Coalition of health groups charge states with not properly funding smoking-cessation programs

WASHINGTON — Fifteen years after reaching more than $246 billion in legal settlements against the tobacco industry, most states have fallen short of spending a significant portion of the money on programs to prevent kids from smoking and help smokers quit, according to a report released Monday by a coalition of public health organizations.

The report, titled "Broken Promises to Our Children: The 1998 State Tobacco Settlement 15 Years Later," was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Cancer Action Network, American Lung Association, Robert Wood Johnson Foundation and Americans for Nonsmokers' Rights.

According to the report, over the past 15 years states have received $390.8 billion in tobacco-generated revenue - $116.3 billion from the tobacco settlement and $274.5 billion from tobacco taxes. But they have spent only 2.3% of their tobacco money - $8.9 billion - on tobacco prevention programs. This year (fiscal year 2014), the states will collect $25 billion in tobacco revenues, but will spend only 1.9% of it, or $481.2 million, on tobacco prevention programs. While this year's funding is a slight increase from a year ago, it fails to restore deep cuts that have reduced tobacco prevention funding by a third since 2008, the report noted.

The states currently provide just 13% of the tobacco prevention funding recommended by the Centers for Disease Control and Prevention. Only two states — North Dakota and Alaska — are funding tobacco prevention programs at the CDC-recommended level. Only four other states — Delaware, Wyoming, Hawaii and Oklahoma — provide even half the recommended funding. 

The report details scientific evidence that tobacco prevention and cessation programs work. Florida, which has a well-funded, sustained program, recently reported that its high school smoking rate fell to just 8.6% in 2013, far below the national rate. Studies have also found that tobacco prevention programs deliver a strong return on investment. A 2011 study in the American Journal of Public Health found that Washington state saved more than $5 in tobacco-related hospitalization costs for every $1 spent during the first 10 years of its program.

"It is public health malpractice that the states are spending so little on tobacco prevention programs despite having so much evidence that these programs work to save lives and save money," Matthew Myers, president of the Campaign for Tobacco-Free Kids said. "To win the fight against tobacco, elected officials at all levels must step up efforts to implement proven solutions, including well-funded tobacco prevention programs."

"This report is a wake-up call to state lawmakers," Nancy Brown, CEO of the American Heart Association said. "It is simply unacceptable that such a tiny fraction of tobacco revenue is used for tobacco prevention and cessation programs. With sufficient funding, these programs save lives and money. Moving forward, the American Heart Association will continue to push for full funding of these programs in all states."

The full report and state-specific information are available at


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