Report Finds Deep Decline in Funds for Smoking Prevention

Under fiscal duress, states are making deep reductions in programs aimed at preventing teens from smoking and at helping adults quit. This year, total funding for the programs dropped 12 percent. In the last four years, it has dropped 36 percent. That’s according to a report released November 30 by the Campaign for Tobacco-Free Kids, which annually assesses state investments in smoking prevention.

Actually, states had one of their best years ever when it came to collecting revenue from cigarette taxes and from the 1998 settlement with tobacco companies. Total collections came to $25.6 billion. But in most states, the lion’s share of that money went to fill budget gaps in other areas.

Only $457 million — 1.8 percent of the total — went to smoking prevention programs. That’s the lowest funding level since 1999, the first year states started receiving tobacco settlements, the advocacy group reported.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that states spend a combined total of $3.7 billion a year on anti-smoking programs — which would still be less than 15 percent of total state tobacco revenues. In addition to state money, the federal government offers grants to states and communities. This year, federal funding came to $91.2 million.  

Combining federal and state funds, only Alaska and North Dakota met the CDC’s recommendations. Most states invested less than one-quarter of what the federal agency says is necessary to continue reducing the number of people who smoke.

According to the report, the reductions come at a time when the overall drop off in smoking in the U.S. has slowed.  Last year, the CDC reported that nearly 20 percent of high school students and 19 percent of adults smoked, only a slight decline since 2004.

The use of tobacco creates a large indirect expense for the states. Tobacco-related health care costs in the United States total nearly $100 billion annually, and states pay a large portion of the bill. “It is truly penny-wise and pound-foolish for the states to cut funding for tobacco prevention and cessation programs,” says Nancy Brown, CEO of the American Heart Association. 

Evidence that prevention programs work comes primarily from state studies. A Washington state health department report, for example, claimed that its program had prevented 13,000 premature deaths and nearly 36,000 hospitalizations, saving about $1.5 billion. Over the last 10 years, the study found that the state saved $5 in reduced hospitalization costs for every $1 it spent on prevention.

One of the most consistently funded programs in the country until it was all but eliminated this year, Washington state’s anti-smoking program was reported to have reduced adult smoking by one-third and youth smoking by more than half since 2000.

In its recommendations, the Campaign for Tobacco-Free Kids called on states to raise tobacco taxes to fill budget gaps, rather than continue to cut funding for prevention programs. In addition, the group urged states to enact smoke-free laws that cover all work areas and public places, including restaurants and bars. So far, 29 states and the District of Columbia have such laws that include restaurants and bars.