the United States.

Our role in both of these issues is to be the voice of reason. As physicians, we are well respected in the statehouse and legislators value our input as they consider these important issues. I'm hopeful that our work will have an impact preventing public health from going up in smoke! Please email any questions or comments to or to post a comments below.


Excellent summary and points Dr. Harker and Dr. Savage.