THE TOBACCO WAR Paydays vs. the Price Paid

Cigarettes' Cost in Dollars and Lives

By Fredrick Kunkle
Washington Post Staff Writer
Monday, February 9, 2009

SUFFOLK, Va. -- Second of two reports examining the impact of tobacco on Virginia

At least one of every 10 patients arrive at Jeffrey D. Forman's medical office with an oxygen tank.

They lug them like carry-on bags. They wheel them on devices that resemble golf caddies, careful not to tangle the plastic tubing that fills their nostrils with life-giving oxygen.

Once, it was cigarettes they carried. Now, battling lung cancer, emphysema or a wasting disease called chronic pulmonary obstructive disorder, they bear the costs of a lifetime of smoking. They illustrate the price that all Americans pay for tobacco and the reason why Virginia Gov. Timothy M. Kaine (D) has brought his tobacco-producing state closer than ever to a ban on smoking in bars and restaurants.

After five decades of smoking, Pattie Tatem, 67, sits in a wheelchair with an oxygen tank at her feet, a victim of severe chronic obstructive pulmonary disease. The disease takes her breath away and makes her feel as if she's drowning. It wiped out her retirement savings. Now it's slowly killing her.

"It catches up with you, and when it hits you, it hits you hard," said Tatem, whose treatment costs are footed mostly by taxpayers through Medicare.

To recover some of Virginia's health-care costs caused by tobacco, Kaine proposed doubling the state tax on cigarettes to 60 cents a pack. The governor and the General Assembly took aim at tobacco in other ways, too, by moving to ban smoking in restaurants and bars and prohibiting people from lighting up in a vehicle when a child is present.

Last week, Kaine announced a compromise with House Speaker William J. Howell (R-Stafford) on a smoking ban that some anti-smoking advocates criticized as too timid. But in years past, even that would have been dead on arrival in the House. The governor's tobacco tax, in contrast, never made it to the floor of the Republican-controlled House or the Democratic-controlled Senate.

In a state whose fortunes have been interwoven with tobacco since Colonial times, opponents warned against damaging an industry that contributes healthy paychecks and tax revenue to the commonwealth.

"These are jobs in my community you're talking about," said Sen. John C. Watkins (R-Chesterfield), whose district is near Philip Morris USA.

But doctors, health advocates and patients tally the costs differently: More than 9,000 Virginians die every year because of tobacco use, and more than 9,000 Virginia youths get hooked every year. More than 1,000 people die from secondhand smoke.

Laurens Sartoris, president of the Virginia Hospital & Healthcare Association, said Virginians pay financially, too, because they pay for smokers' medical bills.

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