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State Tobacco Settlement Funds Not Being Spent on Vigorous Tobacco Control Efforts

State Tobacco Settlement Funds Not Being Spent on Vigorous Tobacco Control Efforts

Each year, tobacco use kills nearly 500,000 Americans
(430,000 smokers and 53,000 from secondhand smoke)[1]—more than the combined
annual number of national deaths from the acquired immunodeficiency syndrome,
alcohol, automobile accidents, murders, suicides, and fires. The annual cost of
treating tobacco-related diseases is about $89 billion.[2]

Recent reports by the Institute of Medicine and the Centers for Disease
Control and Prevention (CDC) concluded that the best available evidence from
states such as California, Massachusetts, and Florida indicate that large-scale
aggressive state tobacco control programs can rapidly reduce cigarette
consumption.[3,4] In California, the reduction in smoking was accompanied by
substantial reductions in lung cancer rates and deaths from heart disease.[5,6]

If states made a significant and comprehensive effort to fund aggressive
anti-tobacco media campaigns, community programs to encourage nonsmoking, quality
cessation programs, and school programs (as the CDC recently recommended
regarding best practices for state tobacco control),[7] tobacco use could be
reduced by nearly 50% in 1 decade.[2]

By 1998, all states had enough funds (billions of dollars) from legal
settlements with the tobacco industry to conduct such a national effort.
Nevertheless, the states have spent very little on tobacco control programs.
This failure to establish such programs is consistent with the tobacco industry’s
long-standing strategy of seeing that the money that might be used for tobacco
control is used for anything else. Thus, reductions in preventable
tobacco-related illnesses and deaths have been minimal.

With vigorous political organizing efforts in all states, progress can be
made in reversing the dismal current record on tobacco control funding. The
basis for this reversal lies in understanding the historical, legal, and
political framework of how the tobacco settlements occurred, how the settlement
funds have been allocated, and what might be done to organize in response to
these political and legal realities.

State Tobacco Lawsuits and Settlements

In 1994, Mississippi, Florida, Texas, and Minnesota were the first states to
file lawsuits to recover Medicaid costs expended in treating sick and dying
smokers on behalf of the taxpayers (who had traditionally borne these costs).
These lawsuits were filed under new legal theories (and sometimes specific
enabling legislation) that focused on class action suits on behalf of large
numbers of smokers and statistical evidence rather than on the traditional
approach of individual wrongful death cases.

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