Future of anti-smoking program unclear

Has Indiana been successful in cutting the rate of smoking in the past decade? It all depends on whom you ask.

Indiana Tobacco Prevention and Cessation staff point to data that suggest the smoking rate among adults is now 23.1 percent, the lowest it has been in a decade and just a tad higher than the goal of 22 percent.

“This is huge progress to see the rate go down to 23 percent for Indiana,” said ITPC Executive Director Karla Sneegas. “Our job is to help smokers quit and to keep young people from ever starting.”

But for some, these gains are not enough to justify the continued existence of the ITPC, which has an $11 million budget. It was created in 2001 with funds from states’ settlement agreement with tobacco companies.

As state lawmakers tried to craft a budget this past session, a plan was floated to collapse the stand-alone agency into the Indiana State Department of Health, which would run smoking cessation programs.

Supporters of that plan say such a measure makes sense in tight economic times, especially given the performance of the agency since its inception. Although the agency remained independent at the close of the legislative session, some still question whether it’s worth its price.

“It appeared we could produce the same or a better level of performance on those programs at a little less administrative cost,” said Sen. Luke Kenley, R-Noblesville. “We thought there might be a chance to get the program to be more effective.”

Kenley, who predicted the question will resurface in two years when budget negotiations start, said the agency spends $1.4 million on administrative costs for its 14 staff members. When the state cut the agency’s budget a few years ago, staff was not reduced, he said.

In addition, he cites federal data that suggest the adult smoking rate in Indiana did not budge from 1998 to 2008.

Bringing the agency under the roof of the Department of Health probably could save “several hundred thousand dollars,” Kenley said.

A few other states, such as Mississippi and Ohio, have made similar moves, said Kevin O’Flaherty, Indiana director of advocacy for the Campaign for Tobacco-Free Kids.

In Mississippi, funding plummeted to zero from $20 million before $10 million was restored. In Ohio, prevention money is about 15 percent of what it was.

Although O’Flaherty said there’s nothing “inherently wrong” with a health department running a tobacco control program — several states have done so successfully — disbanding an existing agency would hurt anti-smoking efforts.

“It’s nearly always a power grab and often a money grab,” he said. “In the end, the programs . . . don’t fare as well as do other departments that have been long-standing in departments of health.”

The Indiana program has already faced adversity. In 2004, the agency’s budget was cut from more than $30 million to $10 million.

Former Sen. Robert Meeks, R-LaGrange, said the plan then was not to merge the agency into the health department but to use its funds elsewhere.

“My mantra was there is no money, you have to cut where you have to cut. Those programs that didn’t have effective results, you had to take their money,” he said.

Instead of funding programs in all 92 Indiana counties, money is now budgeted for 65 counties to combat tobacco.

As the funding went down, so did the number of calls to the Indiana Tobacco Quitline, officials said.

Sneegas, who has worked in tobacco prevention since 1991, saw some signs that things might be turning. Youth smoking rates were dropping. Cigarette consumption was declining.

New preliminary data suggest that the adult smoking rate, which was 27 percent at the agency’s inception, dipped to its lowest rate this year. Now, the state has set a goal of an 18 percent smoking rate by 2015.

Even Sneegas said she would have predicted more progress when the agency began, assuming that its initial funding level remained intact.

“I think we’ve made huge progress,” she said. “It’s just when I started this job in 2001, I really believed . . . we could drop a percentage point a year.”

By Shari Rudavsky, Indystar
March 31, 2010

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