States spending just 2% of tobacco settlement funds on smoking prevention

Despite receiving billions through a 1998 tobacco settlement, states are slashing budgets for tobacco prevention programs, dropping funding to its lowest level in more than a decade, a new study shows.

States are to receive $25.3 billion in tobacco taxes and revenue for fiscal 2011 from the multi-state tobacco settlement. But they are spending only 2% of that money on programs to prevent smoking or help smokers quit, according to a report released in November by the American Heart Assn., American Lung Assn. and others.

That 2%, or roughly $518 million, represents the smallest amount spent on prevention programs since 1999, the first year states received tobacco settlement funds.

"States are breaking their promise to our children; they're not using tobacco dollars for tobacco prevention," said Danny McGoldrick, vice president for research at the Campaign for Tobacco-Free Kids, a nonprofit tobacco control advocacy organization. "We're finding that states are getting a failing grade."

Overall, states reduced tobacco-prevention funding by 9% in the past year and by 28% in the past three years, the study said.

Only two states, Alaska and North Dakota, fund prevention programs at levels recommended by the Centers for Disease Control and Prevention. Only five other states -- Delaware, Hawaii, Maine, Montana and Wyoming -- fund such programs at half the CDC-recommended level, the study showed.

In contrast, Nevada, New Hampshire and Ohio allocated no state funds for prevention programs.

McGoldrick said states likely are using tobacco money to plug other budgetary holes that occurred during the recession.

"But that's no excuse," he said. "By not investing in tobacco prevention, we're actually costing ourselves money."

According to the study, tobacco use and exposure to secondhand smoke kill more than 400,000 people in the United States each year, costing the nation more than $96 billion in health care bills.

$246 billion tobacco settlement

During the 1990s, states sued tobacco companies looking to regain money spent on smokers' health care costs. In 1998, they won a sizable settlement -- an estimated $246 billion over 25 years.

States still funding smoking prevention programs will receive additional support through a new initiative unveiled by the Dept. of Health and Human Services in November. The plan calls for engaging or re-engaging the public through media campaigns, championing state tobacco control efforts and supporting the FDA. The FDA recently has taken a tougher stand against tobacco companies, including a proposal to issue graphic health warnings on cigarette packages in 2012.

"Tobacco dependence still remains the No. 1 cause of preventable illness," said HHS Assistant Secretary for Health Howard Koh, MD, MPH, who estimates that 45 to 50 million people are dependent on tobacco. "We have too much suffering that could and should be prevented."

Although Dr. Koh said the country has made progress in reducing smoking, the decline has leveled since 2004.

"The problem should not be considered solved or acceptable," he said. "We need to reject the status quo and end the tobacco epidemic."

U.S. adult smoking rates have stalled at 20.6% after decades of decline, the study said. Each day 1,000 children become regular smokers, and one-third of them will die prematurely as a result.

"With progress on smoking rates stalled, it's more important than ever for states to focus on community-prevention programs and policies that work, like smoke-free restaurants and workplaces and adequate funding to prevent kids from starting and to help smokers quit," said Risa Lavizzo-Mourey, MD, CEO of the Robert Wood Johnson Foundation.