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The Honolulu Advertiser

Posted on: Tuesday, March 25, 2003

Leave the tobacco fund alone

By Dr. Jay Maddock
Chairman of the Coalition for a Tobacco Free Hawai'i

As legislators are faced with steep budget shortfalls and war, they are looking to help balance the state budget with what is becoming a more and more tempting revenue source: Hawai'i's Tobacco Settlement Special Fund.

Bills are currently being considered that would reduce the amount of money available for tobacco prevention and cessation programs. But in the long run, cutting funding for tobacco prevention and control programs will only cost the state more, in both lives and money.

Together with 46 other states, Hawai'i fought hard against the big tobacco companies to win the $1.2 billion settlement. The primary purpose of the joint lawsuit was to recover part of the past, present and future healthcare costs for tobacco-related illnesses that were being paid by taxpayers. Although the settlement does not place any restrictions on how the money can be spent, many states, including Hawai'i, initially intended to direct substantial portions of the settlement funds toward tobacco prevention and cessation.

In 2001, the amount of the settlement funds specifically allocated for tobacco prevention and control was reduced by half, from 25 percent of the settlement to 12.5 percent (or approximately $5 million a year). The trust fund cannot sustain any more reductions if it is to be able to support effective statewide comprehensive programs.

According to the Centers for Disease Control and Prevention, a successful, effective statewide comprehensive tobacco-control program in Hawai'i will cost between $11 million and $24 million a year. In 2003, Hawai'i has allocated approximately $9 million for tobacco prevention and cessation. We cannot afford to spend any less.

The statistics regarding Hawai'i's tobacco-use problem are staggering. Cigarette smoking is the single most preventable cause of death in Hawai'i and is responsible for more than 1,100 deaths in the Islands each year. Equally alarming, the percentage of young adults in our state who smoke is increasing. Tobacco use also hurts Hawai'i's economy, and costs our state more than $328 million in healthcare and other associated costs annually.

A proven effective way of addressing both the health as well as economic concerns is through well-funded, comprehensive tobacco prevention and control programs. Studies have shown that California and Massachusetts, which started their tobacco prevention programs in 1990 and 1993 respectively, are now saving as much as three dollars in healthcare costs for every dollar spent on tobacco prevention.

In order to save taxpayers' money in healthcare costs, states must spend adequate amounts on prevention and education.

Evidence from both Florida and California have demonstrated that when funding for comprehensive tobacco prevention programs are cut, smoking rates rise. This acts as a warning for the states, including Hawai'i, that tobacco prevention programs must be adequately funded and sustained over time to reduce smoking rates and to protect every generation.

Many of the measures being considered at the Legislature are important. However, we do not believe it is appropriate to reduce the funds going to the tobacco prevention and control trust fund to pay for other programs. Too much work has been done and too many lives are at stake to let such a high-priced trade-off happen.

In these tough economic times and with fewer dollars to go around, we understand Hawai'i must establish priorities and invest in programs that will provide the greatest return on our investment. In the effort to protect both the health of Hawai'i's people and our economy, we believe a comprehensive, statewide tobacco prevention program is crucial.

Jay Maddock, Ph.D., chairman of the Coalition for a Tobacco Free Hawai'i, is an assistant professor in the UH Department of Public Health Sciences and Epidemiology.