States Fall Short On Tobacco Prevention Efforts

States are making little progress this year on anti-smoking prevention programs, say researchers from the American Lung Association. Though there are a few bright spots in Maine and Mississippi, in other parts of the country, lawmakers have backed measures that cap civil suits against the tobacco industry. Numerous states are also opting to use tobacco settlement money to help fill in budget deficits during tight economic times.

Anti-smoking advocates were up in arms this week when news broke that the U.S. Justice Department was mulling a settlement to the federal lawsuit against the tobacco industry instead of charging on to court. "Given the millions of dollars [that the GOP] has received in tobacco campaign contributions... there is every reason to believe that the Bush Administration is more concerned about the health of the tobacco industry than the health of the American public," says Matt Myers of the Campaign for Tobacco-Free Kids.

There's even more bad news for tobacco prevention and education at the state level these days, says the American Lung Association. A report released June 7 by the group finds that with legislatures adjourned in half the states, legislators are making very little progress in protecting the public from the dangers of tobacco use.

Among the group's major findings:

  • Oklahoma and West Virginia enacted laws that put a limit on civil suit damages. Five other states--Florida, Georgia, Kentucky, North Carolina and Virginia--passed similar measures last year.
  • South Dakota joined a growing list of states--Alabama, Alaska, Arkansas and South Carolina--that are selling future settlement revenues in exchange for a lump sum payment up-front known as securitization.
  • Idaho okayed a bill that significantly reduces penalties to retailers for selling tobacco products to minors.
  • Only two states, Maine and Mississippi, have allocated even the minimum amount of funding recommended by the U.S. Centers for Disease Control and Prevention (CDC) to curb tobacco use.

"There hasn't been much of a change from other analyses, which is bad news. It was bad news last year and we're seeing the same in 2001. One difference is that more states are securitizing tobacco settlement money and taking a lump sum payment up front," says the association's Cassandra Welch.

Securitization, which is encouraged by some investment firms and bond sellers, means that states sell expected tobacco payments to a company that then issues bonds to cover the deal. Anti-smoking advocates say that cutting a deal like this brings a state less money overall, a point that is perhaps being overlooked during lean budget times.

"It's irresistible to some legislators to get a [single] payment now because of course a lot of states are grappling with budget deficits. Wisconsin is considering securitization right now for its entire pot of settlement money. It's [part of] a continuing trend that shows how states are failing to live up to what's needed for tobacco prevention and education programs. It's a public health travesty," says Welch.

Ironically, tobacco industry officials back the association's charge that states are coming up short on the pledge to stop smoking addiction. "We would agree that more needs to be done. Certainly states have difficult decisions to make, but in the Master Settlement Agreement, it's stated several times that the reason the settlement is being signed is to discourage youth smoking. We applaud the efforts in states where lawmakers are addressing the issue and hope more states will do that in the future," says Tom Ryan, media affairs manager at tobacco giant Philip Morris .

Health officials might look to Maine as an example of how to forge ahead on the issue. Along with setting out CDC-recommended amounts of money to spread the word on the dangers of tobacco use, lawmakers upped the cigarette tax three years ago and have just approved a bill to raise the cigarette tax again by six more cents, reports the Portland Press Herald.

The state has pumped the new tax money into prevention programs that include expansive ad campaigns, linked up school systems with health facilities to spread the anti-smoking message and enlisted doctors to get people to stop smoking by paying additional money through the Medicaid program for follow up counseling. Lawmakers also passed a ban on smoking in restaurants two years ago.

Maine modeled its programs on similar projects in California and Massachusetts, two states that are often cited as leaders in tobacco prevention efforts.

While Maine Department of Human Services Commissioner Kevin Concannon is proud of his state's accomplishments to date, he expresses chagrin over the lung association's report. "It's very disappointing. I've been in some of the states where the bulk of the tobacco settlement money is going to highways or school construction and it's tragic. The tobacco settlement was a one-time bonanza and to not focus on anti-smoking efforts is very irresponsible and unfortunate," he says.

Concannon also says focusing on anti-tobacco programs is all the more important during tight budget times. "There's not a state in the country that doesn't worry about Medicaid expenditures. We've learned that putting a tourniquet on like [using] HMOs [to cut costs] won't do much. What can make a difference in fighting rising health care costs is attacking preventable illnesses. Even if you're not a public health advocate and you're an accountant with a green lamp shade in your office, you should be concerned about smoking," says Concannon.

Tags: Health