FreeRepublic , LLC
PO BOX 9771
FRESNO, CA 93794
Posted on 10/03/2002 11:56:39 AM PDT by Tumbleweed_Connection
Antismoking activists once had high hopes that the landmark $246 billion tobacco settlement would have a major impact on smoking, but a new study from Yale shows that almost none of the money spent so far has been used for prevention and cessation programs.
Approximately $32 billion has been paid out since the settlement was reached in 1998, with much of the money being used to pay the bills in a growing number of states with budget shortfalls.
"This was a once-in-a-lifetime opportunity for governors and state legislators to address the leading cause of preventable death in the United States," says Bill Core, executive vice president for Campaign for Tobacco-Free Kids. "I think it is fair to say that even prior to the economic downturn most states were not even close to living up to the promises that were made."
Payments from the settlement are being made over 25 years, but 15 states already have sold the rights to some or all future payments in an effort to balance current budgets.
The CDC recommends that states spend from $5 to $15 per person -- or roughly 20% of the settlement money -- on tobacco control programs. But the Yale University researchers found that most states aren't even spending half that amount. Only Maine, Mississippi, Hawaii, Massachusetts, Arizona, and Indiana spent more than the CDC recommendations on tobacco programs last year.
By comparing state tobacco control program expenditures with settlement payments for 2001, lead author Cary Gross, MD, and colleagues conclude that less than 6% of the settlement funds were directed to tobacco programs. The findings are published in the latest issue of The New England Journal of Medicine.
According to Core, only about 4% of the settlement monies paid out for fiscal year 2002 will be spent on tobacco prevention and cessation programs, compared with a high of 9% in 1999.
"Even at the high end, that was only about half of what the CDC has recommended," he tells WebMD.
Though the average state received approximately $28 per person from the settlement in 2001, only about $3.50 per person was spent on tobacco control programs. The states with the most smokers tended to spend less on smoking programs than those with the fewest smokers. And four of the six states that grow 90% of the nation's tobacco -- North Carolina, South Carolina, Tennessee, and Kentucky -- spent almost none of the settlement money on smoking programs.
"What this means is that the states with the most smokers will continue to have the most smokers in the future, and the ones with lower smoking rates investing this money in smoking programs will see greater and greater savings from health benefits," says Gross.
Gross points to California and Massachusetts as states that have had effective smoking control programs for more than a decade. Significant health benefits are already being seen in those two states as a result. California's lung cancer rate decreased by 15% over the first 10 years of its program, compared with a 4% reduction nationwide. The authors note that the effectiveness of these programs is directly related to the funding received. When funding levels in California decreased in the early 1990s, the effectiveness also decreased.
"I think state legislators should be made to account for how they are spending this money," Gross tells WebMD. "We know from past experience that when states do put money into tobacco control programs they see a substantial decrease in smoking-related expenditures."
Core agrees but adds that even though tobacco settlement money is not being used to fund smoking programs, state legislatures seem more willing than they once did to impose new taxes on cigarettes. Lawmakers in 20 states raised tobacco taxes this year to deal with budget shortfalls. Raising cigarette prices, he says, has proven to be one of the best ways to get people to stop smoking.
"If you look at previous recessions, tobacco taxes were not considered an answer to budget problems, but the thinking has shifted," Core tells WebMD. "Legislators now realize that cigarette taxes are a good way to raise revenues and improve people's health at the same time."
In other words, states had to shift resources from other areas of the budget, or else raise taxes, in order to pay for tobacco-related illness.
Given that this funding effectively made up for cuts in other programs and tax hikes, there is no case that the tobacco settlement money *must* be spent on smoking prevention or health care or so forth.
If anything, the 20-year payout should be refunded to each state's tax payers through a reduction in each state's tax rates.
Instead of just posting a comment about the sky being blue or the earth being round, might I just refer you to this bit of D.O.T. brilliance.
/i>
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.