Imagine what we could accomplish in Indiana with an extra $270 million each year.

We could ensure nearly every low-income 4-year-old who remains without access to quality pre-kindergarten receives a state-funded scholarship. We could invest substantial resources in comprehensive prevention programs and expanded addiction treatment services to combat our state’s opioid epidemic.

And we could triple the size of economic development initiatives.

Instead, we’re spending double that amount — $540 million — every year to cover the added health care expenses for Hoosier smokers on Medicaid, a study released this spring by the Richard M. Fairbanks Foundation showed.

While Medicaid is funded jointly by the state and federal governments, ultimately, Hoosier taxpayers shoulder this financial burden.

If we were to cut Indiana’s smoking rate in half, we would be on par with the country’s healthiest states and could save more than $270 million each year.

It’s a key time for our state to prioritize reducing tobacco use, given the strong momentum among our public- and private-sector leaders to address this issue.

The Indianapolis Motor Speedway, Indiana’s focal point in May and a well-deserved source of Hoosier pride, recently announced a plan to make its grandstands smoke-free, a major win for IMS visitors and a powerful indicator of the importance of smoke-free environments.

The recent Fairbanks Foundation study makes clear one of the factors spurring these efforts: Smoking affects every hardworking Hoosier taxpayer — and all of us collectively.

Health care costs for Medicaid members who smoke in Indiana outpace the costs for non-smokers by 51 percent, the study shows. That amounts to a difference of more than $3,864 per year for each smoker on Medicaid.

We shouldn’t forget the toll tobacco takes on Hoosier lives. In light of other addiction epidemics, such as methamphetamine and opioids, it’s easy to become desensitized to the fatal impact of tobacco. Yet it remains the leading preventable cause of death in the United States.

It’s tragic how little we’ve done to make progress in stamping out the tobacco crisis. Indiana ranks 39th among all states when it comes to smoking rates, with one in five Hoosiers lighting up on a regular basis.

If these jarring health statistics don’t move our state to action, perhaps the shared economic burden of smokers’ health care costs will. Instead of investing in better educated kids, drug prevention and treatment and economic development, we’re funneling scarce resources to address the impacts of a devastating — yet preventable — health epidemic.

Our state can combat this challenge by strengthening public policy and investing in prevention and cessation.

Evidence from other states shows that increasing the price of cigarettes is the number-one way to get smokers to quit, and raising the smoking age prevents smokers from starting in the first place.

Because few teens have friends who are much older than their own age, restricting access to tobacco until the age of 21 means it will be harder for young people to purchase cigarettes and other tobacco products.

The second major action is making significant investments in tobacco prevention and cessation. Today’s average 14-year-old has been exposed to more than $20 billion in tobacco-related imagery, advertising and promotional messaging since age 6. To counteract this, Indiana should increase spending on prevention campaigns, which are particularly effective when implemented with expanded services to help smokers quit.

May 31 is World No Tobacco Day, and it serves as a call to action for states like Indiana that struggle with high smoking rates.

Claire Fiddian-Green is president and CEO of the Richard M. Fairbanks Foundation. Paul Halverson is founding dean of the Indiana University Richard M. Fairbanks School of Public Health at IUPUI in Indianapolis. The opinions are the writers’.

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