Georgia receives about $150 million a year from the 1998 tobacco manufacturers' settlement with the states. It spends just 2 percent of it on programs to prevent residents from smoking or to help them quit.
By spending just a small fraction of what the Centers for Disease Control and Prevention recommends for tobacco control programs, the state has 214,000 more smokers than it might otherwise, according to new research.
"Throwing money doesn't solve problems, but investing in effective programs can," said Terry Pechacek, associate director for science at CDC's Office on Smoking and Health and a co-author of the study. "We have the ability now to end this epidemic. It is a matter of political will and social commitment."
Scientists at the Atlanta-based CDC and RTI International, a North Carolina research group, have found that there is strong and direct relationship between the amount of money states have spent on tobacco-control programs and how rapid a decline they've had in adult smoking rates.
Previous research has found that increasing the cost of cigarettes through state taxes reduces smoking. But the new study, published in the February issue of the American Journal of Public Health, found declines in smoking were directly related to the amount of funding given to tobacco-control programs --- separate from cigarette prices.
Based on evidence of effectiveness, the CDC has for years recommended a variety of actions states should be taking. They include media campaigns designed to counter the effects of tobacco company marketing, expanding programs that help people get smoking-cessation counseling, eliminating cost barriers to treatment for tobacco use, and working with community organizations, schools, offices and places of worship to influence people's attitudes toward tobacco.
In Georgia, most of the $2.6 million the state spends on tobacco control goes to school anti-smoking programs and for a telephone counseling hotline to help smokers quit.
If all states had funded their programs at the minimal levels recommended by CDC, the researchers estimate there would have been 2.2 million fewer smokers nationwide. Researchers estimate funding at the optimal level would have resulted in 7.1 million fewer smokers by 2003.
In Georgia, the minimal and optimal levels would have translated into between 68,264 and 214,054 fewer smokers. About 20 percent of Georgians smoke, similar to the national average, CDC data show.
Yet despite the financial windfall from the 1998 master settlement with tobacco manufacturers --- which will give states $206 billion over 25 years --- few states are funding tobacco-control programs at even the minimal levels recommended by the CDC. As states have faced budget crises, they've increasingly turned to the tobacco funds to pay for other needs.
For fiscal year 2008, which ends June 30, Georgia has received $148.3 million in settlement funds. Just 2 percent went for smoking cessation and prevention. About 45 percent of the money went to general health care expenses, such as Medicaid hospital costs and mental retardation programs. Less than one-quarter of the money was spent on general cancer research, screening and treatment. And 32 percent went for rural economic development programs, budget documents show.
To effectively reduce rates of smoking and tobacco use, the CDC recommends that Georgia spend a minimum $42.6 million, and optimally spend $114.3 million this year.
Instead Georgia will spend only $2.6 million.
Six years ago, Georgia spent $26.5 million of the settlement money on smoking-prevention programs.
One program that's taken a major hit has been the state's Tobacco Quit Line (1-877-270-STOP), a free, personalized counseling service that helps smokers quit.
Research has shown that such programs increase quit rates by 56 percent compared with smokers who try to quit on their own.
Dr. Stuart Brown, director of the Georgia Division of Public Health, said there is no longer any money to run media campaigns about the dangers of smoking and direct smokers to the Quit Line.
In 2002, the line received nearly 23,000 calls. Last year, it got just 3,595, the division's records show.
"The media buys that drove people to the Quit Line have essentially gone away, and as a result, we're getting many fewer calls now than we did," Brown said.
Brown said his division requested an additional $5.6 million, for a total of $8.2 million in funding this year. He said the additional funds would have gone to promote the Quit Line and provide services to the increased callers they would get, as well as to add some nicotine replacement therapies to the program. But Gov. Sonny Perdue did not include the additional money in his budget proposal, and funding remained at $2.6 million.
Still, Brown said state health officials are working to maximize the funds they have, working through schools and substance-abuse programs to reduce smoking as part of a comprehensive approach to promoting health and reducing risky behaviors.
Bert Brantley, Perdue's spokesman, said that the governor has to balance many financial needs in the state when making budget decisions. He said Perdue has focused on spending the tobacco settlement money on three main areas: health care, cancer research and bolstering rural economic development.
"There's a balance in the spending you see in those priorities," Brantley said.
But some advocates question how little of the settlement money goes to prevent and stop smoking --- the leading preventable cause of premature death.
"I believe people wanted this money to go for tobacco-use prevention. And most people think that it is --- but it's not," said June Deen, vice president of public affairs for the American Lung Association of Georgia. "It's a missed opportunity."
SMOKING BY THE NUMBERS
20%: Georgia adults who smoke
21%: Georgia youths in grades 9-12 who smoke
55%: Adult smokers in the state who have tried to quit
1,288,000: Number of adults in Georgia who smoke
10,300: Smoking-related deaths in Georgia annually
Source: CDC data highlights 2006
HELP QUITTING
The Georgia Tobacco Quit Line is a free service for Georgians age 13 and older that provides a trained counselor to help tailor an individual quit process for each person. Call 1-877-270-STOP. Help in Spanish is available at 1-877-2NO-FUME; and for the hearing impaired at 1-877-777-6534.
The Quit Line is open Monday through Saturday from 8 a.m. until midnight. It's closed Sundays.
Copyright 2008 The Atlanta Journal-Constitution