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Iowa has the second highest cancer rate in the country. Their leading solution? Increase tax on cigarettes. Not 'increase tax on cigarettes to increase early

Iowa has the second highest cancer rate in the country. Their leading solution? Increase tax on cigarettes. Not 'increase tax on cigarettes to increase early detection initiatives' or increase tax on cigarettes to increase screening subsidies', just 'increase tax on cigarettes so that the state has more money and poor people have less money'.

iso1631 8mo ago
Increasing the price incentivises people not to buy it, econ 101
- saltwatercowboy 8mo ago
  Increasing the price fosters a black market, econ 102
- hexer292 8mo ago
  Just like increasing taxes incentivises people not to work.
- deleted 8mo ago
  [deleted]
- goodmythical 8mo ago
  ooooh, ur so smart. Iowa's tobacco use is relatively low. If tobacco were the primary problem (as indicated by the focus of the solution), you'd expect Iowa to use more tobacco than most or all states. Given that their utilization is so low, it cannot possibly be the leading contributor. Reducing an already low use of the product is a dumb place to start and a worse place to stop if your goal is to decrease the cancer rate. If your goal were to reduce the cancer rate, you'd focus on something about your population that is contributing to the higher cancer rate.
nxor2 8mo ago
Iowa : Industrial Agriculture :: West Virginia : Coal
- tylerrobinson 8mo ago
  Iowa doesn’t grow an appreciable amount of tobacco, though.
toomuchtodo 8mo ago
Smoking is at historic lows [1] (~10-15%). Screening doesn't stop smoking, poor people will still be poor, smokers will still smoke, although GLP-1s may fix this [2] [3] (certainly, if this proves out, use cigarette taxes to help pay for GLP-1s for everyone to impair the dysfunctional reward center loop). There doesn't seem to be political will to simply ban cigarettes, so here we are. Making cigarettes expensive for poor people who smoke destroys demand, no? Otherwise, we accept the cancer rates for their choice and freedom to smoke knowing the consequences (~5k deaths/year in Iowa from this risk). [1] https://www.radioiowa.com/2026/01/02/iowa-smokers-can-save-money-and-their-health-by-quitting/ https://www.radioiowa.com/2026/01/02/iowa-smokers-can-save-m... (“Increasing the cost of tobacco products is one of the most effective ways to reduce use,” Cale says, “and in turn, to lower Iowa’s lung cancer rates.”) [2] GLP-1 drugs may fight addiction across every major substance - https://news.ycombinator.com/item?id=47280797 https://news.ycombinator.com/item?id=47280797 - March 2026 [3] GLP-1 medications get at the heart of addiction: study - https://medicine.washu.edu/news/glp-1-medications-get-at-the-heart-of-addiction-study/ https://medicine.washu.edu/news/glp-1-medications-get-at-the... - March 4th, 2026 (i have personal experience with a loved one who will not quit smoking, so I am not unsympathetic to this risk and harm incurred)
- johannes1234321 8mo ago
  > There doesn't seem to be political will to simply ban cigarettes, so here we are. A simple ban will work as well as prohibition of alcohol did. There will be a black market. Sure, producing tobacco is a bit more involved then producing liquor, but for smuggling there are enough options. The attempt is to raise prices and do marketing against smoking as well as preventing ads for smoking. So that over time the interest goes down and when looking at numbers of smokers that seems to work in some regions. Of course tobacco lobby has a lot of money and tries to prevent all measures.
derektank 8mo ago
Demand for cigarettes isn’t static. If you make them expensive enough, demand falls. Lower demand means less smoking which means less cancer. The only real risk with pigouvian taxes is that if you raise them too high, you can foster the development of a black market, which comes with its own set of negative social consequences.
- goodmythical 8mo ago
  Sure, lower demand does indeed reduce smoking, and a reduction in smoking might decrease cancer (iirc that's really hard to prove as an isolated variable given that those who give up smoking tend to make other lifestyle improvements that could also account for the difference). My point is that the solution is such a blunt tool. Given that smoking rates aren't relatively high in Iowa, smoking alone cannot be the major contributor to their relatively increased cancer rates. Were they to smoke more than any other state and also have high rates, I could maybe see it, but that's just not the case. Even if smoking rates were high and and increasing the tax were a solution, I'd still suggest that it's rather lazy to only do that given that tobacco does not cause a majority of cancer. You could do the same thing in a different direction and be equally relatively ineffective by, for instance, decreasing tax on sunscreen, or subsidizing healthy foods or gym memberships. Given that stress contributes to cancer rates, you could decrease the cost of mental health, run a de-stigmatizing campaign, force all corporations to finance therapy with independently verified therapists etc. There are so many many things that can be done that would likely be better than attempting to decrease an already low smoking rate.
  - derektank 8mo ago
    >a reduction in smoking might decrease cancer I understand that you were trying to make a different point so forgive me for derailing this conversation but this is important and I want to be emphatic. Smoking incontrovertibly and substantially increases your risk of developing cancer. 85-90% of lung cancer cases and a substantial number of other forms cancers of can be attributed to smoking. There are a lot of ways to study this (you can look at people that never started smoking, not just people who quit). Yes, these studies are correlational (we don’t do RTCs on things that can kill you) but they are very high powered and are designed to account for confounding variables. The entire reason we’ve seen a decline in cancer mortality in the US since the 90s is largely attributable to falling smoking rates beginning in the 70s. And while much fewer people smoke, roughly 1 in 7 still do. Encouraging them to find another way to feed their nicotine addiction, and discouraging young people from ever picking up the habit, would save a lot of lives still.
mikkupikku 8mo ago
Smokers know the score by now. It's time for society to stop coddling them. Tax their asses to the Moon, call it reparations for all the smog and stentch they subjected the rest of us to for generations.
- AngryData 8mo ago
  Smokers already pay far more in sin taxes than the average persons entire lifetime medical costs, and also smokers cost less than the average person in medical costs because smoking disqualifies them from many procedures and they don't live until they are 90 when they need expensive hip replacements and 30 medications a day.
  - mikkupikku 8mo ago
    Medical costs? Okay, how about paying for the smog and stench? $200 per pack, increasing yearly. That'd probably be about right. You should have quit years ago. If you started smoking anytime in the past 50 or so years, after being taught in taxpayer funded schools not to smoke, then you should receive an additional one-time fee of a hundred thousand dollars, because genuinely fuck you.
    - AngryData 7mo ago
      So should we also put $200 tax on stinky food? Stinky people? Stink perfumes? Just because you don't personally like something doesn't justify ever increasing taxes on it.
micromacrofoot 8mo ago
I think that one's pretty clear cut, people giving themselves cancer are a financial drain on everyone else. Both the supply and demand side should be punished.

