November 13, 2018
Funding Quit-Smoking Programs
Be Well

Funding Quit-Smoking Programs

by Keng Lam, MD

I‘m a strong advocate of smoking cessation programs because they bring numerous health benefits and cost savings. But recently, I discovered how very little states spend on tobacco prevention and cessation services.

In December 2013, an alliance of advocacy groups, including the Robert Wood Johnson Foundation, the Campaign for Tobacco-Free Kids and the American Lung Association, released its 15th annual report on how well—or more accurately, how inadequately—states are funding smoking prevention and cessation.

The current report notes that states typically spend less than two cents of every dollar in tobacco revenue on services related to tobacco. Out of $25 billion that will be collected from the tobacco industry throughout 2014, the nation's states will spend less than $482 million on programs for smoking prevention and cessation. Compare that to the $12.1 billion this nation spent in 2010 on lung cancer care alone.

Furthermore, only two states (North Dakota and Alaska) fund tobacco prevention programs at the level recommended by the Centers for Disease Control and Prevention (CDC). In fact, about half of the states in the U.S. actually spend less than 10 percent of the amount the CDC recommends for tobacco prevention (each state has a different recommended funding level).

The paltry spending is not due to a lack of monies from tobacco taxes and tobacco-related court settlements. Thanks to a 1998 settlement, the tobacco industry must pay the nation's states a hefty sum in perpetuity to help cover tobacco-related healthcare costs.

So where exactly does the money go? There is no easy answer to that question. Some states use the revenues for education and others for Medicaid (but not specifically for tobacco-related health problems). In other words, money that could be used on tobacco prevention has ended up funding unrelated items.

Of course, Medicaid and education are important. But, they are not what tobacco revenues are for. Public health officials advocated for higher taxes on the tobacco industry, and the general public supported that, because it was understood that this money would go toward helping people quit smoking or preventing young people from picking up the unhealthy habit.

We were deceived.