Public Health Policy in Maryland

Alcohol and cigarettes are common consumer products that are associated with large numbers of injury and disease. Over the past decade, the Maryland General Assembly passed legislation that increased taxes on these two products. The legislation had two aims: to reduce the harm caused by alcohol and cigarette consumption and to generate revenue for public health priorities in Maryland.

Did the legislation achieve those aims? And, if so, what can we learn from the experience?

In this Abell Report, experts from the Johns Hopkins Bloomberg School of Public Health detail the public health benefits of the laws and analyze the revenue generated by them. The researchers conclude that taxing some consumer products is a policy strategy that has the potential to improve the public’s health.

Specifically, the authors found that following the alcohol sales tax increase in 2011:

• Binge drinking by Maryland adults decreased; the 17 percent reduction seen in Maryland between 2011 and 2016 was greater than the 6 percent reduction nationally.
• Among Maryland high school students, between 2011 and 2015, there was a 26 percent reduction in the percentage of students who consumed alcohol in the preceding 30 days, a 28 percent reduction in binge drinking, and a 31 percent reduction in students riding in a vehicle operated by a driver who had been drinking alcohol.
• There was a decrease in alcohol-positive drivers and in sexually transmitted infections in Maryland.

Following the $1.00 per pack cigarette tax increase in 2008:

• Smoking by Maryland adults decreased by 26 percent among current smokers between 2011 and 2016.
• Among Maryland high school students, there was a 47 percent reduction in students who reported smoking a cigarette in the preceding 30 days, as well as a decline in frequent smoking between 2007 and 2015.

Based on their research, the authors provide four recommendations for maximizing public health gains through state policy:

1. Consider taxes an effective policy strategy to improve the public’s health.
2. Monitor the public health impacts of tax policy.
3. Ensure transparency for bills that generate revenue.
4. Employ effective advocacy strategies when promoting public health policy initiatives.