Health & Medicine

Health gets 30% of tobacco settlement

In 2006, Alaska desperately needed cash to complete a museum featuring a mummified bison and other natural wonders of the frozen north. So the state dipped into its share of the landmark 1998 tobacco settlement.

The billions that began flowing from cigarette makers to the states a decade ago also helped outfit the golf course for New York's Niagara County with new carts and sprinklers.

And the money has gone toward college scholarships in Michigan; tax breaks in Illinois and Ohio; a dogcatcher in Lincoln, Neb.; and jails and schools elsewhere.

Despite the promises of politicians and policy-makers, states and counties have spent the lion's share of the settlement money on things that have nothing to do with public health or smoking. Teen smoking rates have stopped dropping.

Of the $61.5 billion divided among 46 states between 2000 and 2006, only 30 percent was spent on health care, according to federal Government Accountability Office data analyzed by The Associated Press. Less than 4 percent went to anti-smoking efforts.

That number roughly matches the guidelines set up for the use of the money by the Kentucky General Assembly in 2000. Because of Kentucky's dependence on tobacco agriculture, half of the state's thus far $209 million share of the settlement was targeted for agriculture initiatives. The other half was to be split between health care and early childhood initiatives. About $39 million was targeted for health care in the 2000 legislative session.

"A lot of people on both sides thought we were going to enter a new Eden, and we haven't," said Thomas Glynn, director of cancer science and trends at the American Cancer Society.

States defend the myriad ways they have spent their tobacco money, which is still being paid out in annual installments and over 25 years is expected to total $294 billion in today's dollars. They note that no strings were attached to the settlement reached Nov. 23, 1998.

States had sued the industry to recover the crushing costs of treating smoking-related illnesses in people in public health programs such as Medicare and Medicaid. Big Tobacco also agreed to eliminate advertising aimed at teenagers. In return, it won protection from future lawsuits.

"We should use this money to fund cancer research, offer health insurance to the poor, keep kids from smoking and arrest those who sell tobacco products to our children," said Mike Fisher, who was Pennsylvania's attorney general.

But even then, lawmakers and others were eyeing the money for other needs.

Gregory Connolly, director of Massachusetts' Tobacco Control Program from 1993 to 2003, said the failure to funnel more of the money into anti-smoking campaigns was a retreat from implicit promises made at the time of settlement.

"Every state court case had that built into it, that we're here for the kids," said Connolly, now a professor at the Harvard School of Public Health. "But the legislatures said, 'This is our money. Thanks for suing, but we're going to decide how to spend the money.'"

A University of Kentucky study released Thursday concluded the settlement has produced 1,300 jobs and created some 500 new animal and crop-based products in Kentucky. New markets ranged from naturally cured hams to glue made out of low-quality wheat. The report largely praises the way Kentucky has spent its share of the settlement.

This fiscal year, states are expected to spend about $718 million on preventing tobacco use, the Campaign for Tobacco-Free Kids estimates — well below the $3.7 billion recommended by the government's Centers for Disease Control and Prevention.

The tobacco industry spent $13.1 billion in 2005 on advertising and marketing, according to the Federal Trade Commission's most recent figures.

According to the CDC, the percentage of U.S. high school students who said they smoked cigarettes grew from 27 percent in 1991 to more than 36 percent in 1997.

The figure fell to about 22 percent in 2003 but has remained essentially static since then. Use of other tobacco products is on the rise.

The drop in smoking has been attributed to higher cigarette taxes, tougher workplace and restaurant smoking bans, and anti-smoking campaigns.

"The total number of Americans who die every year from tobacco is continuing to grow in part because of the failure of the states to spend a reasonable amount of the funds they received on tobacco prevention," said Matthew Myers, president of Tobacco-Free Kids.