Massachusetts stamping out anti-tobacco funding

State leaders have gutted funding for anti-tobacco initiatives more than 90 percent in the last 10 years, leading to fewer spot checks of retail stores for cigarette sales to minors, cuts to programs that help smokers quit and diminished prevention campaigns.
In fiscal 2001, state programs to combat smoking were flush with cigarette tax revenue and funding from a 1998 multi-state settlement with the tobacco industry, with a budget of $50.5 million, according to the Mass. Budget and Policy Center.
Today, funding for anti-tobacco initiatives has plunged to $4.1 million, with the new state budget dealing the programs another cut of $335,000 from fiscal 2011.
Anti-smoking advocates say the cuts make little long-term financial sense given the toll that tobacco takes on state health care costs.
“Every dollar we spend on prevention is a few dollars saved on the treatment side,” said Tom Carbone, president of the Massachusetts Health Officers Association, which represents local health departments.
Some tobacco opponents support legislation sponsored by state Rep. Jonathan Hecht, D-Watertown, and Sen. Harriet Chandler, D-Worcester, that would guarantee a portion of state tobacco revenue be set aside for smoking cessation and prevention programs.
“Less than one half of 1 percent really gets spent on doing something about tobacco,” said Steve Shestakofsky, executive director of Framingham-based Tobacco Free Mass. “That, I think, really needs to be changed.”
State health officials said they have made progress lowering Massachusetts’ smoking rate since beginning anti-smoking programs in the early 1990s and have maintained their core initiatives.
But they acknowledged recent cuts have forced them to eliminate or scale back efforts they believe to be beneficial.
“I think we’re losing an opportunity,” said Lois Keithly, director of the state Department of Public Health’s tobacco control program.
Despite the cuts, Keithly said her staff has worked to preserve “key infrastructure,” including the smokers’ helpline, youth programs and working with health care professionals to ensure they identify tobacco users and refer them for help.
Federal sources have helped fill some gaps, largely helping to maintain the helpline, Keithly said, though some of that was temporary stimulus money.
State data suggests Massachusetts has had success in reducing tobacco use:
Julia Hurley, a DPH spokeswoman, said the statewide smoking rate dropped from 23.5 percent in 1992, the year before state anti-tobacco programs began, to 14.1 percent in 2010.
Cigarette use among high school students also dipped from a high of 35.7 percent in 1994 to 16 percent in 2009, according to a statewide Youth Risk Behavior Survey.
Anti-smoking advocates called the cuts counterproductive. In a report last year, the Campaign for Tobacco-Free Kids said Massachusetts ranked 37th in the U.S. in its spending on anti-tobacco programs – just 5 percent of the funding level recommended by the Centers for Disease Control.
“Obviously the state is facing serious financial challenges and health care costs are a big part of those,” said Katie King, director of health promotion and public policy for the American Lung Association of New England.
“But tobacco is still the leading cause of death and disability in the state, and 10 percent of health care costs are tied to tobacco use,” she said.
Pending legislation would set aside at least 3 percent of state tobacco revenues for anti-smoking programs but the legislation has not advanced since a committee hearing in May.
Keithly hopes to see some funding restored as the state recovers from the recession.