Twenty years ago, four major tobacco companies settled a court case with 46 states and the District of Columbia. The Tobacco Master Settlement Agreement (MSA) remains the largest civil settlement in U.S. history, and as a result, kids are better protected from tobacco marketing (see you later Joe Camel!). The funding from the settlement was intended to be allocated to lifesaving tobacco control efforts in states, not just when the agreement was signed, but through annual payments by the tobacco companies to the states forever due to the death and disease their products cause.

Tobacco Control include policies designed to prevent and reduce tobacco use, such as smokefree air laws, access to quit smoking support, tobacco taxes, efforts to raise the minimum age of sale of tobacco products to 21, and more. These are proven policies that have been found to not only save lives, but also reduce tobacco-related disease, ultimately saving states and our federal government healthcare costs.

The American Lung Association knows the value of the MSA funds firsthand, as it has funded and implemented programs and services that benefit millions of Americans. The American Lung Association’s tollfree Lung HelpLine and Tobacco QuitLine was funded in part by MSA funds, and offers free, on-demand quit smoking support from tobacco treatment specialists and registered nurses that has successfully helped hundreds of thousands of smokers quit.

With MSA funding the Lung Association is helping smokers quit with proven methods through the Freedom From Smoking® program in both Hawaii and Ohio, and we are also working to help prevent kids from beginning smoking in Ohio, Wisconsin, West Virginia, Idaho, Pennsylvania, Vermont, Nevada, Arkansas and more. Funding is also helping to secure more smokefree spaces in New Mexico, Alaska and Nevada.

These are important efforts to prevent and reduce tobacco use, and the Lung Association has and will continue to focus on these efforts with or without MSA funding. However, as we ask in our annual “State of Tobacco Control” report – a report which grades states on their efforts to implement tobacco control policies and help smokers quit – are states doing enough?

Programs like these are a lifeline for smokers trying to quit, workers trying to protect themselves from the harms of secondhand smoke and preventing kids from ever starting tobacco use; however, states aren’t always using the MSA funds toward these efforts. In fact, as we’ve reported before, despite receiving huge annual sums from tobacco settlements and collecting billions more in tobacco taxes; in the past 20 years, states have by and large failed to fund tobacco prevention and cessation programs at the levels needed to drive down smoking rates.

While at the time of the MSA, many states did establish tobacco control programs - very few states have funded them at Centers for Disease Control and Prevention (CDC)-recommended levels over the last 20 years. And only one state funded these programs at CDC-recommended levels in fiscal year 2018, according to the Lung Association’s annual “State of Tobacco Control” report. In Fiscal Year 2018, the states collected $27.5 billion from tobacco settlement payments and taxes. But they will spend less than 3 percent of it – $721.6 million – on programs to prevent kids from smoking and help smokers quit. 

The good news is that when it comes to helping smokers quit, we know what works – tobacco control efforts. Perhaps just as importantly, states have a way to pay for it through the Tobacco Master Settlement Agreement funds. All that remains is for states to do the right thing for the health of residents, and to fund these tobacco control efforts at appropriate levels. We’ll see a strong return on investment not only for lives saved and a reduction in tobacco-related disease, but also in reduced healthcare costs. It’s the smart thing to do—we just need our leaders to find the will to make it happen.

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