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Funding Tobacco Control Programs: A Dollar Well Spent

The Centers for Disease Control (CDC) identified tobacco use as the single biggest cause of premature death in every state in the U.S. They recommended in 2007 that New Jersey state government should spend $120 million per year on tobacco control ($13.75 per person per year, and 12% of total tobacco-related revenue to the state).

Here in New Jersey, our Comprehensive Tobacco Control Program (CTCP) started in 2000, with annual funding of just over $30 million via the Master Settlement Agreement (MSA). The program was set up to follow CDC guidelines to have components for media, evaluation, community activities, youth prevention, and smoking cessation. With the post 9/11 recession causing severe budget problems for the state, funding was drastically cut by 66% to $11 million in 2004 and then in 2009 it was cut again to around $8m. The state brings in approximately $1 billion per year from tobacco sources (MSA plus tobacco taxes) and so New Jersey has recently been spending around 1% of tobacco revenues on tobacco control. Despite being drastically underfunded, the New Jersey CTCP has had many noteable achievements. Here’s just a few.

– The number of cigarettes smoked by New Jersey youth was cut by 50% from 1999 to 2006 (i.e. from around 180 million to around 90 million cigarettes per year).

– Adults cigarette smoking fell from 21% during the mid 1990s to under 17% since 2007

– A national report released in 2009 found that New Jersey has the highest proportion of ex-smokers of any state in the nation (62% of smokers have quit, compared with 52% nationally and 41% in West Virginia).

So there is no doubt that New Jersey’s tobacco control program has been doing an excellent job.

Some point to the successes in reducing smoking and seem to be under the misguided impression that smoking is so rare nowadays that there is no longer a need for robust tobacco control programs. The reality is that according to our latest data (2006), New Jersey’s 7th through 12th graders smoke 90 million cigarettes a year. This does not include the significant proportions smoking cigars and bidis, or chewing tobacco.

In 2009, 283 million packs of cigarettes were sold in New Jersey, (providing $730 million in tax revenue to the state treasury).

To put New Jersey’s current investment in tobacco control into perspective, on an annual basis it is less than the amount of revenue the state receives in excise taxes from illegal cigarette sales to kids ($11.5 million)!

Yet in that scenario of incredible success despite serious underfunding, New Jersey’s Comprehensive Tobacco Control Program is currently threatened with complete elimination. In his proposed budget for the year ahead, Governor Christie proposed cutting all of the CTCP funding.

I don’t think we can really say that with New Jersey’s youth smoking 90 million cigarettes per year, and with 43 packs being consumed annually for every person in the state, that the work for tobacco control is done. We are only beginning to see the return on investment in terms of reduced health effects from tobacco. For example, the number of admissions to New Jersey hospitals for heart attacks was 24278 in 2000, but dipped below 22,000 in 2004 and has continued to fall to below 20,000 since 2006. To cut the program now would result in a reversal of the progress, and directly cause more heart attacks, more cases of lung cancer and emphysema, and more premature babies.

Tobacco control spending provides an excellent return on investment, and it is for this reason that CDC recommends that New Jersey should spend $120 million, rather than be considering cutting from $11m. Even in tough financial times, a dollar spent on tobacco control is a dollar well spent on improving health and reducing healthcare costs.

Full details and evaluation of New Jersey’s Comprehensive Tobacco Control Program can be found here.

For details on what a New Jersey Quitcenter does to help smokers quit, click here.

For more details on the toll of tobacco in New Jersey, click here.

For the CDC’s best practices for Comprehensive Tobacco Control (2007), click here.

This post, Funding Tobacco Control Programs: A Dollar Well Spent, was originally published on by Jonathan Foulds, Ph.D..

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