Since 2001, Missouri has received more than $500 million from the settlement of litigation against tobacco companies over smoking-related health care costs. Meanwhile, the General Assembly has given state health officials only $500,000 to help deter Missourians from smoking.
Deborah Markenson of the Missouri Department of Health and Senior Services said her department had planned to start several prevention programs last year. However, tobacco revenue earmarked for the programs was redirected to make up for the state’s budget shortfall.
Markenson described Missouri’s prevention strategy as “going forward with pieces that do not cost us money, moving forward and providing technical assistance to communities to do policy-based strategies.”
Missouri consistently ranks among states with the highest percentage of smoking-related deaths. The state health department estimates that 10,300 Missourians die prematurely every year because of tobacco use.
A national study published in October reported that, each year, Missouri women lose 69,000 years of potential life due to smoking. The study’s authors, the National Women’s Law Center and the Center for Women’s Health at Oregon Health & Science University, ranked Missouri among the worst in helping women quit smoking.
Kim Dude, director of the MU Wellness Resource Center, said funds from the tobacco settlement could have helped pay for smoking-cessation programs aimed at specific groups, such as women and college students.
“We had a tremendous opportunity to not be at the bottom of the barrel,” Dude said.
The Centers for Disease Control and Prevention estimates that effective state programs to reduce tobacco use would cost $32.8 to $91.4 million annually, but would significantly reduce health care costs.
Markenson said that the $500,000 appropriated to the health department wasn’t enough to start any new programs. However, information from a survey of 15,000 Missourians this year about various health risks, including smoking, will be used to develop a long-term strategic plan to reduce tobacco use.
According to the health department, strategies for meeting the plan’s goals include raising the price of tobacco products, offering more cessation programs and supporting local efforts to control smoking in public areas.
Rep. Vicky Riback Wilson, D-Columbia, said she would like to see more funding to reduce tobacco use in Missouri, but that the tobacco settlement was needed to save “the programs, the few programs, that we do have” from deeper budget cuts.
“There’s always a tension between wanting to make the investment for long-term saving and long-term health versus having to pay for mandated or necessary costs at the present,” Wilson said. “That’s a very difficult balance.”
The tobacco settlement is expected to eventually give Missouri $4.5 billion over 25 years. Since the state received its first payment in May 2001, legislators have failed to come up with a permanent spending plan.
More than $88 million was redirected in 2001 to make up for a general shortfall in the budget. Another $210 million was used that same year to fund a state tax credit for prescription drugs. Tobacco settlement revenue has also been used to fund life science research and early childhood programs.
Bonnie Linhardt, public advocacy director for Missouri American Heart Association, said the state’s tobacco prevention efforts have been “very pitiful.” She hopes state health officials will highlight the recent findings on smoking-related death and illnesses among Missouri women to state lawmakers.
“We should use this report as a tool to let our policy makers know we have women dying every day from smoking-related illnesses,” Linhardt said.
But Rep. Chuck Purgason, R-Howell County, said the lack of funding for anti-smoking programs reflects a general lack of concern about the issue among legislators.
“Basically, the tobacco settlement is not going where it’s intended, nor do I think it ever will,” Purgason said. “There’s too much of a desire to fund pet programs than to actually go by what the tobacco settlement is about.”