I read with interest the commentary by Drs. Michael S. Givel
and Stanton A. Glantz, regarding state-level disbursement of monies generated by
the Master Settlement Agreement with Big Tobacco, which appeared in the February
2002 issue of ONCOLOGY. Unfortunately, the authors omitted the key challenge
facing antitobacco activists. Although they accurately depicted underfunding of
tobacco control programs (~5% of total annual allocated payments)far lower
than levels recommended by the Centers for Disease Control and Prevention
(~25%)they failed to analyze the deceptive nature of how the remaining
funds are being categorized.
Immediately following announcement of the Master Settlement
Agreement, I cowrote a commentary for the Philadelphia Inquirer, addressing
these deficiencies and predicting precisely what would transpire. Big Tobacco
bought immunity from a major category of liability lawsuits. And Big Tobacco
bought off the state governments, purposefully failing to mandate that their
"blood money" be directed at fighting the cause of the litigation,
Certain states, including Pennsylvania, heralded plans to
ensure that these monies were escrowed and spent solely on health-related
pursuits. Yet, it was unclear whether such appropriations were supplementing
funds that would otherwise not have been made, or whether they were supplanting
dollars that would then be redirected to other budgetary items.
Unfortunately, no state is mandated to support tobacco
control, cancer control, public health, or even overall health care. My suit
failed to accomplish thisdespite an appeal to the US Supreme Courtbecause
the courts refused to grant me standing, despite the fact that I had also filed
an action that proved I met the legal standard ("a case or controversy ripe
for adjudication at this time"). As a result, there was never an
opportunity to modify the contents of the Master Settlement Agreement.
The implications are profound. No private citizen can attempt
to enforce the provisions of the Master Settlement Agreement when Big Tobacco
violates it, as it already has (repeatedly). And no taxpayer can sue when this
money is diverted to other pursuits (including road construction) that the
legislature favors. Our inability to obtain any stipulation from the parties
(considering how the Attorney General "ran interference" for Big
Tobacco) remains the medical legacy of this ongoing payoff.
1. Givel MS, Glantz SA: State tobacco settlement funds not
being spent on vigorous tobacco control efforts. Oncology 16:152-157, 2002.
2. Centers for Disease Control and Prevention: Best Practices
for Comprehensive Tobacco Control ProgramsAugust 1999. Atlanta, US Department
of Health and Human Services, August 1999.
3. Godshall WT, Sklaroff R, Barg J: Tobacco settlement leaves
far too much unsettled. Philadelphia Inquirer. December 1, 1998.
4. Sklaroff R: Petition to Intervene by Robert B. Sklaroff,
MD, William T. Godshall, Jeffrey Barg and Smoke-Free Pennsylvania. Filed
November 18, 1998. In re: Commonwealth of Pennsylvania by D. Michael Fisher, in
His Official Capacity as Attorney General of the Commonwealth of Pennsylvania,
Plaintiff, v Philip Morris, Inc; R. J. Reynolds Tobacco Company; Brown &
Williamson Tobacco Corporation; B.A.T. Industries, plc; the American Tobacco
Company, Inc c/o Brown & Williamson Tobacco Corporation; Lorillard Tobacco
Company; Liggett Group, Inc; United States Tobacco Company; the Tobacco
Institute, Inc; the Council for Tobacco Research-USA, Inc; Smokeless Tobacco
Council, Inc; and Hill and Knowlton, Inc, Defendants. Court of Common Pleas,
Philadelphia County, Pennsylvania. Case No 97-2443, April Term, 1997.