Without a broadbased sales or income tax, New Hampshire has always been heavily reliant on the so-called "sin taxes" known in the vernacular as levies on butts and booze.
All told, the taxes on tobacco, plus a nationwide tobacco settlement created to spend more on stop-smoking programs, will bring in $256 million in the coming year.
How much does New Hampshire spend in state dollars to encourage adults to quit smoking and the youth to never start taking it up? $125,000.
That's less than 1 percent of what the federal Centers for Disease Control says New Hampshire should be spending given its size and tobacco use — in our case, $16.5 million.
"New Hampshire is putting children's health at risk and costing taxpayers money by refusing to fund tobacco prevention programs that save lives and health care dollars," said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids.
"Because of the tremendous progress our country has made in reducing smoking, it is within our reach to win the fight against tobacco and make the next generation tobacco-free. New Hampshire should be doing everything it can to protect kids from tobacco."
As the state has just elected its first Republican governor in 12 years and has a newly reelected Republican Legislature, leaders in the state chapter of the American Cancer Society realize this could be a tough year for New Hampshire to improve this outlook but key officials say it's worth the effort.
"We know Governor-elect Chris Sununu has a lot of demands for spending but I believe we can show him that this kind of investment comes back to the state in better productivity, sick days not lost and health care dollars not having to be spent," said Michael Rollo, director of government relations for the ACS.
"We don't expect the state to go from $125,000 to $16.5 million but back in 2003 we had spent $1 million as a state and even that would do a lot of good."
For nearly a decade and throughout the last recession, New Hampshire spent no money on tobacco prevention.
Outgoing Gov. and U.S. Sen.-elect Maggie Hassan changed that by proposing the $125,000 investment in her first budget and the current one.
This money goes to help those who cannot afford nicotine replacement therapy such as the patch.
"Each year the money only lasts for about six months because of the demand," Rollo said.
New Hampshire is just above the national average in adult smoking rates — 15.9 percent compared to the national rate of 15.1 percent — and is just below the mark when it comes to youth smoking — 9.3 percent of kids smoke here compared to 10.8 percent of kids across the country.
"Despite the fact smoking rates are going down these programs to get more people to quit are very popular," Rollo continued.
Anti-tobacco officials maintain cigarette and cigar makers spend $81 million in advertising a year to promote sales. This translates to 650 times what the state spends to help people stop the habit.
The federal government spends nearly $2 million a year in New Hampshire manning a quit line and that budget contains a small amount of money for advertising to promote it.
"We have tracked those calls and right after the ads run, there's a real spike in people who call to try and get help quitting," Rollo said. "On average it takes people at least three attempts to successfully quit smoking."
Many Republican conservative legislators have opposed attempts to increase state spending on tobacco prevention, pointing to the federal program.
House Finance Chairman Neal Kurk, R-Weare, has often said the use of tobacco has been steadily declining and that that trend will continue whether the state spends money on these programs or not.
Indeed, a Journal of American Medicine study recently concluded that adult smoking of cigarettes in the United States could be eliminated by 2035.
But anti-tobacco advocates point out the use of e-cigarettes is steadily on the rise particularly with the younger generation.
The state's Youth Risk Survey recently found about 25 percent of youths under 18 have tried or regularly use e-cigarettes.
"This is a growing problem and we need to wage a public information campaign to stem this tide," Rollo said.
State Rep. Rebecca McBeath, D-Portsmouth, is authoring legislation in 2017 to tighten up the definitions of e-cigarettes, equating them with traditional tobacco so law enforcement can issue citations for youths who are caught with them.
The State Liquor Commission has supported this change and a House committee spent last fall working on the compromise language that will make up this bill.
Advocates decided, given the new governor and Legislature, it was not the right time for a separate bill to either raise the tobacco tax or to dedicate more money to tobacco control, which means that this campaign, if it's going to go anywhere, will have to be part of the debate over the next two-year state budget.
"This is where the battle belongs, competing with all the important needs the state has, because we feel this one is literally a matter of life or death," Rollo added.
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