Tobacco use prevention severely underfunded despite settlement boon, say advocates

Of $2.3 billion tobacco settlement, Kansas has spent just $10.5 million on anti-smoking efforts

0 | Tobacco

Anti-smoking advocates used today’s 15th anniversary of a multi-billion dollar settlement reached by 46 states and the nation’s major tobacco companies to urge Kansas policymakers to increase spending on programs that help people quit or avoid the smoking habit.

Between 1999 and 2013, Kansas collected more than $2.3 billion from the settlement and tobacco taxes. It spent $10.5 million on tobacco control programs.

“Out of that $2.3 billion, Kansas has invested less than one-half of 1 percent in tobacco prevention,” said Jeff Willett, vice president of programs for the Kansas Health Foundation and a former director of the New York State Tobacco Control Program.

The foundation is the largest funder of Kansas Health Institute, the parent organization of the KHI News Service.

“The fact is that tobacco use is the leading preventable cause of death in Kansas,” Willett said, noting that it also is responsible for more than $1 billion in “unnecessary health care costs” to the state, about $200 million of which are borne by the state’s Medicaid program – KanCare.

In the current budget year, the state is expected to spend $946,671 on tobacco prevention programs, well short of the $32.1 million recommended by the Centers for Disease Control and Prevention. That ranks Kansas 41st among the states in tobacco prevention spending, according to a report released by a coalition of anti-smoking groups.

“Kansas spends virtually nothing on tobacco prevention and cessation,” said Danny McGoldrick, vice president of research for the national Campaign for Tobacco Free Kids.

Paula Clayton, director of the Bureau of Health Promotion at the Kansas Department of Health and Environment, declined to say whether she thought the state’s current investment in tobacco prevention programs was sufficient. Instead, she said the agency and the local programs it helps to fund would continue to get the most from the dollars spent.

“We’re always looking for ways to be more effective with what we have,” Clayton said, noting that the agency closely monitors tobacco use and has made progress in reducing smoking among adults and adolescents.

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Courtesy Kansas Health Foundation

Jeffrey Willett

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But Willett said the state hasn’t made enough progress. The overall smoking rate among adults was 21 percent when the Master Settlement Agreement was signed; it’s 19 percent today. And, he said, the rate has either increased or remained the same among low-income Kansans and those with less education.

“I think there is this perception that more progress has been made than actually has been made,” Willett said. “In the 15 years since the Master Settlement Agreement there has been a very modest reduction in adult smoking. And there has been absolutely no progress made in reducing smoking for low-income Kansans.”

The smoking rate among Kansas who make between $15,000 and $25,000 a year increased to 27.6 percent from 25.6 percent between 1999 and 2012, according to KDHE data. The rate among Kansans who make less than $15,000 hasn’t budged, remaining at 31.6 percent.

Since 1999, most of the settlement money received by Kansas has been used to pay for a wide range of health, education and social programs for children.

It is time to re-visit that decision, McGoldrick said.

“That’s not to say that some of the settlement dollars aren’t being spent on worthy issues, obviously we have a lot of things we need to address,” he said. “But these suits (against the tobacco companies) were brought about to address the tobacco problem. And again, it would just take a portion of those funds to fund tobacco prevention at the level recommended by the CDC.”

If Kansas were to follow the CDC recommendation, it would need to spend $32.1 million of the $55 million it expects to receive this year in settlement funds on tobacco control programs.

It also could raise its tobacco tax, McGoldrick said. The current tax of 79 cents a pack is well under the national average of $1.53. Roughly doubling the current tax — in addition to generating just under $100 million a year — would generate enough to spend the amount recommended by the CDC recommended on tobacco prevention without shortchanging the children’s programs that depend on the settlement revenue.

Even so, the call for higher tobacco taxes isn’t likely to get serious attention in the Legislature, which is controlled by conservative Republicans who have approved large tax cuts in each of the last two years. Many have signed pledges to oppose any tax increases.



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