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New Report: States Spend Less Than Two Percent of Tobacco Revenues to Fight Tobacco Use

States Missing Opportunity to Save Lives and Reduce Health Care Costs
December 06, 2012

WASHINGTON, DC — The states this year will collect a record $25.7 billion in revenue from the 1998 tobacco settlement and tobacco taxes, but will spend less than two percent of it — $459.5 million — on programs to prevent kids from smoking and help smokers quit, according to a report released today by a coalition of public health organizations. This means the states are spending less than two pennies of every dollar in tobacco revenue to fight tobacco use.

Most states are falling woefully short of funding levels for tobacco prevention and cessation programs recommended by the Centers for Disease Control and Prevention (CDC). They have also failed to reverse deep budget cuts to these programs that have set back the nation’s efforts to reduce tobacco use, which kills more than 400,000 Americans each year and is the number one cause of preventable death in the United States.

As the nation implements the health care reform law, the Affordable Care Act, the report warns that states are missing a golden opportunity to reduce tobacco-related health care costs, which total $96 billion a year in the U.S. There is growing evidence that tobacco prevention programs not only reduce smoking and save lives, but also save money by reducing health care costs. One recent study found that Washington state saved more than $5 in tobacco-related hospitalization costs for every $1 spent during the first 10 years of its program.

'Given such a strong return on investment, states are being truly penny-wise and pound-foolish in shortchanging tobacco prevention and cessation programs,' the report concludes.

Other key findings in the report include:

  • Total state funding for tobacco prevention this year (fiscal year 2013) amounts to just 12.4 percent of the $3.7 billion the CDC recommends for all the states combined. It would take less than 15 percent of their tobacco revenues to fund tobacco prevention programs at CDC-recommended levels in every state.
  • States have failed to reverse deep budget cuts that reduced funding for tobacco prevention by 36 percent, or $260.5 million, from FY 2008 to FY 2012. Funding this year is essentially flat with the $456.7 million budgeted last year.
  • Only two states — Alaska and North Dakota — currently fund tobacco prevention programs at the CDC-recommended level. Only three other states — Delaware, Wyoming and Hawaii — provide even half the CDC-recommended funding. Find out how each state ranks.

The report, titled 'Broken Promises to Our Children,' was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Cancer Action Network, American Lung Association, Robert Wood Johnson Foundation and Americans for Nonsmokers' Rights. Issued annually, the report assesses whether states have kept their promise to use their tobacco settlement funds — estimated to total $246 billion over the first 25 years — to fight tobacco use. The states also collect billions more each year from tobacco taxes.

While the nation has made enormous progress in reducing smoking, smoking declines have slowed in recent years. Nationally, 19 percent of adults and 18.1 percent of high school students still smoke.

To accelerate progress, the report calls on elected officials at all levels to aggressively implement proven strategies to reduce tobacco use:

  • In addition to increasing funding for tobacco prevention programs, the states must step up the pace in enacting tobacco tax increases and smoke-free workplace laws, which has slowed in recent years.
  • Nationally, priorities include preservation of the Prevention and Public Health Fund created by the Affordable Care Act, continuation of the highly successful national media campaign launched by the CDC earlier this year, ensuring that health insurers provide the coverage for tobacco cessation treatments required by the Affordable Care Act and effective implementation of the Food and Drug Administration’s new authority to regulate tobacco products. The prevention fund has provided grants to state and community tobacco prevention programs and supported the CDC’s campaign.

'We know how to win the fight against tobacco, but it will require strong leadership and action by elected officials at all levels,' said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. 'The states have an obligation to use more of their billions in tobacco revenues to fight the tobacco problem. Their failure to do so makes no sense given the evidence that tobacco prevention programs save lives and save money by helping reduce health care costs.'

'The combination of regular and significant increases in tobacco taxes, passage of comprehensive smoke-free laws and fully funded tobacco prevention and cessation programs is the most effective way to curb the tobacco epidemic in this country,' said John R. Seffrin, PhD, chief executive officer, American Cancer Society Cancer Action Network, the advocacy affiliate of the American Cancer Society. 'States with comprehensive tobacco control programs experience faster declines in cigarette sales, smoking prevalence and lung cancer incidence and mortality than states that do not invest in these programs.'

'The paltry amount of money that states spend on tobacco prevention and cessation programs is extremely disappointing,' said Nancy Brown, CEO of the American Heart Association. 'If the funds were used as intended to discourage children from smoking and help current smokers quit, we would see the real impact of tobacco use prevention on health care costs. The more smokers we convince to stop smoking, and the more kids we prevent from ever starting not only saves future dollars, but improves the overall health of our nation. These programs work and it’s time for states to put more skin in the game.'

'Too many states are failing their citizens by abandoning their responsibility to invest in proven programs that prevent people from smoking and help smokers quit,' said Paul G. Billings, senior vice president of Advocacy & Education at the American Lung Association. 'Supporting these programs at recommended levels is not only the right thing to do, it's the smart thing to do — quitting smoking or never starting saves lives and saves money.'

The full report and state-specific information are available here.

Additional media contacts:

Lauren Walens, American Cancer Society Cancer Action Network, 202-661-5763
Retha Sherrod, American Heart Association, 202-785-7929
Mike Townsend, American Lung Association, 202-715-3450