Double Bind

Keep smoking—your health depends upon it!


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As editor of this magazine, a lot of press releases cross my desk. One in particular caught my eye. “New Health Laws Go into Effect,” says the state House of Representatives. The first two items? “Cigarette Tax Increase” and “Statewide Trauma Care.”

As someone who’s been known to buy a pack of cigarettes during existential crises, and who knows that trauma can befall anyone who walks, drives, swims, climbs stairs or otherwise gets up every morning and gets out of bed, I was intrigued.

“The purpose of [this cigarette tax increase] is to deter smoking, especially by teenagers and young adults, by raising the Hawai‘i cigarette tax ... from the current $1.40 to $2.60 a pack over a period of five years.”

To deter smoking. Keep that in mind as I quote the statewide trauma care law.

“Act 305 establishes a trauma system fund with moneys from the cigarette tax increase to support the development of a statewide system, one that ensures the availability of trauma care throughout the state [emphasis added]. The Legislature finds that Hawai‘i’s trauma care is in a state of crisis. ... we may be in jeopardy of losing the level of care currently available. ... The bill was introduced by Rep. Dennis Arakaki, chair of the House Committee on Health.”

“‘These two measures will have a greater impact on the health and safety of Hawai‘i’s citizens than people realize,’ said Arakaki, who was also manager for the cigarette tax bill.”

That’s where I stopped reading. Maybe you already see the problem. Trauma care is in crisis, and the state needs more money to protect us by maintaining the currently available level of trauma care. To get the money, it has tied trauma funding to a cigarette tax increase that was explicitly designed to protect us by getting people to stop smoking.

illustration: istockphoto

Let me give our legislators the benefit of the doubt for a moment and assume that they are well-intentioned people who simply don’t know the meaning of the phrase “mutually exclusive.” Both of these laws can’t possibly be effective at the same time. If the tax increase works, where is the trauma funding supposed to come from?

Well, the tax increase won’t work to deter smoking, not much, that’s been established by social-control experiments conducted nationwide over decades. There’s a core of roughly 20 percent of the population that hasn’t quit smoking, no matter how many tax increases are thrown at it. Our Legislature must know this, because it is banking on smokers to continue smoking to guarantee a steady stream of tax revenue, and doing so in plain view, boasting of their enlightened nobility along the way.

While our legislators are looking up “mutually exclusive,” they might want to also look into the phrase “morally bankrupt.” When the state sets up sin taxes to profit from behaviors it pretends to find offensive—but counts on us not giving up—it becomes the equivalent of pimps and drug pushers, another class of people who hold contempt for their weak-willed customers while happily taking their cash. Rolling those profits into some other social good barely disguises the hypocrisy. The state is budgeting, to the penny, the proven consequence that some of us will die from heart attacks and lung cancer so that others will live through better trauma care.

I feel safer already.

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Honolulu Magazine December 2018
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