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New CDC Study Finds Full Funding for Tobacco Prevention Would Double Smoking Declines

Statement of William V. Corr Executive Director, Campaign for Tobacco-Free Kids
September 26, 2003

Washington, D.C. — A landmark new study shows that if all states had funded tobacco prevention and cessation programs at levels recommended by the Centers for Disease Control and Prevention (CDC), cigarette sales would have declined at twice the rate they did between 1994 and 2000. This groundbreaking work, conducted by the CDC and other researchers and published in the September 2003 Journal of Health Economics, provides some of the most powerful and irrefutable evidence to date of the effectiveness of comprehensive tobacco prevention programs. Using sophisticated statistical methods to control for other possible explanations for smoking declines, the new study demonstrates more clearly than ever that tobacco prevention works.

The study finds that states with the best funded and most sustained tobacco prevention programs during the 1990s – Arizona, California, Massachusetts and Oregon – reduced cigarette sales more than twice as much as the country as a whole (43 percent compared to 20 percent). Opponents of tobacco prevention spending have argued that such declines are caused by other factors such as cigarette price increases. However, this new study, the first to compare cigarette sales data from all the states and to isolate the impact of tobacco control program expenditures from other factors that affect cigarette sales, demonstrates a dose-response relationship between spending on tobacco prevention and declines in smoking. In essence, the more states spend on tobacco prevention, the greater the reductions in smoking, and the longer states invest in such programs, the larger the impact. The study concludes that cigarette sales would have declined by 18 percent instead of nine percent between 1994 and 2000 had all states fully funded tobacco prevention programs.

The bad news, however, is that few states have kept their promise to use proceeds from the 1998 state tobacco settlement to adequately fund tobacco prevention and cessation programs, and many states, including those with the most successful programs, have cut or eliminated funding for their programs over the past two years. The failure of most states to properly fund tobacco prevention is tragic and inexcusable in light of the overwhelming scientific evidence that these programs work and the fact that, despite their current budget woes, states are collecting more revenue from the tobacco settlement and tobacco taxes than ever before. Unless they reverse course and use more of their tobacco money to adequately fund tobacco prevention, state officials will miss a once-in-a-lifetime opportunity to address the nation's leading preventable cause of death.

The study adds to the already significant body of evidence that tobacco prevention programs work when they are comprehensive, well-funded and sustained over time. Scientific studies and results from the states that have implemented such programs show that they dramatically reduce smoking among both youth and adults, save lives and save money by reducing smoking-caused health care costs. States with such programs have reduced youth smoking by anywhere from 36 percent to 47 percent, depending on the age group, in just a few short years. Studies show California, which started the nation's oldest tobacco prevention program in 1990, has saved tens of thousands of lives by reducing smoking-caused birth complications, heart disease, strokes and lung cancer. Studies also show that California and Massachusetts have saved up to three dollars in health care costs for every dollar spent on tobacco prevention. (For more information on state program successes, please see the Campaign's fact sheet at

Unfortunately, only two states – Maine and Mississippi – currently fund tobacco prevention programs at the minimum levels recommended by the CDC, down from a high of five states at the start of 2002, and only 10 more states are funding tobacco prevention at even half the CDC's minimum level, down from 19 states at the start of 2002. In the past two years, some of the most successful state tobacco prevention programs have been decimated by budget cuts. Funding for Massachusetts' program was cut by 95 percent from $48 million to just $2.5 million, while funding for California's program was cut by more than a third and funding for Oregon's program was cut by 76 percent. Arizona's program faced deep cuts as well until voters increased the state cigarette tax and restored much of the money, indicating how strongly the public supports tobacco prevention. Promising new programs have also been cut deeply, including those in Florida, Indiana, Maryland, Minnesota and New Jersey.

The 50 states and the District of Columbia will receive more than $19 billion in tobacco settlement and tobacco tax revenues in Fiscal Year 2004. It would take less than 10 percent of these total revenues for every state in the country to fund a comprehensive tobacco prevention and cessation program at levels recommended by the CDC. Such programs include public education, advertising to counter tobacco industry marketing, community and school-based programs, helping smokers quit, and strictly enforcing laws that establish smoke-free areas and restrict youth access to tobacco products.

Tobacco use kills more than 400,000 people in the U.S. ever year, and more than 8.6 million people in the U.S. are living with at least one serious illness caused by tobacco use, according to the CDC. Tobacco use costs our nation more than $75 billion a year in health care costs. Nearly 90 percent of smokers start as teens or younger. Every day, another 2,000 kids become regular, daily smokers, one-third of whom will die prematurely as a result. The new study shows we know how to reduce tobacco's terrible toll. What's missing is the political will to do so.


The new study was conducted by researchers at the CDC, the Research Triangle Institute in North Carolina, and the University of Illinois at Chicago. For a copy of the article, 'The Impact of Tobacco Control Program Expenditures on Aggregate Cigarette Sales: 1981-2000,' email or call CDC, Office on Smoking and Health, at 770-488-5493. The CDC press release can be found at