California Medical Assn. Urges Bill to Set Up $3-Per-Pack Cigarette Tax : Resolution: The group says revenue from the proposed tax could be used to treat tobacco-related diseases.

ANAHEIM —  Attempting to speed up a national decline in smoking and raise funds to combat smoking-linked disease, the California Medical Assn. here Tuesday called for legislation to establish a $3 excise tax on each pack of cigarettes.

Dr. Richard F. Corlin, outgoing president of CMA, said revenue from the $3 tax would reflect the estimated cost of caring for medical problems caused by cigarette smoke. The Clinton Administration is already considering a $2 tax per pack.

Corlin said an existing $3-per-pack tax in many other industrialized countries has reduced smoking. “There is plenty of evidence that cigarette smoking is price-sensitive,” he said.

When voters approved CMA-supported Proposition 99 in 1989, he said, the measure’s additional 25-cents-per-pack tax resulted in a 12% reduction in state cigarette sales.

The CMA House of Delegates, holding its annual session here this week, passed a resolution seeking the tax legislation, although the measure didn’t say directly whether it should be a national or state tax.

The resolution, approved by voice vote after scant debate, also declared that the estimated $120 billion that would be raised annually if the tax were imposed nationwide should be spent “for treatment of tobacco-related diseases, tobacco research, smoking cessation and educational programs.”

Corlin said he has met with Dr. Steven Gleason, an adviser to the Clinton Administration, to present a more detailed plan for a national tax hike and how revenue could be split between state and federal governments.

While Corlin said Gleason seemed interested, Corlin nonetheless acknowledged that he expects strong opposition to the proposal from “the tobacco lobby.”

No one from the Tobacco Institute in Washington could be reached Tuesday to comment on the CMA plan.

Corlin denied the tax would be harsh on the poor or elderly on fixed incomes who smoke. “We don’t have to make an apology for increasing the tobacco tax on the poor because they need protection from tobacco as much, if not more, than anybody else,” he said.

“We are trying very hard to control health care costs and (eliminating smoking) is a way that we could eliminate 15% of what we spend on health,” he added, noting that cigarettes have been associated with life-threatening diseases ranging from lung and throat cancer to emphysema and heart attacks.

Corlin said he would be in Sacramento today to testify for a CMA-sponsored bill carried by Assemblyman Terry B. Friedman (D-Brentwood) that would ban smoking in all indoor public places and enclosed work areas.

Taking further aim at cigarettes, the CMA delegates Tuesday also passed a resolution that the CMA “support educational efforts to inform the public that smoking in cars and other enclosed spaces is harmful to them and their children.”

“We intend to be relentless in this area until we put the tobacco industry out of business,” Corlin declared.

In other actions, the CMA also urged new legislation to increase taxes on all alcoholic beverages. The resolution passed despite efforts by some delegates to recommend a tax only on distilled spirits in order to protect California’s wine industry.

And in an attempt to stop the spread of AIDS, the CMA supported amendments to California’s Health and Welfare Code requiring routine prenatal and premarital testing for HIV and agreed to support any revisions to state law that would allow the distribution of condoms in correctional facilities.

The doctors also debated the ethics of doctor-assisted suicide. While the CMA has firmly opposed the legalization of physician participation in ending life, the organization has declared that doctors must receive much clearer direction on how to compassionately care for dying patients.

Dr. Rex Ehling, Orange County’s director of public health, said the medical community traditionally has focused on cures and has avoided confronting the needs of the dying, and he blamed this “blind spot” for recent efforts by the public to legalize physician-assisted suicide.

“I think the reason this is happening is that we as physicians have failed to respond to the need for palliative care” for the dying, he said.

The delegates approved a resolution proposed by Ehling to encourage development of medical school, graduate and continuing educational programs in pain management and other kinds of care to help dying patients.

Delegates further called upon hospitals and long-term care institutions to develop more structured policies for assisting dying patients, and for the CMA to expand existing legislation so physicians would be protected from disciplinary action for prescribing or administering controlled drugs when treating patients for intractable pain.