Frustration abounds over tobacco settlement spending

Only four states meet CDC standards for dedicating significant amounts of settlement funds to smoking prevention and cessation programs.

By Susan J. Landers, AMNews staff. Feb. 17, 2003.

Washington -- When it comes to discouraging words about what's become of anti-smoking dollars provided by the landmark 1998 tobacco settlement agreement, few could beat those of Cheryl G. Healton, DrPH, president and CEO of the American Legacy Foundation.

"History will view [the settlement] as a golden opportunity for public health that fell flat on its face," she said, pointing to what she views as minuscule contributions from most states in terms of funding for anti-smoking measures.

Addressing a National Health Policy Conference in Washington, D.C., last month, Dr. Healton bolstered her remarks with specifics about state allocations from the settlement for anti-smoking efforts.

Making the biggest effort this year is Maine, which allocated $12.7 million of its $15.2 million fiscal year 2003 settlement payment to smoking prevention efforts.

Maine is one of just four states that meet the minimum recommendations made by the Centers for Disease Control and Prevention. That number may soon drop to three as the governor of Maryland has proposed diverting half the state's current allocation to other uses.

Growing state budget woes are causing more and more legislatures to take this step, shifting their share of the $206 billion master settlement agreement to other needs. For example, Massachusetts' budget problems have resulted in its plunge from the No. 1 spot last year to No. 38 this year.

"The tragedy of the master settlement agreement was that there were no strings attached to the use of the money by the states," said Dr. Healton.