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Fifteen Years after Tobacco Settlement, Report Finds Most States Continue to Shortchange Prevention Programs

Effective Programs Save Lives and Health Care Dollars
December 09, 2013


WASHINGTON, DC – Fifteen years after reaching more than $246 billion in legal settlements against the tobacco industry, most states have broken their promise to spend a significant portion of the money on programs to prevent kids from smoking and help smokers quit, according to a report released today by a coalition of public health organizations.

States are being “penny-wise and pound-foolish” in shortchanging tobacco prevention and cessation program despite conclusive evidence that these programs reduce smoking, save lives and save money, the report concludes. Tobacco use is the number one cause of preventable death in the United States, killing more than 400,000 Americans and costing the nation $96 billion in health care bills each year.

Key findings of the report include:

  • Over the past 15 years, the states have received $390.8 billion in tobacco-generated revenue – $116.3 billion from the tobacco settlement and $274.5 billion from tobacco taxes. But they have spent only 2.3 percent of their tobacco money – $8.9 billion – on tobacco prevention programs.

  • This year (fiscal year 2014), the states will collect $25 billion in tobacco revenues, but will spend only 1.9 percent of it – $481.2 million – on tobacco prevention programs. While this year’s funding is a slight increase from a year ago, it fails to restore deep cuts that have reduced tobacco prevention funding by a third since 2008.

  • The states currently provide just 13 percent of the tobacco prevention funding recommended by the Centers for Disease Control and Prevention. Only two states – North Dakota and Alaska – are funding tobacco prevention programs at the CDC-recommended level. Only four other states – Delaware, Wyoming, Hawaii and Oklahoma – provide even half the recommended funding. Find out how each state ranks.

  • Tobacco companies spend more than $18 to market tobacco products for every one dollar the states spend to reduce tobacco use. According to the latest data from the Federal Trade Commission (for 2011), tobacco companies spend $8.8 billion a year – one million dollars each hour – to market cigarettes and smokeless tobacco.

The report, titled “Broken Promises to Our Children: The 1998 State Tobacco Settlement 15 Years Later,” 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.

The report details the ever-growing scientific evidence that tobacco prevention and cessation programs work. Florida, which has a well-funded, sustained program, recently reported that its high school smoking rate fell to just 8.6 percent in 2013, far below the national rate. Studies have also found that tobacco prevention programs deliver a strong return on investment. A 2011 study in the American Journal of Public Health 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.

“It is public health malpractice that the states are spending so little on tobacco prevention programs despite having so much evidence that these programs work to save lives and save money,” said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. “To win the fight against tobacco, elected officials at all levels must step up efforts to implement proven solutions, including well-funded tobacco prevention programs.”

This report comes as the nation nears the 50th anniversary of the first Surgeon General’s report on smoking and health, which was released on January 11, 1964. In recent decades, the U.S. has cut smoking rates in half, but around 18 percent of Americans still smoke and smoking declines have slowed in recent years.

To accelerate declines in tobacco use – and ultimately eliminate the death and disease it causes – the report calls for bold action by the states and the federal government:

  • The states should increase funding for tobacco prevention programs to CDC-recommended levels, raise tobacco taxes and enact comprehensive smoke-free laws.

  • At the federal level, the Food and Drug Administration must fully and effectively exercise its authority under a 2009 law to regulate the manufacturing, marketing and sale of tobacco products. The CDC should continue and expand its media campaign, called Tips from Former Smokers, that has proven highly effective at encouraging smokers to quit. The federal tobacco tax should be significantly increased, as President Obama recommended earlier this year. The Obama Administration must also aggressively implement provisions of the Affordable Care Act that require insurance coverage for smoking cessation therapies.

“It’s inexcusable that states are spending less than two cents of every dollar they receive in settlement funds and tobacco taxes on cessation programs that are proven to help people quit, and ultimately better the health of its residents,” said John R. Seffrin, PhD, chief executive officer, American Cancer Society Cancer Action Network, the advocacy affiliate of the American Cancer Society. “Evidence shows what works in tobacco control: comprehensive smoke-free laws, significant, consistent increases in tobacco taxes and fully-funded tobacco prevention and cessation programs.”

“This report is a wake-up call to state lawmakers,” said Nancy Brown, CEO of the American Heart Association. “It is simply unacceptable that such a tiny fraction of tobacco revenue is used for tobacco prevention and cessation programs. With sufficient funding, these programs save lives and money. Moving forward, the American Heart Association will continue to push for full funding of these programs in all states.'

“States have had 15 years to make meaningful investments in proven programs that prevent youth from starting to smoke and to help smokers quit but tragically, almost all have failed,” said Harold Wimmer, National President and CEO of the American Lung Association. “State policymakers must begin to fund these proven programs in order to ensure another generation’s lives are not put at risk for devastating lung and other tobacco-related diseases.”

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

Additional Contacts:

  • Lauren Walens, American Cancer Society Cancer Action Network, 202-661-5763
  • Retha Sherrod, American Heart Association, 202-785-7929
  • Gregg Tubbs, American Lung Association, 202-715-3469
  • Christine Clayton, Robert Wood Johnson Foundation, 609-627-5937