Although South Dakota spends only 52 percent of what the Centers for Disease Control and Prevention recommends on tobacco prevention programs, state anti-tobacco activists say the money has been enough to make a significant difference.
In the past decade, South Dakota has lowered the rate of teenage smoking from 40 percent to 24.7 percent, said Dr. Allen Nord, a Rapid City physician and member of the South Dakota Tobacco-Free Kids Network.
“We’re making a huge difference in the lives of children,” said Nord, who points out that most adult smokers begin the habit as teenagers. “This money is saving lives.”
A recent report issued by the Campaign for Tobacco-Free Kids and other national health organizations criticizes states for not spending more on tobacco prevention programs.
The report finds that prevention spending has actually dropped by 15 percent in the past year.
And it’s not because tobacco funds have dried up.
States can fund prevention programs with money from the 1998 multi-state tobacco settlement, state taxes and federal grants. An estimated $246 billion dollars is being paid over a 25-year period from the tobacco settlement, and states collect about $25.1 billion a year in tobacco revenue.
The report shows that only North Dakota is funding tobacco prevention programs at the level recommended by the CDC ($9.4 million).
Thirty-one states and Washington, D.C. provide less than a quarter of the CDC-recommended amounts. New Hampshire is the only state providing no state funding for tobacco prevention, using just $1 million in federal grant money.
Nine states meet half of the CDC recommended levels.
One of those nine is South Dakota.
South Dakota ranks 10th nationwide and is expected to spend $6 million in 2010. The CDC, which calculates the suggested amounts based on population, recommends the state spend $11.3 million.
Jason Dilges, commissioner for the state Bureau of Finance and Management, said South Dakota does not receive payments from the tobacco settlement any longer.
In 2001, the state sold the rights to its ongoing settlement payments in exchange for a lump sum payment of $278 million. The sale shifted the risks to the bond holders and away from the state, Dilges said.
None of the $278 million, or the $70 million that had already been paid from the tobacco settlement, went toward tobacco prevention in South Dakota. It was placed into the Education Enhancement Trust, he said.
Instead, South Dakota looks to its own taxes to fund tobacco prevention programs.
In 2007, the state passed a tax increase on tobacco products, committing $5 million of that income each year to the state Department of Health’s tobacco-prevention program.
The state collects $57 million in tax dollars from cigarettes and $5.4 million from other tobacco products. The state’s general fund receives the first $30 million of that money. The Department of Health receives the next $5 million for tobacco prevention. The Property Tax Reduction Fund receives 33 percent, as does the Education Enhancement Tobacco Tax Fund. The Health Care Tobacco Tax Fund receives 34 percent, Dilges said.
The Department of Health also receives federal grants. In 2010, the state will collect a $963,000 federal grant, bringing the total prevention funds to $6 million.
Nord said South Dakota’s success at reducing smoking has been largely due to the Department of Health’s program. The program includes public education, a media campaign and a highly successful Quit Line. Through the Quit Line, smokers can be prescribed medication to help with smoking cessation, as well as counseling.
Nord said the Department of Health’s Quit Line is considered “one of the best in the country. A lot of states look at our Quit Line as a model,” he said.
While the CDC’s calculations indicate South Dakota should spend more, it’s probably not realistic and perhaps unneeded, Stalley said. The Department of Health has shown that it can be effective with its $6 million budget.
“We certainly believe at this time the Department of Health has adequate resources,” Stalley said. “As long as we can fund the Quit Line fully and media campaigns, I think that we’re seeing that the money dedicated now is adequate for doing that … But I wouldn’t want to see us pulling back from that.”
Pulling back is exactly what the report warns against.
The report urges states not to slow down or decrease funds, especially in light of the “remarkable” progress already made. In the report, the CDC notes that overall progress on adult smoking reduction has stalled since 2004. And while teenage smoking rates have improved, the fact that 20 percent still smoke is troubling. Government must not become “complacent” the report reads.
Nord and Stalley agree.
One of the most positive things about South Dakota’s prevention efforts is the promise of funding each year, Stalley said. “We have long advocated that the Department of Health be given adequate and sustained funding … we have accomplished that with tax dollars,” Stalley said.
Nord said that while he’s proud of the accomplishments that have been made in South Dakota, the fight against tobacco use is far from over.
As a family physician who sees patients every day with smoking-related illnesses, Nord sees the battle against tobacco use a critical one, both for humanitarian and financial reasons. Each year, the state of South Dakota pays $58 million through its state Medicaid program to deal with smoking-related ailments.
It doesn’t have to be that way. “$58 million and every single penny of that is preventable,” Nord said.
Contact Lynn Taylor Rick at [email protected] or 394-8414.
December 26, 2009