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A State-by-State Look at the
1998 Tobacco Settlement 21 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. In the midst of a youth e-cigarette epidemic, such programs are as critical as ever.

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. As the e-cigarette epidemic threatens the nation’s progress in reducing youth tobacco use, most states continue to shortchange the very programs designed to prevent kids from using tobacco products.

In the current budget year, Fiscal Year 2020, the states will collect $27.2 billion from the settlement and taxes. But they will spend just 2.7% of it – $739.7 million – on programs to prevent kids from smoking and help smokers quit.

Meanwhile, tobacco companies spend $9.1 billion a year – $1 million every hour – to market their deadly and addictive products. This means tobacco companies spend over $12 to market their products for every $1 the states spend to reduce tobacco use.

States must do more to fight tobacco use – still the nation’s No. 1 cause of preventable death and disease – to accelerate progress 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 $739.7 million the states have budgeted for tobacco prevention amounts to just 22% 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 three states – California, Alaska and Maine – 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. Another strong year from California helped bring its high school smoking rate down to a record-low 2.0%. Florida, with one of the longest-running programs, reduced its high school smoking rate to 3.6 percent in 2018.

    Along with separate policy actions, including higher tobacco taxes and comprehensive smoke-free laws, state tobacco prevention programs have helped drive down smoking rates to record lows – 13.7 percent among adults and 5.8 percent among high school students. 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. More than 34 million U.S. adults still smoke and 49 million – about 1 in 5 adults – still use some form of tobacco. 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. The latest data show that youth use of e-cigarettes has skyrocketed to over 5.3 million users, including more than one in four (27.5%) high school students now using e-cigarettes.

    On the 21st anniversary of the tobacco settlement, it is time for a renewed national commitment to finish the fight against tobacco, eliminate the death and disease it causes, and end the youth e-cigarette epidemic threatening to addict a whole new generation. With bold action, our nation can make the next generation tobacco-free.

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    Last updated Jan. 16, 2020