Anti-Smoking Programs Fall as Taxes Rise
By Petros Kasfikis and Mike Trinh
source: Massachusetts Department of Public Health
Twenty years ago, supporters of a tobacco tax increase for Massachusetts had lofty goals for the money.
A voter-approved 1992 ballot initiative nearly doubled the cigarette tax from 26 cents to 51 cents a pack to fund the creation of the Massachusetts Tobacco Cessation and Prevention Program. The program used advertizing, counseling and other steps to help smokers quit.
By 1994, the program’s budget was $52.2 million – about 22 percent of the tax revenue.
But although the tax was increased three more times to the current $2.51 a pack, spending on anti-smoking programs dropped 92 percent as more and more tax revenue was used to plug gaps in the state budget.
This fiscal year state government will collect a combined $815 million in tobacco taxes and payments from a 1998 settlement with tobacco companies. It will spend $4.1 million on anti-tobacco programs – less than 1 percent of total revenues.
The programs could see even less money in the next budget despite the likely passage of another $1-per-pack tax increase. The $165 million the hike is already earmarked for the state’s transportation system.
Other states have gone in similar directions.
A March 2010 article in the medical journal, CHEST, reported that in 2000, 26 percent of the settlement money paid out to states by major tobacco companies went to non-health programs, such as roads and education. By 2006, 15 states did not use any settlement money for health care.
“Unfortunately, over the past decade or so, with the economy having difficult times back in the early 2000s and 2008, legislators had to make choices and tobacco control has taken a significant hit,” said Marc Hymovitz, a Massachusetts official with the American Cancer Society
As a result, the American Lung Association’s 2013 State of Tobacco Control report card gave Massachusetts a B for cigarette taxes but an F for spending on prevention programs. The U.S. Center for Disease Control and Prevention recommends $90 million in state funding.
The Massachusetts Tobacco Cessation and Prevention Program provides free services, such as the Massachusetts Smokers’ Helpline, to help smokers quit and funds programs, such as The84, that work to prevent children from smoking.
Dr. Michael Siegel, an expert in smoking prevention at Boston University, says anti-tobacco ads can be very effective in dissuading the young from smoking.
“Massachusetts used to spend $13 million a year on television ads,” Siegel said. “My own research showed about a 50 percent decline in youth smoking initiation.”
However, since no portion of the tax revenue was specifically dedicated to the cessation program, its share of the tobacco tax revenues is not guaranteed.
In 2002, the same year that saw a cigarette tax increase, Gov. Jane Swift cut cessation program funding to $5.8 million to balance the state budget, eliminating money for such advertising.
According to the Centers for Disease Control and Prevention, Massachusetts saw an uptick in smoking rates, from 18.9 percent in 2002 to 19.1 percent in 2003.
With the exception of modest increases in the economically stable fiscal years of 2004 and 2008, the program’s budget saw cuts over the next decade.
Matthew Farrelly, a senior director at RTI International, a private research firm in Triangle Park, N.C., said its evaluation of cessation programs found that anti-smoking programs can help reduce the cost of tobacco-related illnesses, which the American Cancer Society estimates at $4 billion annually for Massachusetts.
“This is not a waste of money; this is a way to help people quit or stay away from smoking,” he said. “It is important to keep in mind that the state ends up spending money on Medicaid because smoking has health consequences.”
Hymovitz said raising tobacco taxes can dissuade some people from smoking, but the state needs to do more with the money it raises.
“If we increase the price of tobacco we owe it to the smokers who want to quit to provide programs to help them quit,” he said.