US: Tobacco Programs Face Cuts

Source from:  Daily Record 09/17/2013

This year, the state of Washington set aside $2.5 million for tobacco cessation and prevention programs. While this may sound like a generous contribution, it's only 0.4 percent of the estimated $571 million in tobacco-generated revenue the state collects each year.

In 2011, the Washington State Department of Health reported that funding for the Tobacco Prevention and Control Program had been reduced by more than 60 percent since 2008 with further cuts in the future.

The Kittitas County Public Health Department is one of the many agencies using state funds to support local tobacco prevention and education programs. The majority of health department's tobacco funding was from the Tobacco Prevention and Control Account, which included revenue from the 1999 Master Settlement with "Big Tobacco" and the 2001 voter-approved cigarette tax increase.

In 2002, a ballot initiative directed $26.24 million of this tobacco revenue to the state's Basic Health Plan and required the state to spend that amount annually on tobacco prevention and cessation.

However, in 2009, the Washington State Legislature changed this law and tobacco tax money was funneled back into to the general fund. As a result, by July 2011, the Tobacco Prevention and Control Account had no funds remaining to sustain the program and the effects began to trickle down to the county level.

These funding cuts will affect local programs which focus on prevention, cessation resources, and education to all members of the community, especially high-risk populations.

Evidence shows that the more money a state invests in these programs over time the more impact they have. A 2007 CDC study on Washington's smoking policies showed that although some progress was made in the nineties, tobacco use did not decline significantly in Washington until after the substantial investment was made in the state's comprehensive tobacco control program.

According to a 2010 study published in the American Journal of Public Health, Washington's cessation and prevention program had, at that time, saved 13,000 lives, prevented 36,000 hospitalizations and saved the state $1.5 billion.

The Washington State Department of Health, Tobacco Prevention and Control Program Progress Report of March 2011 revealed that since its implementation, the Tobacco Prevention and Control program reduced the state incidence of adult smoking by one third and cut youth smoking by half.

County follows state trends

Kittitas County tobacco use followed the trends of the state. Washington State DOH's 2010 Kittitas County profile shows the overall tobacco usage by both adults and youth (18 and under) has decreased since the implementation of the state funded cessation and prevention initiative.

According to WA DOH, the number of adult smokers in Kittitas County is down 6 percent from 2003 reports. The 2012 Healthy Youth Survey states that 14 percent of Kittitas County 12th graders have smoked cigarettes; however, this number is down from 25 percent in the 2002 survey.

The data indicates a similar trend in smokeless tobacco use by high school seniors as well. The overall decline in use of tobacco use has been significant enough to attribute it to the efforts of tobacco cessation and prevention programs.

In the face of funding cuts, the county health department will be looking for ways to continue tobacco prevention and education in Kittitas County. Effective prevention and cessation programs involve implementing several key factors at once: education and media campaigns, community and school based programs, effective enforcement of laws prohibiting tobacco sales to minors, affordable and accessible assistance for smokers trying to quit and diligent evaluation of these programs to make sure they are delivering results.

Without the same resources, the health department is refocusing its efforts. The department is now using funds from a Community Transformation Grant to focus on policy, systems, and environmental changes that help people to quit or protect them from exposure to tobacco. Current projects include contacting local businesses and community partners to create policy initiatives that re-shape the environment and support tobacco free norms.

The health department will also continue to assist with state and county wide assessment of tobacco use to identify further areas of needed support. Local public health recognizes the benefits of keeping prevention programs active in the community and will continuously seek additional sources of funding to support them.

Amy Fuller is a health educator with the Kittitas County Public Health Department, working primarily on Community Health and Chronic Disease Prevention Projects. Enditem