Key Findings

• Key Findings: National Tobacco Control Policy
• Key Findings: State Tobacco Control Policy
• Tobacco Prevention and Control Spending 
• Smokefree Air
• Cigarette Taxes
• Youth Access
• Key Findings: Conclusion

State Tobacco Control Policy

The state report looks at four areas: Tobacco Prevention and Control Funding, Smokefree Air, Cigarette Taxes and Youth Access. Below are the key findings by program area.

Tobacco Prevention and Control Funding

Seven years have passed since the Master Settlement Agreement (MSA) was signed in 1998. The MSA’s success in reducing smoking and smoking-related diseases is evident in the few states that have dedicated a portion of MSA funding to tobacco prevention programs. In 2005, six states—Arkansas, Colorado, Delaware, Maine, Mississippi and Wyoming—honored the commitment to use a significant amount of the funding to prevent tobacco use and addiction.ⁱ Unfortunately, a majority of states have chosen to direct funding away from life-saving tobacco prevention programs.

Tobacco Prevention Programs Work

The evidence that well-funded, sustained and comprehensive tobacco prevention and cessation programs are effective was bolstered in 2005. Studies indicate that thousands of illnesses and deaths from tobacco use could be prevented and billions of dollars in medical expenses could be saved if all states made long-term investments in a sustained campaign to prevent tobacco- related disease and death. A study published in the American Journal of Public Health concluded that if states spend just the minimum amount recommended by the CDC, youth smoking nationally would be 3 to 14 percent lower.⁵ The study also predicts that states such as Massachusetts and Minnesota, both of which have drastically cut their programs, will experience a significant increase in teen smoking as a result of the budget cuts.⁶

The tobacco industry spent 25 times more marketing cigarettes than states did to prevent smoking and help smokers quit in 2003.

Tobacco prevention programs in California, New York, Maine, Mississippi, Ohio and Washington have been credited with significantly reducing smoking rates. In Mississippi, since it began funding its program in 1999, smoking among public high school students is down 32 percent and down 48 percent among public middle school students.⁷

Another study on the effectiveness of tobacco prevention programs was published in the Journal of Health Economics. The study found that cigarette sales dropped more than twice as much in states with comprehensive tobacco control programs than in the United States as a whole. Between 1990 and 2000, sales fell an average of 43 percent in four states with large investments—Arizona, California, Massachusetts and Oregon—compared with only a 20 percent drop for all other states. Further, the study concluded that the impact grows as programs continue to dedicate resources to curbing tobacco use and programs become more efficient and “make better and better use of each additional dollar” over time.⁸

Tobacco counter-marketing campaigns have been found to decrease youth smoking. The American Legacy Foundation’s national youth smoking prevention truth® campaign marked its fifth anniversary with impressive results. The campaign was found to be responsible for 22 percent of the overall decline in youth smoking between 2000 and 2002. A report in the March issue of the American Journal of Public Health found that there were approximately 300,000 fewer young smokers as a result of the truth® campaign.⁹ State-sponsored counter-marketing campaigns have also been shown to reduce youth smoking by changing youth attitudes and beliefs regarding tobacco use.¹⁰ Despite the success of these campaigns, they are among the first to be cut by state legislators. In Minnesota, annual funding for tobacco control programs was severely reduced, resulting in the elimination of the successful Target Market^TM, a media campaign aimed at young people. As a result, the percentage of adolescents susceptible to cigarette smoking increased from 43 percent to 53 percent in less than six months.¹¹

Cuts in tobacco prevention program funding have also made it easier for youth to obtain tobacco products. Data released by the decimated Tobacco Free Massachusetts program indicate that communities that have experienced a dramatic reduction in tobacco control funding have seen an average increase of 74 percent in illegal sales of cigarettes to minors. Data from communities that have completely lost their programs show an even higher increase.¹²

2005 Highlights

Legislators in Arkansas, Colorado, Delaware, Maine, Mississippi, and Wyoming were able to see the fiscal wisdom of maintaining at least 90 percent of the CDC’s minimum recommended funding level for tobacco control programs. Rather than face worsening budget shortfalls in the future with no programs left to raid, these states will see their health-related costs gradually drop as prevention and cessation programs reduce the prevalence of smoking and tobacco-related disease. In fact, Maine has been successful in reducing high school smoking rates by 59 percent between 1997 and 2005.13 Tobacco control programs translate into healthier citizens and reduced health care costs down the road. Unfortunately, 36 states, the District of Columbia, and Puerto Rico received an F for program funding.

The evidence that tobacco prevention programs save lives and money is apparent; what is lacking is the political will. The American Lung Association State of Tobacco Control 2005 report challenges failing states to stop turning a blind eye to the health and economic costs of tobacco use and addiction and join other states in making a commitment to tobacco prevention programs.

i Significant funding represents 90 percent or more of the minimum recommendation by the Centers for Disease Control and Prevention.

Key Findings Continued...