By Glynis Kazanjian


Researchers from Johns Hopkins University want lawmakers to use tax increases as a strategy to improve public health after a study they conducted showed declines in alcohol and tobacco usage when Maryland raised taxes on both.   

The report, “Public Health Policy in Maryland:  Lessons from Recent Alcohol and Cigarette Tax Policies,” showed a decreased use in both products and improvements in people’s health after taxes on a pack of cigarettes increased from $1.00 to $2.00 in 2008 and taxes on alcoholic beverages increased from  6% to 9% in 2011.

The study was commissioned by the Abell Foundation, a Baltimore organization with a mission to improve the quality of lives for underserved populations.

“This report allowed us to investigate the effect that targeted tax legislation had both on improving health outcomes related to cigarette smoking and alcohol consumption, and creating the revenue needed to further address health challenges,” said Terry Staudenmaier, senior program officer for health and human services at the Abell Foundation. “The findings prove that this type of legislation is an effective public health tool in Maryland.”

Among some of the key findings, the study showed a drop in binge drinking and alcohol consumption among youth.

Reduced binge drinking

According to the report, from 2011 to 2015, there was a 26% reduction among Maryland high school students who consumed alcohol at least once in a preceding 30-day period. Comparatively, the study showed a 17% reduction among students nationwide.

During the same time period, binge drinking among youth reduced 28% and students who reported riding in a vehicle driven by a person who had consumed alcohol dropped 31%. Binge drinking is defined as having five or more consecutive drinks.

Among Maryland adults, from 2011 to 2016, binge drinking dropped 17% in Maryland, compared to 6% reduction nationwide.

“The relationship that is evident across studies is clear: As the price of alcohol increases, death and injury decrease generally, with specific declines in alcohol-related diseases, violence, traffic crashes, and crime,” the report states.

The study also found that Maryland retailers sold 182 million packs of cigarettes in 2015 compared to 269 million packs sold in 2007.

Upon passage of the 2008 cigarette tax, revenues increased by $72 million from $268 million in 2007 to $340 million in 2008. In 2016, the state collected $360 million.

“The number of smokers has continued to drop every year since the tax increases went into effect,” Staudenmaier stated.

Youth smoking declines

The percentage of youth smokers who reported smoking at least once in a previous 30-day period decreased from 17% to 9% from 2007 to 2015. The study also found that young adults who do not start smoking in high school are less likely to smoke as adults and are less likely to use illegal substances when compared to peers who smoke.

Researchers noted that alcohol and cigarette usage are linked to a number of public health problems, including driving under the influence, sexually transmitted diseases that cause cancer and cardiovascular and respiratory diseases.  

“There was a decrease in alcohol-positive drivers and in sexually transmitted infections in Maryland,” the report states.

In addition, researchers pointed out that smoking is the leading cause of death in Maryland, noting that 7,500 die each year from smoking-related diseases.

Cherry-picked data

Marc Kilmer, a senior fellow at the Maryland Public Policy Institute, called the report a simple analysis and said the authors cherry picked data.

“I think it oversells the effects of these two tax increases on these two products to bolster the advocacy this group is predisposed to support,” Kilmer said. “It attempts to link a variety of health effects from both alcohol and cigarette to these two tax increases, whereas people’s actions depend on a variety of factors — to cultural norms and federal policies and, of course, the price of something plays a role in that.”

Kilmer said he thinks the study misses the business affects of the taxes.

Cross-border sales

“I think there was evidence before Maryland raised the cigarette taxes that people would come into the state to buy alcohol, and now there’s evidence that that’s reversed direction,” Kilmer said. “I live by a ‘Tax Free Liquor’ store on the Maryland-Delaware border. It’s not named that out of coincidence.

“There are definitely cross-border sales of alcohol and tobacco. Maryland is the state where the vast majority of residents live very close to other jurisdictions where there’s different tax policy on alcohol and tobacco. The idea that Marylanders haven’t shifted their buying habits is pretty naive.”

Daraius Irani, chief economist for the Regional Economic Studies Institute at Towson University, said “sin taxes” are a good approach to changing behavior of individuals.

“The outcomes mentioned speak strongly to the impact that these policies can have on improving public health.”