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New Report: States Shortchange Tobacco Prevention Programs That Can Stop 7 Million Kids from Smoking, Save Over 2 Million Lives

States Challenged to Follow Florida’s Example in Cutting Youth Smoking to Record Lows
December 11, 2014

WASHINGTON, DC — The states are missing an opportunity to save millions of lives and over $120 billion in health care costs because they continue to shortchange proven programs that prevent kids from smoking and help smokers quit, according to a report released today by a coalition of public health organizations.

This year (fiscal year 2015), the states will collect $25.6 billion from the 1998 tobacco settlement and tobacco taxes. But they will spend less than two percent of it — $490.4 million — on tobacco prevention and cessation programs, according to the annual report assessing state funding of such programs.

This year's report challenges the states to do more by shining the spotlight on Florida, which has cut high school smoking to just 7.5 percent — one of the lowest rates recorded by any state. Among its efforts to reduce tobacco use, Florida has a long-running and well-funded tobacco prevention program.

The report details the lives and health care dollars each state, and the nation as a whole, could save by reducing youth smoking to Florida's low rate. If the national high school smoking rate declined from the current 15.7 percent to 7.5 percent, the report finds it would:

  • Prevent 7 million kids from becoming adult smokers
  • Save 2.3 million kids from premature, smoking-caused deaths
  • Save $122 billion in future, tobacco-related health care costs.

Tobacco use is the No. 1 cause of preventable death in the United States, killing 480,000 Americans each year. A new Centers for Disease Control and Prevention (CDC) study released Wednesday showed that smoking costs the nation about $170 billion in annual health care spending, which is more than previously estimated. Without strong action now, 5.6 million kids alive today will die prematurely from smoking-caused disease, according to the U.S. Surgeon General.

Today's report, titled 'Broken Promises to Our Children: A State-by-State Look at the 1998 Tobacco Settlement 16 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.

'Most states are literally sacrificing the health of their children and costing taxpayers billions by refusing to properly fund tobacco prevention efforts and ignoring the mountain of evidence that these programs save lives and money,' said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. 'Florida's remarkable progress shows we can create a tobacco-free generation — but only if elected leaders wake up and aggressively implement proven solutions. That's why we’re issuing this 'Florida Challenge' to spur every state to increase funding for tobacco prevention programs, a crucial step toward our tobacco-free vision.'

Other key findings of the report include:

  • The $490.4 million the states have budgeted for tobacco prevention amounts to just 14.8 percent of the $3.3 billion recommended by the CDC. It would take less than 13 percent of total state tobacco revenues to meet the CDC’s recommendations in every state.
  • Only two states — Alaska and North Dakota — are funding tobacco prevention programs at the CDC-recommended level when both state and federal funds are included. Only five other states — Delaware, Hawaii, Maine, Oklahoma and Wyoming — provide even half the recommended funding. New Jersey, which ranks last, is the only state that has allocated no state funds for tobacco prevention programs. Find out how each state ranks.
  • Tobacco companies spend $18 to market tobacco products for every $1 the states spend to reduce tobacco use.
  • States have slightly increased tobacco prevention funding from the $481.2 allocated last year. But current funding is still down nearly a third from the $717.2 million spent in fiscal 2008.

Studies have found that tobacco prevention and cessation 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.

This year's report comes as the U.S. marked the 50th anniversary of the first Surgeon General's report on smoking and health and as a new Surgeon General's report, issued in January, called for bold action to accelerate progress and ultimately eliminate the death and disease caused by tobacco use. These recommendations include 'fully funding comprehensive statewide tobacco control programs at CDC-recommended levels.'

Other recommendations of the Surgeon General include:

  • Conducting national media campaigns such as the CDC’s Tips from Former Smokers campaign and the FDA's youth prevention campaigns 'at a high frequency level and exposure for 12 months a year for a decade or more.'
  • Increasing cigarette taxes to prevent kids from smoking and encourage smokers to quit.
  • Fulfilling the Affordable Care Act's requirement that health plans provide coverage for proven tobacco cessation treatments, including counseling and medication.
  • Effectively implementing the FDA's authority over tobacco products 'in order to reduce tobacco product addictiveness and harmfulness.'
  • Enacting comprehensive smoke-free laws that protect all Americans from secondhand smoke. Currently, 24 states, Washington, DC, and hundreds of cities have such laws, protecting nearly half the U.S. population.

'Meager funding levels threaten the viability of state tobacco control programs that help people quit, reduce tobacco use and promote public health,' said John R. Seffrin, PhD, chief executive officer of the American Cancer Society Cancer Action Network, the advocacy affiliate of the American Cancer Society. 'If we're going to protect vulnerable people from the unscrupulous tactics of the tobacco industry, lawmakers across the country must prioritize fully funding tobacco cessation and prevention programs, in addition to passing comprehensive smoke-free laws and significantly increasing tobacco taxes.'

'It's disgraceful that states don’t use some portion of the billions of dollars they receive from tobacco for prevention programs. There is simply no excuse for this inaction year after year,' said Nancy Brown, CEO of the American Heart Association. 'Florida has shown the way by setting an example that other states should follow. The American Heart Association calls on all state lawmakers to invest in these proven programs that will save lives and money.'

'States are still not funding these vital, proven programs at the levels needed to truly prevent youth from starting to smoke and to help smokers quit,' said Harold Wimmer, National President and CEO of the American Lung Association. 'State policymakers must spend more of their tobacco-related revenue on prevention and cessation programs if we are to eliminate tobacco-caused death and disease, including lung cancer and COPD.'

'Secondhand smoke exposure remains a top preventable cause of chronic disease, early death, and health care costs in the United States. Smoke-free laws save lives and support a healthier workforce across a region,' said Cynthia Hallett, MPH, Executive Director of Americans for Nonsmokers' Rights. 'Despite some progress, many states still fail to ensure smoke-free air in workplaces — due in part to campaign contributions and other tobacco industry interference tactics. Everyone deserves the right to breathe smoke-free air inside workplaces and public places — including the casino and hospitality sector workforce. Smoking sections, smoking rooms and ventilation systems do not address the serious health hazards of secondhand smoke.'

The full report and state-specific information are available at: