Criminal Indifference

Submitted by Tim.Byers on Wed, 11/30/2011 - 15:39

You Seinfeld enthusiasts might be familiar with the crime of “criminal indifference.”  That was that charge against Jerry, Elaine, George, and Kramer in the final episode of the Seinfeld series.  They were convicted, of course, based on their many examples of self-indulgent indifference to others over the years.

The term “criminal indifference” came to mind to me today as I read a new report about how tobacco settlement and tax funds are being used in the United States.   That report (“A Broken Promise to our Children”, available online at www.acscan.org) tells the shameful story of how state funding for tobacco prevention and control has been slashed by 36% over the past 4 years.  During this fiscal year states are expected to collect about $26 billion in revenues from taxes and the tobacco settlement agreement, but they will spend only 1.8% of that total on tobacco prevention and control programs.  That is less than 2 cents out of every tobacco tax/settlement dollar for tobacco control. 

When about one in every 5 Americans still smokes tobacco, and when tobacco prevention and cessation are clearly the most effective and cost-saving public actions we can take to improve health, this is a disgraceful record.  Of course, we are all aware of the reasons for this.  Money is tight.  But those of us in the public health arena cannot be held blameless about those decisions.   I have not been indifferent in what I have believed, or in what I have said, but I have acted indifferently by not really doing anything about this.  One needs to be judicious in laying down in front of buses, of course, but  I for one have been a little too indifferent about this problem of eroding support for tobacco prevention. 

Tobacco control needs to be the highest of our public health priorities, and if we are collecting taxes and taking settlement monies from smokers, I think we have a strong ethical obligation as well as a strong evidence-basis for fully investing in tobacco prevention and control programs.  Anything less is criminal indifference.