A State-by-State Look at the
1998 Tobacco Settlement 20 Years Later

Despite receiving over $27 billion from the tobacco settlement and tobacco taxes, the states continue to severely underfund tobacco prevention and cessation programs proven to save lives and money.

Since the states settled their lawsuits against the major tobacco companies in 1998, our annual reports have assessed whether the states are keeping their promise to use a significant portion of their settlement funds – estimated at $246 billion over the first 25 years – to attack the enormous public health problems caused by tobacco use in the United States.

Despite receiving huge sums from the settlement and collecting billions more in tobacco taxes, the states continue to shortchange tobacco prevention and cessation programs that are proven to save lives and reduce health care costs.

In the current budget year, Fiscal Year 2019, the states will collect $27.3 billion from the settlement and taxes. But they will spend just 2.4 percent of it – $655 million – on programs to prevent kids from smoking and help smokers quit.

Meanwhile, tobacco companies spend $9.5 billion a year – $1 million every hour – to market their deadly and addictive products. This means tobacco companies spend $14 to market their products for every $1 the states spend to reduce tobacco use.

Our report challenges states to do more to fight tobacco use – still the nation’s No. 1 cause of preventable death and disease – to accelerate progress, address large disparities in who still smokes, and confront the growing epidemic of youth e-cigarette use in America.

This report is issued by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Cancer Action Network, American Lung Association, Robert Wood Johnson Foundation, Americans for Nonsmokers’ Rights and Truth Initiative.

Map: State Funding for Tobacco Prevention

Click on each state to view the full data. Follow this link for information on the District of Columbia.

Other key findings include:

  • The $655 million the states have budgeted for tobacco prevention amounts to less than 20 percent of the $3.3 billion the Centers for Disease Control and Prevention (CDC) recommends for all states combined. Not a single state currently funds tobacco prevention programs at the level recommended by the CDC.
  • Only two states – California and Alaska – provide even 70 percent of the recommended CDC funding. Twenty-eight states and the District of Columbia are spending less than 20 percent of what the CDC recommends.
  • States with well-funded, sustained tobacco prevention programs continue to report significant progress. Florida, with one of the longest-running programs, reduced its high school smoking rate to 3.6 percent in 2018, one of the lowest ever reported by any state.

Along with separate policy actions, including higher tobacco taxes and comprehensive smoke-free laws, the settlement has helped drive down smoking rates to record lows – 14 percent among adults and 7.6 percent among high school students in 2017. But tobacco use still kills more than 480,000 Americans and costs the nation about $170 billion in health care expenses each year.

Our progress shows that the battle against tobacco is entirely winnable if proven strategies are fully implemented. But enormous challenges remain. The latest data show that 34.3 million U.S. adults still smoke and 47 million – about 1 in 5 adults – still use some form of tobacco. There are large disparities in who still smokes and who suffers from tobacco-related disease, with especially high smoking rates among people with lower income and less education and other specific populations. In addition, the youth e-cigarette epidemic, driven by the skyrocketing popularity of Juul, is an urgent challenge that must be addressed to prevent yet another generation from becoming addicted to nicotine.

On the 20th anniversary of the tobacco settlement, it is time for a renewed national commitment to finish the fight against tobacco and eliminate the death and disease it causes. With bold action, our nation can finally end this entirely preventable epidemic and make the next generation tobacco-free.

Infographics

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Last updated December 13, 2018