iso1631 8mo ago

Increasing the price incentivises people not to buy it, econ 101

saltwatercowboy 8mo ago
Increasing the price fosters a black market, econ 102
hexer292 8mo ago
Just like increasing taxes incentivises people not to work.
deleted 8mo ago
[deleted]
goodmythical 8mo ago
ooooh, ur so smart. Iowa's tobacco use is relatively low. If tobacco were the primary problem (as indicated by the focus of the solution), you'd expect Iowa to use more tobacco than most or all states. Given that their utilization is so low, it cannot possibly be the leading contributor. Reducing an already low use of the product is a dumb place to start and a worse place to stop if your goal is to decrease the cancer rate. If your goal were to reduce the cancer rate, you'd focus on something about your population that is contributing to the higher cancer rate.

nxor2 8mo ago

Iowa : Industrial Agriculture :: West Virginia : Coal

tylerrobinson 8mo ago
Iowa doesn’t grow an appreciable amount of tobacco, though.

toomuchtodo 8mo ago

Smoking is at historic lows [1] (~10-15%). Screening doesn't stop smoking, poor people will still be poor, smokers will still smoke, although GLP-1s may fix this [2] [3] (certainly, if this proves out, use cigarette taxes to help pay for GLP-1s for everyone to impair the dysfunctional reward center loop). There doesn't seem to be political will to simply ban cigarettes, so here we are. Making cigarettes expensive for poor people who smoke destroys demand, no? Otherwise, we accept the cancer rates for their choice and freedom to smoke knowing the consequences (~5k deaths/year in Iowa from this risk). [1] https://www.radioiowa.com/2026/01/02/iowa-smokers-can-save-money-and-their-health-by-quitting/ https://www.radioiowa.com/2026/01/02/iowa-smokers-can-save-m... (“Increasing the cost of tobacco products is one of the most effective ways to reduce use,” Cale says, “and in turn, to lower Iowa’s lung cancer rates.”) [2] GLP-1 drugs may fight addiction across every major substance - https://news.ycombinator.com/item?id=47280797 https://news.ycombinator.com/item?id=47280797 - March 2026 [3] GLP-1 medications get at the heart of addiction: study - https://medicine.washu.edu/news/glp-1-medications-get-at-the-heart-of-addiction-study/ https://medicine.washu.edu/news/glp-1-medications-get-at-the... - March 4th, 2026 (i have personal experience with a loved one who will not quit smoking, so I am not unsympathetic to this risk and harm incurred)

