NC 45th in nation in funding for tobacco prevention programs

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A coalition of public-health advocacy groups has taken North Carolina’s elected leaders to task again for keeping the funding spigot cut off for tobacco-prevention programs.

The coalition issued today its 15th annual national report that follows up on an initial study titled “Broken promises to our children.”

North Carolina is tied for 45th in terms of state funding being spent directly on tobacco prevention programs during fiscal year 2013-14.

By comparison, the federal Centers for Disease Control and Prevention recommends that the state dedicate $106.8 million. That means North Carolina is spending just 1.1 percent of the CDC recommendation.

The coalition estimates there are $2.46 billion in annual smoking-related health-care costs in North Carolina.

“It is public health malpractice that the states are spending so little on tobacco prevention programs despite having so much evidence that these programs work to save lives and save money,” Matthew Myers, president of the Campaign for Tobacco-Free Kids, said in a statement.

The CDC said Nov. 14 that youth smoking rates fell to another historic low during 2012. Smoking levels dropped from 15.8 percent in 2011 to 14 percent in 2012 among high-school students, and from 4.3 percent to 3.5 percent among middle-school students.

Myers has called North Carolina “one of the most disappointing states” because of the elimination of state funding for programs such as QuitLineNC.

Tobacco companies, including R.J. Reynolds Tobacco Co., agreed in 1998 to settle lawsuits that 46 state attorneys general brought over smoking-related health-care costs by paying those states about $206 billion over more than 20 years.

However, most states, including North Carolina, do not spend money from the Master Settlement Agreement directly on tobacco-prevention or health-care costs. Economists say they are not surprised by the limited spending since most states have become dependent on MSA money and tobacco excise taxes to fill gaps in their budgets.

Tobacco manufacturers, in opposing higher tobacco-excise taxes supported by anti-tobacco advocates, say the states should use more of the MSA money for the initial intended purposes.

In 2011, the N.C. General Assembly chose to abolish the N.C. Health and Wellness Fund after 10 years of existence, as part of an attempt at resolving the state’s budget gap. That meant the fund’s $32.9 million annual MSA allocation goes to the N.C. Department of Health and Human Services.

DHHS officials could not be reached for comment on how much the agency is spending on tobacco-prevention programs in fiscal 2013-14 from its MSA allocation.

In June, legislators approved redirecting allocations to the Golden Leaf Foundation to the state’s General Fund for the 2013-15 state budgets. The General Fund will receive $136 million from the MSA payments during that time.

Peter Hamm, a spokesman for the Campaign for Tobacco-Free Kids, said there tends to be broad Republican and independent support on spending MSA funds on tobacco-prevention programs “because it’s distasteful to many people that so little goes to the tobacco health costs that the settlement was supposedly about.”

“But all state governments love unrestricted dollars and like to keep them that way.”

The coalition said that since the MSA was enacted, participating states have spent just 2.3 percent of their tobacco-generated revenues on tobacco prevention and cessation programs, or basically 2 cents for every dollar.

For fiscal 2013-14, the states will collect $25 billion in tobacco revenues, but spend 1.9 percent of it – $481.2 million – on tobacco prevention programs.

Only six states are spending at least 50 percent of the CDC recommendation in fiscal 2013-14, none in the Southeast. New Jersey is the only state that spends nothing on the programs, according to the coalition.

Since 2000, the percentage of high-school students who smoke has dropped from 28 percent to 14 percent. The percentage of middle-school students smoking has gone from 11 percent to 3.5 percent.

By comparison, after decades of decline, the adult smoking rate has stalled at about 20 percent in recent years.

Besides the Campaign for Tobacco-Free Kids, coalition members are American Heart Association, Cancer Action Network, American Lung Association, the Robert Wood Johnson Foundation, and Americans for Nonsmokers’ Rights.

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