Funding for State Tobacco Prevention Programs at Lowest Level Since Tobacco Settlement

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According to a report recently released by a coalition of public health organizations, states in the U.S. have decreased funding for programs to reduce tobacco use to the lowest level since 1999, when they first received tobacco settlement funds [1].

The coalition includes organizations such as the Campaign for Tobacco-Free Kids, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association and Robert Wood Johnson Foundation. Since the November 1998 multi-state tobacco settlement, these organizations have issued annual reports assessing whether states are keeping their promise to use a significant portion of their settlement funds to address the enormous public health problems posed by tobacco use in the United States.

Map of state funding for tobacco prevention


In addition to the billions of dollars received by states every year from the tobacco settlement, billions more are collected in tobacco taxes. In fiscal year 2011, states will collect a total of $25.3 billion from the two sources. Despite the huge sums of money being collected, however, states have cut funding for tobacco prevention and cessation programs to the lowest level since 1999. Indeed, states are spending only 2% of their tobacco revenue on programs to prevent kids from smoking and to help smokers quit. Moreover, states have cut funding for such programs by 9% ($51.4 million) in the past year and by 28% ($199.3 million) in the past three years.

Most states are falling far short of the Centers for Disease Control (CDC)-recommend funding levels for tobacco prevention programs. The $517.9 million the states have budgeted amounts to just 14% of the $3.7 billion the CDC recommends for all the states combined. Counting both state funds and federal grants, only two states — Alaska and North Dakota — currently fund tobacco prevention programs at the recommended levels. Only five states — Hawaii, Montana, Wyoming, Delaware and Maine — provide even half the recommended funding. Thirty-three states and Washington DC provide less than 25%, and three states — Nevada, New Hampshire and Ohio — provide zero state funds for tobacco prevention this year. The complete Fiscal Year 2011 rankings of funding for state tobacco prevention programs is shown below.

Where does your state rank?

Rank State FY2011 Current Annual Funding ($millions) CDC Annual Recommendation ($millions) FY2011 Percent of CDC’s Recommendation
1 Alaska* $9.8 $10.7 92.0%
2 North Dakota* $8.2 $9.3 88.1%
3 Hawaii $9.3 $15.2 61.1%
4 Montana $8.4 $13.9 60.4%
5 Wyoming $5.4 $9.0 60.0%
6 Delaware $8.3 $13.9 59.5%
7 Maine $9.9 $18.5 53.5%
8 Oklahoma $21.7 $45.0 48.2%
9 Vermont $4.5 $10.4 43.4%
10 Minnesota $19.6 $58.4 33.6%
11 Arkansas $11.8 $36.4 32.4%
12 South Dakota $3.5 $11.3 31.0%
13 Utah $7.1 $23.6 30.2%
14 New Mexico $7.0 $23.4 29.8%
15 Florida $61.6 $210.9 29.2%
16 Arizona $19.8 $68.1 29.1%
17 Mississippi $9.9 $39.2 25.3%
18 New York $58.4 $254.3 23.0%
19 West Virginia $5.7 $27.8 20.4%
20 Iowa $7.3 $36.7 20.0%
21 Washington $13.4 $67.3 19.8%
22 North Carolina $18.3 $106.8 17.1%
23 California $75.0 $441.9 17.0%
24 Louisiana $9.0 $53.5 16.9%
25 Oregon $7.1 $43.0 16.6%
26 Nebraska $2.9 $21.5 13.3%
27 Colorado $7.0 $54.4 12.9%
28 Indiana $9.2 $78.8 11.7%
29 Wisconsin $6.9 $64.3 10.7%
30 Pennsylvania $14.7 $155.5 9.5%
31 Virginia $9.4 $103.2 9.1%
32 Idaho $1.5 $16.9 8.9%
33 South Carolina $5.0 $62.2 8.0%
34 Maryland $4.3 $63.3 6.9%
35 Illinois $9.5 $157.0 6.1%
36 District of Columbia $0.569 $10.5 5.4%
37 Massachusetts $4.5 $90.0 5.0%
38 Rhode Island $0.735 $15.2 4.8%
39 Kentucky $2.6 $57.2 4.5%
40 Texas $11.4 $266.3 4.3%
41 Kansas $1.0 $32.1 3.1%
42 Michigan $2.6 $121.2 2.1%
43 Georgia $2.0 $116.5 1.8%
44 Alabama $0.86 $56.7 1.5%
45 Connecticut $0.4 $43.9 0.9%
46 New Jersey $0.6 $119.8 0.5%
47 Tennessee $0.222 $71.7 0.3%
48 Missouri $0.06 $73.2 0.1%
51 Nevada $0 $32.5 0.0%
51 New Hampshire $0 $19.2 0.0%
51 Ohio $0 $145.0 0.0%

* Alaska and North Dakota currently fund tobacco prevention programs at the CDC-recommended levels if both state and federal funding is counted.

According to the latest data from the Federal Trade Commission, tobacco companies spend $12.8 billion a year on marketing; that equates to $25 tobacco companies spend to market tobacco products for every $1 the states spend to fight tobacco use. Perhaps not surprisingly, a recent CDC study reports that the number of adult smokers dropped between 2000 and 2005, but the adult smoking rate has stalled at 20-21% since 2005 [2].

Tobacco use is the number one cause of preventable death in the United States. It claims more than 400,000 lives every year, more than AIDS, alcohol, car accidents, murders, suicides, illegal drugs and fires combined [3-4]. Every day, 1,000 kids become regular new smokers and another 1,200 Americans die from tobacco use. Given the magnitude of the problem, states’ funding of tobacco prevention and cessation programs is woefully inadequate.

According to the report, the current budget crisis should not be an excuse for states to reduce funding for tobacco prevention programs. Every scientific authority that has studied the issue, including the Institute of Medicine (IOM), the President’s Cancer Panel, the National Cancer Institute, the CDC and the U.S. Surgeon General, has concluded that the programs not only reduce smoking and save lives, but also save money by reducing tobacco-related healthcare costs. The report maintains that [1]:

Even in these difficult budget times, tobacco prevention is one of the smartest and most fiscally responsible investments that states can make.

The report warns that continued progress against tobacco use is at risk unless states increase funding for tobacco prevention and cessation programs. It also calls on states to increase tobacco taxes and, for states that have yet to do so, to enact strong smoke-free laws that apply to all workplaces, restaurants and bars. The report further calls on the federal government to robustly fund and implement the new tobacco control strategy announced earlier this month by the U.S. Department of Health and Human Services [5].

References

  1. A Broken Promise to Our Children: The 1998 State Tobacco Settlement 12 Years Later. The Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Cancer Action Network, American Lung Association and Robert Wood Johnson Foundation. 2010 Nov 17.
  2. Centers for Disease Control and Prevention (CDC). Vital signs: current cigarette smoking among adults aged >or=18 years — United States, 2009. MMWR Morb Mortal Wkly Rep. 2010 Sep 10;59(35):1135-40.
    View abstract
  3. Centers for Disease Control and Prevention (CDC). Smoking-attributable mortality, years of potential life lost, and productivity losses–United States, 2000-2004. MMWR Morb Mortal Wkly Rep. 2008 Nov 14;57(45):1226-8.
    View abstract
  4. Minino et al. Deaths: final data for 2004. Natl Vital Stat Rep. 2007 Aug 21;55(19):1-119.
    View abstract
  5. HHS announces new tobacco strategy and proposed new warnings and graphics for cigarette packs and advertisements. U.S. Department of Health and Human Services. 2010 Nov 10.
About the Author

Walter Jessen is a senior writer for Highlight HEALTH Media.