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Report Shows Most States Falling Short in Using Tobacco Settlement Funds for Tobacco Prevention

State Budget Shortfalls Threaten Already Meager Tobacco Prevention Funding Despite Conclusive Evidence that Programs Reduce Smoking, Save Lives and Save Money
January 15, 2002

Washington, DC — Three years after reaching $246 billion in legal settlements with the tobacco industry, most states are failing to keep their promise to use a significant portion of their settlement proceeds to fund tobacco prevention programs, and even the meager amounts allocated for prevention are at risk as state legislatures convene to address budget shortfalls, according to a report released today by a coalition of public health organizations.

January 2002 Report Materials

Executive Summary (21K .pdf)

Complete Report (750k .pdf)

Table: Rankings of States by Level of Funding for Tobacco Prevention (19K .pdf)

Table: Status of State Decisions on Spending Tobacco Settlement Money (12K .pdf)

Appendix A: History of State Settlement Spending for Tobacco Prevention (30K .pdf)

Appendix B: Settlement Payments Received, Current Annual State Funding and Minimum Recommendation for Tobacco Prevention (18K .pdf)

State Summaries

Use the dropdown to see state-specific settlement information:

The report, entitled 'Show Us the Money: An Update on the States' Allocation of the Tobacco Settlement Dollars,' was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society and American Lung Association.

'Even in these difficult budget times, tobacco prevention is one of the smartest and most fiscally responsible investments that governors and state legislators across the country can make,' the report concludes, calling efforts to cut tobacco prevention 'penny-wise and pound-foolish.' The report points out that California and Massachusetts, with the most established tobacco prevention programs, are saving as much as $3 in smoking-caused health care costs for every dollar spent on tobacco prevention.

'We have conclusive evidence that tobacco prevention works. States that have implemented such programs have dramatically cut smoking among both children and adults, reduced the incidence of lung cancer and heart disease, and saved millions of dollars in health care costs,' said William V. Corr, Executive Vice President of the Campaign for Tobacco-Free Kids. 'All of these benefits will be lost if the states do not live up to their promise to fund tobacco prevention programs.'

The report found that only five states – Arizona, Maine, Massachusetts, Mississippi and Minnesota — currently fund tobacco prevention programs at the minimum levels recommended by the U.S. Centers for Disease Control and Prevention (CDC) and the majority of states fund tobacco prevention at less than half the CDC minimum. Public health groups have advocated that states allocate settlement funds for tobacco prevention according to CDC guidelines (approximately 20 to 25 percent of each state's settlement funds).

Despite the small amounts committed to tobacco prevention, some states are using settlement funds, including funds previously committed to tobacco prevention, to balance their budgets, according to the report.

Florida, for example, cut funding for its highly successful program by 20 percent in December despite reducing smoking by 47 percent among middle school students and 30 percent among high school students in just three years. In Tennessee, the Legislature voted to use all the state's settlement money received to date to balance the budget for just one year. Other states, including Montana, Wisconsin, Ohio and Arizona, have also cut allocations they had previously committed to tobacco prevention.

'It is bad enough that so few states have kept their promise to use their tobacco settlement dollars to address the terrible toll of tobacco,' said M. Cass Wheeler, CEO of the American Heart Association. 'It would be even more tragic for states to reduce this commitment just as we are beginning to make progress in reducing smoking and the deadly diseases, including cardiovascular disease, that it causes.'

The report details the powerful evidence from the few states with comprehensive tobacco prevention programs that these programs work to reduce smoking, save lives and reduce smoking-caused health care costs.

In addition to Florida's results, Maine has cut smoking by 36 percent among high school students in three years; Oregon has cut smoking rates among eleventh graders by 41 percent since 1996; and Mississippi has cut smoking by 25 percent among public high school students since starting its program in 1999. Recent studies show that California, which started the nation's oldest tobacco prevention program in 1989, has saved tens of thousands of lives by reducing smoking-caused birth complications, heart disease, strokes and lung cancer.

The report also describes the growing evidence that cutting funding for tobacco prevention programs can quickly stall or reverse their progress. California's progress in reducing smoking rates stopped for a period in the mid-1990s after funding for tobacco prevention was cut and resumed after funding was partially restored. Florida's most recent results indicate that cuts to its program are already reducing its effectiveness among middle school students.

'The states should not squander this opportunity. Comprehensive tobacco prevention programs are an excellent investment,' said John L. Kirkwood, CEO of the American Lung Association. 'With a modest commitment, the entire nation can replicate the dramatic reduction in youth smoking that comprehensive programs deliver.'

'Tobacco prevention programs are a vaccine that can protect our kids from tobacco addiction, disease and death. Now that this vaccine has been proven to work, we have an obligation to provide it every year to every child in every state,' said John R. Seffrin, PhD, CEO of the American Cancer Society.

Specific results from the report show:

  • Only five states are funding tobacco prevention programs at the minimum levels recommended by the CDC.

  • Only 19 states (including the five above) have committed even 50 percent of the minimum funding level recommended by the CDC.

  • Sixteen states have committed between 25 and 50 percent of the minimum amount recommended by the CDC.

  • Twelve states have committed less than 25 percent of the minimum amount recommended by the CDC.

  • Three states – Michigan, North Carolina and Tennessee – and the District of Columbia have committed none of their settlement money or other major funding source, such as a tobacco tax, to tobacco prevention.

Tobacco use is the leading cause of preventable death in the United States, killing more than 400,000 Americans every year. The annual cost of treating tobacco-related disease exceeds $89 billion. About 90 percent of current smokers took up the habit at or before age 18. Every day, 5,000 kids try their first cigarette. Another 2,000 kids become regular, daily smokers, one-third of whom will die prematurely as a result.

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