ND Measure Shifts School, Health Money to Tobacco

Source from:  Monday October 27, By Blake Nicholson, Associated Press Writer 10/28/2008

North Dakota tobacco measure boils down to priorities: Health, or water and education? Arguments about a ballot measure that would devote more state money to anti-tobacco programs go deeper than dollars. Supporters believe the measure will promote savings on health care costs while opponents say the extra cash will never be enough. "How much money can you possibly spend trying to get a teenager to stop or not start smoking?" said state Rep. Frank Wald, R-Dickinson. "You spend millions of dollars, but you get back to the issue of parents demonstrating individual responsibility. "I think this is one of those warm, fuzzy, feel-good measures that simply defies common sense," he said. Backers of Measure 3 on the Nov. 4 ballot say it's common sense to use more money from a lawsuit settlement against tobacco companies to fight tobacco use. They say North Dakota's tobacco prevention programs, while effective in recent years, still fall short of national standards, and that tobacco still costs the state hundreds of lives and hundreds of millions of dollars each year. "If we can get people to stop smoking, we will dramatically improve the health of our state, but we also will save tremendous amounts of money," said Heidi Heitkamp, who led the effort to put the measure on the ballot. Heitkamp was North Dakota's attorney general for much of the 1990s, and helped negotiate a 46-state settlement of a lawsuit against the nation's biggest tobacco companies in 1998. So far, the settlement has brought more than $233 million to North Dakota's treasury. Education and water projects each get a 45 percent share, with the rest going to health programs. Less than one-tenth of the health program money goes to anti-tobacco efforts, said Karalee Harper, director of the state Health Department's tobacco control and prevention division. The ballot measure would establish a nine-member board, appointed by the governor, to develop an anti-tobacco plan that would meet standards established by the federal Centers for Disease Control and Prevention. It would be financed largely by lawsuit bonus payments the state is expecting until 2017 for its work in negotiating the tobacco settlement. Education and water projects would lose the bonus money, but Heitkamp says it should be easily made up by increased revenue from North Dakota's oil extraction tax. Part of the tax is earmarked for schools and water projects. "Water and schools are getting historic amounts of money from the oil extraction tax," she said. "If we are ever going to fully fund a tobacco program, and this is not the time to do it, then when is?" Schools and water projects each got $36.5 million from the oil extraction tax during the state's last budget year, said Kathy Strombeck, a state Tax Department analyst. Budget forecasters predict they will get $57 million during the current budget year, which ends June 30, 2009. Members of North Dakota's Water Commission, which has not taken a position on Measure 3, say the tobacco settlement money has helped to build a new Grand Forks dike system, the Devils Lake outlet and the Southwest Water Pipeline, which supplies water to southwestern North Dakota communities. "There has been a perception that allowing only 10 percent of the tobacco settlement money to be used for tobacco cessation has been inadequate, but I'm not certain that that's been demonstrated to be true," said Harley Swenson, of Bismarck, a longtime member of the Water Commission. Swenson believes a better strategy for discouraging smoking in North Dakota is to raise the state's tobacco tax. The state levies a 44-cent tax on a pack of cigarettes, compared to $1.70 in Montana, $1.53 in South Dakota and $1.70 in Minnesota. "There's only so much that you can reasonably throw at a program and spend it wisely," Swenson said. "I don't know what that level is, but it seems like a good effort has been made." The bonus payments are expected to bring in $14 million each year. Meeting the federal guidelines would cost an estimated $9.3 million per year, triple what the Health Department says is being spent now. Heitkamp said as smoking rates decline, so will the program's cost. The Campaign for Tobacco-Free Kids, which supports the measure, estimates it would save $113 million in smoking-related health care expenses over five years. The North Dakota Health Department's Web site lists almost 60 tobacco cessation programs in 40 of the state's 53 counties. Department data show a decline in adult smoking of nearly 4 percent between 2000 and 2006, and a 19 percent drop in high school smokers during roughly the same time. The measure's supporters say even more can be done. "Look at what has happened in California -- lung cancer declining four times faster than in the rest of the country," Heitkamp said. June Iljana, a spokeswoman for the California Department of Public Health, confirmed the statistic. She said the federal tobacco program recommendations are based in part on California's anti-smoking efforts. If the North Dakota initiative's tobacco fund lacks the money needed to meet CDC standards, the measure says the money will be taken from the water development trust fund. "We get done what people want done," said Robert Thompson, a Water Commission member from Page, in Cass County. "If people want the projects, the funding will be there. If it isn't from this source, it will be from another source." But Rep. Rick Berg, R-Fargo, the House majority leader, said some of the water fund money already is dedicated to pay off bonds that were sold to finance water projects. No lawmaker is opposed to reducing tobacco use, Berg said. "The real crux of it is, what happens if we have a (money) shortfall," he said. Heitkamp said she is confident the tobacco fund will take in enough money to run a CDC-approved program for at least 20 years. If the Legislature would ever have to kick in additional money, "we're 20 years into the future," she said. Supporters say the measure would dip into the water fund rather than the education fund because public schools already play a role in health education. The North Dakota Education Association, the state's largest teachers' union, is supporting the tobacco measure. The North Dakota School Boards Association has not taken a position on the measure, said its director, Jon Martinson. Enditem