1. Raise the cigarette tax by $2 per pack with parity across all tobacco products, including e-cigarettes;
2. Enact legislation prohibiting the sale of all flavored tobacco products; and
3. Enact a comprehensive smokefree air law that covers bars, clubs, and gaming venues.
During the 2020 legislative session, the American Lung Association in Indiana supported the passage of Senate Bill 1, raising the minimum sales age of tobacco products to 21. Indiana's state law is now aligned with federal statute. Notably, the bill also made several important changes to strengthen penalties for retailers that violate the law. Under the new law, fines for repeat retail offenders are doubled. The law also doubles the "look back period" from six months to one year. The look back period is the time during which a retailer may accumulate repeat underage sale violations. Based on a retailer's total previous violations, fines are escalated, ultimately putting the retailer's license in jeopardy.
One non-legislative advancement in tobacco control was an announcement from Indiana Medicaid, outlined in IHCP Bulletin 202050. Under the new directive, copays are no longer required for tobacco cessation medications. The change applies to fee-for-service as well as managed care plans.
At the municipal level, the town of Winfield enacted a comprehensive local smokefree air law. State legislators have not seriously considered stronger secondhand smoke protections at the state level since passing a statewide law in 2012. Existing state law leaves thousands of workers vulnerable to harmful secondhand smoke exposure on the job.
The Indiana General Assembly did not advance any of several bills addressing flavored tobacco products during the 2020 session.
A 2020 poll released by the American Lung Association in Indiana found strong support for smokefree casinos and other tobacco control policies. Eighty-three percent of Hoosier voters agree secondhand smoke is a health hazard, with 70% supporting a prohibition of smoking and vaping in all workplaces, including bars, clubs, and casinos. The poll also found strong public support for raising the cigarette tax (63%) and imposing a tax on e-cigarettes equal to cigarettes (70%). Fifty-one percent of voters support prohibiting the sale of flavored tobacco products.
Raising the cigarette tax is the most important tobacco control policy that legislators can undertake in 2021. Indiana has the lowest cigarette tax in the region, and one of the highest smoking rates in the country. A significant increase of the cigarette tax will drive down smoking rates and prevent many young Hoosiers from ever smoking at all. Raising the tax will also generate funding for tobacco prevention and other crucial public health needs.
Economic Cost Due to Smoking: $2,930,404,456
Adult Smoking Rate: 19.2%
High School Smoking Rate: 5.2%
High School Tobacco Use Rate: 22.9%
Middle School Smoking Rate: 1.9%
Smoking Attributable Deaths per Year: 11,070
Adult smoking data come from CDC's 2019 Behavioral Risk Factor Surveillance System. High school and middle school smoking and high school tobacco use data are taken from the 2018 Indiana Youth Tobacco Survey.