Financing & Strategies for Sustaining Innovation

dnp 711 spring 2020 syllabus-20200109

In Arizona, cigarettes are subject to a state excise tax of $2.00 per pack. Cigarattes are also subject to Arizona sales tax of approximately $0.37 per pack. Cigarettes excise tax rate has not been changed in over a decade in AZ. With tobacco use on the rise, lawmakers ask voters to sharply increase the taxes smokers pay on cigarettes and similar products they buy. A further increase in the cost per pack will prevent teens to start the habit or give up the habit (1).

The process of policy making has mistakes of omission and commission.  Policy modification phase helps to adjust to accommodate changing circumstances. Incrementalism in public policymaking is the method of change by which many small policy changes are enacted over time in order to create a larger broad based policy change. There were large scale policy modifications like Medicare enactment and healthcare reform during Obama administration.  However, pattern of incrementalism is likely to continue like getting to universal health insurance coverage by filling the gaps in existing system (2). Incrementalism is a significant strategy to attain sustainable results. Sustaining an innovation is only through creating an interest among key legislators, stakeholders, and decision makers. Strategies for sustainability include maintaining contacts with key leaders, sending newsletters or updates and developing press releases on the topic (3).

According to the report of the Surgeon General of United States “use of e-cigarettes is increasing rapidly among young people, even among those who have never smoked cigarettes”. His Call to Action presents strategies to reduce e-cigarette use among youth and young adults. It is vital to work in unity with individuals and families; civic and community leaders; public health and health care professionals; e-cigarette manufacturers and retailers; voluntary health agencies; researchers; and other stakeholders (4). The strategies are as follows:

A) Implement a comprehensive strategy to address e-cigarettes that will avoid adverse consequences and give careful consideration to the risks for youth and young adults. This can be done by including e-cigarettes in policies and programs related to conventional cigarette smoking at the national, state, local, tribal, and territorial levels.

B) Educate parents, teachers, coaches, and other influencers of youth about the risks of e-cigarette use among youth and young adults. Educate health professionals about the risks of e-cigarette use among youth and young adults.

C) Implement FDA regulatory authority over the manufacturing, marketing, and distribution of e-cigarettes. Reinforce other federal agencies as they implement programs and policies to address e-cigarettes.

D) State, local, tribal, and territorial governments should implement population-level strategies to reduce e-cigarette use among youth and young adults, such as including e-cigarettes in smoke-free indoor air policies, restricting youth access to e-cigarettes in retail settings, licensing retailers, and establishing specific package requirements.   Coordinate, evaluate, and share best practices from state and local entities that have implemented programs and policies to address e-cigarette use among youth and young adults.

E) Curb e-cigarette advertising and marketing that are likely to attract youth and young adults.  Urge the e-cigarette companies to stop advertising and marketing that encourages and glamorizes e-cigarette use among youth and young adults.

F) Improve the quality, timeliness, and scope of e-cigarette surveillance, research, and evaluation. Address surveillance, research, and evaluation gaps related to e-cigarettes.

 Applying these strategies and continue to apply it to e-cigarettes and other tobacco products to sustain the innovation. Strong state-based public health programs focused on preventing smoking and tobacco use are critical to the nation’s health. CDC is the only federal agency that provides funding to help support states for tobacco control efforts (5).

References

1) Arizona: Tobacco excise taxes. (2020). Retrieved from https://www.salestaxhandbook.com/arizona/tobacco

2) Longest, B. B. (2016). Health policymaking in the United States (6th ed.). Health Administration Press.

3) Patton R.M., Zalon, M.L., & Ludwick, R. (2015). Nurses making policy: From bedside to boardroom. New York: Springer.

4) E-cigarette Use Among Youth and young adults (2016). A report of the surgeon general. Retrieved from https://ecigarettes.surgeongeneral.gov/documents/2016_SGR_Full_Report_non-508.pdf

5) Centers of disease control and prevention. (2020).Smoking and tobacco use. Retrieved from https://www.cdc.gov/tobacco/about/foa/index.htm