Lots more to do in fight against deadly tobacco epidemic

AMA Leader Commentary. By J. Edward Hill, MD, March 20, 2006.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from the president of the American Medical Association, J. Edward Hill, MD.

What kills more Americans, every year than alcohol, AIDS, car crashes, illegal drugs, murders and suicides combined? The answer, as always, is smoking.

As a physician deeply committed to public health, and as president of an organization that has made tobacco control one of its top priorities, I am appalled by this statistic -- and saddened that I have to keep trotting it out year after year.

What's most maddening is that there are dozens of effective, proven programs for preventing tobacco use and helping motivated smokers to quit. What's more, we, as a nation, have the funds to support these programs. All we lack is the political will -- and the good sense -- to use those funds appropriately.

A little more than seven years ago, every state received millions upon millions of dollars from the settlement of a multistate lawsuit against the tobacco industry. In return, the medical and public health community were led to believe that the states would use those funds to combat tobacco use at every level.

Anti-tobacco activists hoped that these dollars could save some of the 400,000 American lives lost annually to tobacco addiction. They also hoped to reduce the direct and indirect costs of tobacco use, which in 2005 added up to $182 billion.

Today, states are collecting record amounts of tobacco-generated revenue from the tobacco settlement and from higher tobacco taxes. Yet these dollars are not, in most cases, going to tobacco education, cessation and prevention programs. Instead, this money has been used to fill state budget gaps or to fund various pet projects, including, in the AMA's home state of Illinois, a new parking lot at a state facility.

Thirty-seven states and the District of Columbia fund tobacco prevention at less than half the Center for Disease Control and Prevention's recommended minimum. Four states -- Michigan, Missouri, South Carolina and Tennessee -- have committed no tobacco settlement or tobacco tax dollars to ending the epidemic.