Anti-smoking efforts nationwide remain woefully underfunded as states squander most of their tobacco tax revenue, a major report from a coalition of public health groups shows.
For fiscal 2013, states will receive nearly $26 billion through a combination of cigarette taxes and revenue from their landmark 1998 legal settlement with U.S. tobacco companies. Only $459 million will go to smoking prevention campaigns and other initiatives to help addicts quit, with some states — such as New Jersey, Ohio, New Hampshire and North Carolina — spending nothing on the efforts, according to the joint study by the Campaign for Tobacco-Free Kids, the American Heart Association, the American Cancer Society Cancer Action Network and other organizations.
"The paltry amount of money that states spend on tobacco prevention and cessation programs is extremely disappointing," said Nancy Brown, CEO of the American Heart Association. "If the funds were used as intended to discourage children from smoking and help current smokers quit, we would see the real impact of tobacco use prevention on health care costs. These programs work and it's time for states to put more skin in the game."
The report comes as the federal government, led by the Centers for Disease Control and Prevention, ramps up its efforts to snuff out tobacco use. The CDC this year launched its first major media campaign, spending $54 million on the "Tips From Former Smokers" television commercials. The spots depict smokers explaining in graphic detail how they suffer on a daily basis as a result of their addiction to cigarettes.
President Obama's health care reform law also contributed to the effort by providing additional money to states for anti-smoking campaigns, and it's possible new tax revenue from a "fiscal cliff" deal between the White House and congressional Republicans also could lead to more funding.
The Food and Drug Administration has intensified its approach of discouraging potential smokers through warning labels on tobacco products. The proposed labels include pictures of diseased lungs, rotting teeth and gums, and other disturbing images.
But the FDA's proposals have been blocked in court amid First Amendment concerns. A U.S. Court of Appeals on Wednesday declined to hear the case after a lower court ruled that tobacco companies do not have to use the labels.
The federal government may appeal to the Supreme Court.
Anti-tobacco activists believe federal intervention is both a blessing and a curse. Grants for smoking cessation and other programs clearly help, they argue, but they also let states off the hook and allow lawmakers to feel justified in using tobacco tax revenue for other means while the federal government picks up the slack.
"We see it going both ways. Members of Congress point to states and states point to members of Congress" to fund the initiatives, said Cathy Callaway, associate director of state and local campaigns at the American Cancer Society. "We've found it's most effective when these programs are funded at both the state and federal level."
The federal government also provides states with a recommended spending level, detailing how much tobacco revenue should be dedicated to help smokers kick the habit.
Only one state, Alaska, exceeds that recommendation. Alaska will collect $103 million from taxes and the 1998 tobacco settlement, and $10.9 million of that will go to anti-smoking programs. The federal government recommended the state spend $10.7 million on those efforts, though there are no laws at the state or federal levels requiring that a certain amount be spent.
Virginia, Maryland and the District fall far short of the federal goals, as do the vast majority of states. Virginia will pull in $336 million in tobacco revenue this fiscal year, with only $8.4 million earmarked to help smokers quit. The federal government recommends the state spend more than $100 million.
Maryland and the District will collect $590 million and $76 million, respectively, but will spend only $4.2 million and $495,000, the study shows.
"The states have an obligation to use more of their billions in tobacco revenues to fight the tobacco problem. Their failure to do so makes no sense given the evidence that tobacco prevention programs save lives and save money by helping reduce health care costs," said Matthew L. Myers, president of the Tobacco-Free Kids initiative.
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