U.S. State and Local Issues:… | Campaign for Tobacco-Free Kids
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Reducing Smoking, Saving Lives, Saving Money

Comprehensive, well-funded state programs that prevent kids from smoking and help smokers quit are proven to save lives and money.

The U.S. Centers for Disease Control and Prevention (CDC) has established Best Practices that recommend key elements of tobacco prevention and cessation programs and how much each state should spend on them.

Key elements include:

  • Coordinated state and community interventions aimed at preventing youth and young adults from starting to use tobacco, promoting quitting among current tobacco users and eliminating exposure to secondhand smoke;
  • Mass media campaigns and other public education efforts;
  • Cessation interventions that encourage and help tobacco users to quit; and
  • Surveillance and evaluation activities to ensure the program is having the desired impact.

The evidence is clear: The more states spend on these programs, and the longer they do so, the greater the impact.

Most States Falling Short

Unfortunately, most states are failing to properly fund these proven effective programs — and have slashed funding in recent years — despite collecting nearly $27 billion a year in tobacco revenue from the 1998 state tobacco settlement and tobacco taxes.

The Campaign for Tobacco-Free Kids and our public health partners issue an annual report assessing whether the states are adequately funding tobacco prevention and cessation programs, as many states promised to do at the time of the tobacco settlement. Our latest report (issued Jan. 15, 2021) gave most states a failing grade:

  • The states this year (Fiscal Year 2021) will collect $26.9 billion from the tobacco settlement and tobacco taxes, but are spending only 2.4 percent of it — $656 million — on tobacco prevention and cessation programs. This means the states are spending less than three cents of every dollar in tobacco revenue to fight tobacco use.
  • Not a single state currently funds tobacco prevention programs at CDC-recommended levels.

Tobacco Prevention Programs Work

The states lack excuses for failing to do more given their huge sums of tobacco revenue and the extensive evidence that tobacco prevention programs are highly effective:

  • Tobacco prevention programs reduce smoking. States with sustained, well-funded prevention programs have cut youth smoking rates in half or even more. Florida has reported that its high school smoking rate fell to just 3.6 percent in 2018, one of the lowest ever reported by any state.
  • Tobacco prevention programs save lives. California, with the nation’s longest-running prevention and cessation programs, has reduced lung and bronchus cancer rates twice as fast as the rest of the U.S. Washington state estimates that its smoking reductions have prevented 13,000 premature deaths.
  • Tobacco prevention programs save money. A 2011 study 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.

Given such a strong return on investment, states are being penny-wise and pound-foolish in shortchanging tobacco prevention and cessation programs. To continue reducing smoking, states must increase funding for tobacco prevention and cessation programs.

Last updated Jan. 27, 2021