Twenty-five years ago, four major tobacco companies settled a court case with 46 states and the District of Columbia that resulted in the major tobacco companies being forced to pay states for tobacco-caused healthcare costs and ended certain tobacco marketing aimed at kids (see you later, Joe Camel!). The funding from the settlement was intended to be allocated to lifesaving tobacco prevention efforts in states, not just when the agreement was signed, but through annual payments by the tobacco companies to the states for as long as they continue to sell cigarettes due to the death and disease their products cause.

The American Lung Association knows the value of the Master Settlement Agreement (MSA) funds firsthand, as it has funded and implemented programs and services that benefit millions of Americans. Our toll-free Lung HelpLine and Tobacco QuitLine was and continues to be funded in part by MSA funds from the state of Illinois.  The Lung Helpline and Tobacco Quitline offers free, on-demand quit smoking support from tobacco treatment specialists and registered nurses that has successfully helped hundreds of thousands of people quit. MSA funds also serve as a source of some of the funding for Lung Association prevention, education and quit tobacco efforts in a number of states.

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 often say in our annual “State of Tobacco Control” report – which grades states on their efforts to implement tobacco control policies and help individuals quit – states could be doing much more.

Programs like these are a lifeline for people 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, despite receiving huge annual sums from tobacco settlements and collecting billions more in tobacco taxes; in the past 25 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 prevention and education programs - very few states have funded them at Centers for Disease Control and Prevention (CDC)-recommended levels over the last 25 years. And only two states funded these programs at CDC-recommended levels in fiscal year 2023, according to the  “State of Tobacco Control” report. In fiscal year 2023, the states collected an estimated $26.7 billion from tobacco settlement payments and taxes. But they will spend less than 3 percent of it – $733.5 million – on programs to prevent kids from smoking and help individuals who use tobacco to quit. 

The good news is that when it comes to helping people quit, we know what works – including higher tobacco taxes and ending the sale of flavored tobacco products. Perhaps just as importantly, states have a way to pay for it through the Tobacco Master Settlement Agreement funds and the billions of dollars states collect from tobacco tax revenue. 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, with one study showing that for every $1 spent on the longest-running tobacco control programs, $55 billion in benefits were created. So, these programs not only save lives and reduce tobacco-related disease, but also reduce healthcare costs. It’s the smart thing to do—we still just need our leaders to find the political will to make it happen.

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