johannes1234321 8mo ago
> There doesn't seem to be political will to simply ban cigarettes, so here we are. A simple ban will work as well as prohibition of alcohol did. There will be a black market. Sure, producing tobacco is a bit more involved then producing liquor, but for smuggling there are enough options. The attempt is to raise prices and do marketing against smoking as well as preventing ads for smoking. So that over time the interest goes down and when looking at numbers of smokers that seems to work in some regions. Of course tobacco lobby has a lot of money and tries to prevent all measures.

derektank 8mo ago

Demand for cigarettes isn’t static. If you make them expensive enough, demand falls. Lower demand means less smoking which means less cancer. The only real risk with pigouvian taxes is that if you raise them too high, you can foster the development of a black market, which comes with its own set of negative social consequences.

goodmythical 8mo ago
Sure, lower demand does indeed reduce smoking, and a reduction in smoking might decrease cancer (iirc that's really hard to prove as an isolated variable given that those who give up smoking tend to make other lifestyle improvements that could also account for the difference). My point is that the solution is such a blunt tool. Given that smoking rates aren't relatively high in Iowa, smoking alone cannot be the major contributor to their relatively increased cancer rates. Were they to smoke more than any other state and also have high rates, I could maybe see it, but that's just not the case. Even if smoking rates were high and and increasing the tax were a solution, I'd still suggest that it's rather lazy to only do that given that tobacco does not cause a majority of cancer. You could do the same thing in a different direction and be equally relatively ineffective by, for instance, decreasing tax on sunscreen, or subsidizing healthy foods or gym memberships. Given that stress contributes to cancer rates, you could decrease the cost of mental health, run a de-stigmatizing campaign, force all corporations to finance therapy with independently verified therapists etc. There are so many many things that can be done that would likely be better than attempting to decrease an already low smoking rate.
- derektank 8mo ago
  >a reduction in smoking might decrease cancer I understand that you were trying to make a different point so forgive me for derailing this conversation but this is important and I want to be emphatic. Smoking incontrovertibly and substantially increases your risk of developing cancer. 85-90% of lung cancer cases and a substantial number of other forms cancers of can be attributed to smoking. There are a lot of ways to study this (you can look at people that never started smoking, not just people who quit). Yes, these studies are correlational (we don’t do RTCs on things that can kill you) but they are very high powered and are designed to account for confounding variables. The entire reason we’ve seen a decline in cancer mortality in the US since the 90s is largely attributable to falling smoking rates beginning in the 70s. And while much fewer people smoke, roughly 1 in 7 still do. Encouraging them to find another way to feed their nicotine addiction, and discouraging young people from ever picking up the habit, would save a lot of lives still.

mikkupikku 8mo ago

Smokers know the score by now. It's time for society to stop coddling them. Tax their asses to the Moon, call it reparations for all the smog and stentch they subjected the rest of us to for generations.

AngryData 8mo ago
Smokers already pay far more in sin taxes than the average persons entire lifetime medical costs, and also smokers cost less than the average person in medical costs because smoking disqualifies them from many procedures and they don't live until they are 90 when they need expensive hip replacements and 30 medications a day.
- mikkupikku 8mo ago
  Medical costs? Okay, how about paying for the smog and stench? $200 per pack, increasing yearly. That'd probably be about right. You should have quit years ago. If you started smoking anytime in the past 50 or so years, after being taught in taxpayer funded schools not to smoke, then you should receive an additional one-time fee of a hundred thousand dollars, because genuinely fuck you.
  - AngryData 7mo ago
    So should we also put $200 tax on stinky food? Stinky people? Stink perfumes? Just because you don't personally like something doesn't justify ever increasing taxes on it.

micromacrofoot 8mo ago

I think that one's pretty clear cut, people giving themselves cancer are a financial drain on everyone else. Both the supply and demand side should be punished.