State Tobacco Control Resources, 1998-2006: Missed Opportunities?

Background: The 1998 Master Settlement Agreement (MSA) required tobacco companies to pay states for smoking-related costs imposed on state Medicaid programs, thereby providing states with millions annually to address tobacco use. Several states also have additional revenue from tobacco excise taxes. The purpose of this study was to document the trends in potential state funding resources for tobacco control since the MSA in the context of tobacco use prevalence and consumption, as well as recommendations from the Centers for Disease Control for tobacco control funding levels.

Methods: We searched the National Association of Attorneys General's website, U.S. Government Accountability Reports, states' tobacco control/department of health websites, states' tax revenue departments, and the Centers for Disease Control websites. The data collected included individual states' MSA allocations, tax revenues from tobacco products, and tobacco use prevalence and cigarette consumption for the period of 1998 through 2006.

Results: As a result of a few states' decisions to securitize their MSA payments, overall MSA allocations have mildly decreased in the last three years. While smoking prevalence remains relatively stable in many states, tobacco consumption has declined, resulting in more light smokers and decreased tobacco tax revenues. In addition, inflation has also eroded the power of currently available dollars.

Conclusion: Resources for tobacco control efforts continue to dwindle as declines in tobacco use have stalled. Health officials and advocates alike must demand that revenues generated from the use of tobacco products be dedicated to decreasing the negative health consequences associated with tobacco use.