Don't gut tobacco prevention programs

THE Washington State House budget proposes a 43-percent decrease to one of the most important public-health programs in our state. Washington's tobacco prevention and control programs have generated a remarkable success story, delivering dramatic results in less than 10 years, including:

• A decrease in adult smoking over the past decade from 22.4 to 16.5 percent;

• A decrease in youth smoking among 12th graders from 35 percent to 20 percent in the past decade;

• An improvement in our national rank from 20th to 6th place in the United States for lowest rate of smoking.

These results translate into remarkable benefits for adults who quit, youth who avoid starting, and all other state residents and institutions. Recent research shows that smokers who quit in their 30s add 10 years to their life expectancy. In Washington, 250,000 smokers have quit successfully in the past decade: this translates into more than 2 million extra years of life from the work of the tobacco programs. Because ongoing smoking costs the state more than $5,000 per smoker per year in excess health care and lost productivity costs, the program is saving the state more than $1 billion a year.

How did we achieve these remarkable results? Through an ongoing series of programs, policies, and financial commitment, we:

• Dedicated money from the master settlement with tobacco companies to a multifaceted program;

• Increased that dedication in 2001 by passing I-773, a citizens initiative increasing our tobacco taxes and requiring the state to spend at least $26 million a year on tobacco prevention programs;

• Reinforced these commitments with policy support such as I-901, which banned indoor smoking;

• Provided comprehensive education to citizens, including youth, through the media and community programs, about tobacco and how to quit;

• Worked with health-care providers and the Washington Quit Line to ensure all tobacco users who want to quit have easy access to evidence-based help.

Despite our tremendous progress, smoking is still the No. 1 cause of death and disability in the state. One in six Washington adults still smoke, costing us more than $5 billion a year in health-care and lost-productivity costs. The tobacco industry is still spending more than $160 million per year to promote tobacco use in Washington. If we let down our guard, our gains will be eroded quickly. Yet the state House is proposing a draconian 43-percent cut.

Tobacco-control funding represents a tiny fraction of the revenue from tobacco taxes and the Master Settlement Agreement payments from the tobacco companies, which Gov. Chris Gregoire negotiated when she was our attorney general. The current annual $26 million mandated by voters in 2001 for tobacco prevention is a small fraction (less than 5 percent) of the total revenue we, as citizens, are getting from addicted tobacco users. It is less than half what the Centers for Disease Control and Prevention recommend states spend on tobacco programs. If we now make this drastic 43-percent cut in our already limited tobacco-control programs, we are further abandoning the principles then-Attorney General Gregoire established as a core rationale for her efforts to win the tobacco settlement in the 1990s.

The timing of this takeaway is particularly disturbing. Over the past few months, smokers have experienced a 62-cent increase in the federal cigarette tax, which is bringing in revenue to help extend health insurance for young children. As hoped for, many smokers are trying to quit. Our own state Quit Line has seen a tripling in the number of calls registered in April 2009 compared to April 2008.

We cannot justify taxing tobacco by saying "it's an unhealthy addiction" while at the same time denying help to those who are trying to free themselves from that addiction. Our state will be in the untenable position of benefiting financially from the ongoing use of tobacco by its citizens, while at the same time reneging on its commitment to continue to devote a significant fraction of tax and tobacco-settlement revenue to prevent tobacco use and help those who want to quit.

We urge you to contact the governor, Secretary of Health Mary Selecky and state representatives to restore funding to these vital tobacco-prevention programs.

Jeffrey R. Harris is director of the Health Promotion Research Center at the University Washington School of Public Health. Greg Vigdor is president and CEO of the Washington Health Foundation. Tim McAfee is the chief medical officer for Free & Clear.