Increasing tobacco levies will relieve burdens on doctors, health care

I had a busy Saturday recently, while making my weekend hospital rounds. I started the long on-call weekend on Friday with a referral from an emergency room physician in Rumford. I was told of a truck driver – who I’ll call “Ron” – who had become quite sick, with severe chest pain.

Unfortunately, Ron hadn’t sought medical attention until several days had passed; he finally came to the hospital after realizing he didn’t have strength enough to get out of bed. The emergency room physician took one look at Ron’s electrocardiogram and knew that serious damage had been done.

Ron was soon one of my weekend charges.

He was not alone when I walked into his room. He was pale and a little short of breath, but stuck out his hand and seemed glad to be in a hospital with cardiac specialists. He told me he’d been foolish, and he regretted his decision to smoke cigarettes. He knew he should have quit, but as a truck driver, boredom got the better of him. We talked about his addiction to cigarettes. Before I left, I joked with him a little and asked how it felt to be an ex-smoker.

I started Ron’s evaluation with an echocardiogram, which would give me an idea of the amount of damage present in his heart. I looked in shocked silence at a heart that barely moved, with large blood clots present inside it. Worse yet, three of the four heart valves were leaking badly. I was looking at a heart that had almost died.

I wondered how on earth Ron had survived. Two days later, after additional testing, Ron was transferred by ambulance to a Boston hospital with the capability to perform heart transplants. Ironically, he was the second patient I had sent there in a week. Both were smokers.

I moved to Maine a decade ago, when the state had one of the highest percentages of teen smokers in the nation. Since then many states – including Maine – settled a class action lawsuit versus tobacco companies and received millions of dollars. Our elected officials decided to use that money to improve the health of the people of Maine, and to develop a campaign to prevent smoking.

They have also raised tobacco taxes, something they would like to do again.

The results, so far, have been dramatic: the number of new teen smokers has decreased to one of the lowest in the nation, and there has also been a reduction of adult smokers, reducing the health care costs and saving millions in taxes.

Along with a doctor’s advice to stop smoking, the most effective way to reduce smoking is increasing the cost of cigarettes. My patients have told me that they expect the cigarette tax to go into effect, and are planning to quit smoking on the day the tax is enacted!

I recently heard there are well-meaning members of our Legislature who feel that cigarette taxes penalize the poor. The poor citizens of Maine are actually penalized by the scourge of disease spread by tobacco addiction.

Heart attacks and strokes, high rates of lung and other cancers, asthma in children, increased rates of sudden infant death syndrome, even the tragedy of home fires are the penalties they pay because of smoking.

Some in Maine’s Legislature feel there isn’t room for additional taxes, but I know my tax dollars are supporting the one in every seven Maine residents receiving government-subsidized health care. When these individuals require intensive care, surgeries and prolonged hospitalizations, my tax dollars help pay for it. The least expensive approach to this problem is through prevention. Less disease means lower health care costs and fewer tax dollars spent.

In medicine, we strive to provide “evidence-based” treatments that we know work well and are safe. I ask our current lawmakers to use “evidence-based legislation,” employing laws that are proven to be safe and effective, such as the increased tax on cigarettes.

Legislators, please pass the governor’s suggested $1-per-pack cigarette tax.

I need your help, and so do my patients.

Dr. Dervilla M. McCann is a cardiologist at Androscoggin Cardiology Associates in Auburn. She lives in Winthrop.