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New Study Finds California's Tobacco Control Program Has Saved Billions in Medical Costs, Shows Why States Should Increase Funding for Such Programs

Statement of William V. Corr, Executive Director, Campaign for Tobacco-Free Kids
August 26, 2008

Washington, D.C. — A new scientific study being published this week finds that California's state tobacco control program saved $86 billion (in 2004 dollars) in personal health care costs in its first 15 years and provides important new evidence for states to increase spending on tobacco prevention and cessation programs. This study demonstrates powerfully that state tobacco prevention and cessation programs are smart, cost-effective investments that not only improve health and save lives, but also save money by dramatically reducing health care costs for government, businesses and families. It should spur states to significantly increase funding for tobacco prevention and cessation programs with the $25 billion in revenue they collect each year from the tobacco settlement and tobacco taxes.

The new study was conducted by researchers at the University of California, San Francisco, and published in the August 25, 2008, online issue of the peer-reviewed medical journal PLoS Medicine (published by the Public Library of Science, or PLoS). Between 1989, when the state-funded California Tobacco Control Program began, and 2004, when the study ended, the program saved $86 billion in personal health care costs, while the state spent $1.8 billion on the program, for a 50-to-1 return on investment, according to the study. The program prevented 3.6 billion packs of cigarettes from being smoked during this period, the researchers found.

These dramatic cost savings came even as funding for California's tobacco control program was reduced substantially in the mid-1990s. If funding had remained consistent with the program's early years, California's total health care cost savings could have reached $156 billion, according to the researchers. The researchers attribute the savings to declines in tobacco-related diseases in California, especially heart disease, cancer and lung diseases, that have far exceeded national declines.

The California study adds to the already overwhelming evidence from scientific studies and states' results that tobacco prevention and cessation programs work to reduce smoking among both youth and adults, save lives and save money. Just last week, the National Cancer Institute issued a comprehensive, 684-page report, titled The Role of the Media in Promoting and Reducing Tobacco Use, that concluded that mass media campaigns are effective at reducing tobacco use, especially when combined with school and community programs. The NCI report found that such programs can change youth attitudes about tobacco use, prevent youth from starting to smoke and encourage adult cessation.

This overwhelming evidence that state tobacco prevention and cessation programs work and deliver so many health and financial benefits leaves elected leaders with no excuse for failing to fund such programs in every state at levels recommended by the U.S. Centers for Disease Control and Prevention. Despite the success of these cost-effective programs, too often they have been among the first targets for budget cuts whenever states have faced budget deficits, as they do now. This new study shows why states should increase funding for tobacco prevention programs and why cutting funding for them is penny-wise and pound-foolish. The decision to properly fund these programs should be an easy one:

  • The problem is huge and warrants urgent action. Tobacco use is the leading preventable cause of death in the United States, resulting in 400,000 premature deaths and costing the nation nearly $100 billion in health care bills each year. These expenditures include $65 billion under state and federal health care programs such as Medicaid, amounting to hidden tax of $575 on every American household.
  • We know the solution works. Comprehensive, well-funded state tobacco prevention and cessation programs are highly effective, especially when combined with higher tobacco taxes and smoke-free workplace laws.
  • States have the revenue. The states will collect about $25 billion this year in revenue from the tobacco settlement and tobacco taxes. It would take just 15 percent of this revenue for each state to fund a tobacco prevention and cessation program at the CDC's recommended levels. Right now, the states are spending less than 3 percent.
  • The public supports it. Poll after poll shows that Americans strongly believe tobacco settlement and tax dollars should be spent on tobacco prevention.

Despite the overwhelming evidence that state tobacco prevention and cessation programs are highly effective when they are funded appropriately, only three states currently fund these programs at even the minimum level recommended by the CDC. This is part of the reason that declines in both youth and adult smoking in the United States have stalled in recent years. With the tobacco companies spending more $13.4 billion per year marketing their deadly products, it is imperative that state leaders act now to fund programs that we know work to prevent kids from smoking and help smokers quit.