Commentary: For All That Tobacco Money, Don't Stint On The Smoking War

Experts say that there has never been a more effective antismoking campaign than Florida's. Over the past year, a series of commercials portraying the tobacco industry as sinister and manipulative helped cut smoking rates among middle-school students by 19%, according to the Florida Dept. of Health. Yet on Apr. 27, the Florida legislature voted to slash funding for the program nearly in half, to $41 million.

It's an ominous sign. Florida's $70 million program, funded with just a trickle of the $13 billion the state won from the tobacco industry, had raised hopes that a significant chunk of the $246 billion the tobacco companies will pay to all states over the next 25 years would go to improving public health. Yet in 16 states and the District of Columbia, politicians propose to spend less than 2% of their tobacco funds on smoking prevention and control, according to the Campaign for Tobacco-Free Kids.

REVAMP THE MORGUE? True, some states plan to spend the bulk of their money on health. Washington, which is getting $330 million over the next two years, will set aside $100 million for prevention programs. The remaining $230 million will go toward basic public health. But in many states, the windfall has set off a scramble to fund anything but tobacco-related programs. North Dakota may renovate its state morgue, while Los Angeles Mayor Richard J. Riordan wants to build new wheelchair-friendly sidewalks. New York, Louisiana, and Idaho plan to reduce state debt.

Certainly, states have a right to use tobacco money for other things. For years they had to find money in their budgets to fund tobacco-related Medicaid costs. So it's reasonable to use some of the settlement windfall for general expenses. Indeed, even the Campaign for Tobacco-Free Kids is only recommending that about 25% of the money go toward smoking prevention and control programs. Anything more would be overkill--producing diminishing returns.

Still, states would be shortsighted not to give prevention programs adequate funding. Tobacco use in the U.S. causes more than 430,000 deaths and runs up $50 billion to $73 billion in medical expenses yearly. Each day, 3,000 teenagers become smokers; one in three will eventually die of smoking-related diseases, the Center for Disease Control and Prevention says. "It's extremely frustrating to see us turn our backs on what is an immense opportunity," says Washington State Attorney General Christine O. Gregoire.

Florida's program shows that "if you run a program that's big and aggressive, it will save lives and money," says Stanton A. Glantz, professor of medicine at the University of California at San Francisco. An $18 million ad campaign showed how teenagers were being manipulated by Big Tobacco. In one ad, a 17-year-old girl phones the makers of Lucky Strikes and asks if "you could tell me what is the lucky part about Lucky Strike? Is it that I might live?"

The tobacco settlement has created a historic opportunity to fund tobacco-prevention efforts. If citizens and groups such as the American Cancer Society challenge politicians more aggressively, such efforts won't get snuffed out.