Report: California Skimping On Spending For Tobacco Prevention
December 10, 2013 1:19 p.m.
Debra Kelley, Director of Advocacy and Health Policy, American Lung Association
Danny McGoldrick, Vice President of Research, Campaign for Tobacco-Free Kids
MAUREEN CAVANAUGH: This is KPBS Midday Edition, I am Maureen Cavanaugh. It's been fifteen years since most US states agreed to a settlement with a big tobacco companies to recover healthcare healthcare costs the settlement amount was huge, more than $246 billion. Many thoughts thought that I would be enough to help smokers that would wanted to quit and deter the next generation from picking up the habit but it proved proof group of public health organizations find that here in California to make an prevention programs are getting small cut of the very large pot of money. During me to talk about how California share of the tobacco settlement is being spent, but my guess. Debra Kelley is involved with Debra Kelley and Danny McGoldrick. Welcome to the program. Now, let me speak to you about this report, the title is broken promises to our children, how have promises from the to tobacco settlement broken?
DANNY MCGOLDRICK: As he mentioned this is a settlement between the states and the tobacco companies. It's about $250 billion and just the over just twenty-five years the states to help them cover all the cost that they incurred treating smoking costs and the payments are actually just for volume that those we have smoking we have payments the states, are fifteenth anniversary our fifteenth anniversary report a sad picture of using those dollars to help smokers quit. Our states and failing misery miserably at using this money photos and tended and this will have a huge effect of a health and economy of our state by reducing health benefits. The $25 billion that the state will roughly taken this year, in their settlement payments they are spending less than 2% on the on the prevention programs that we have to reduce smoking. This is a tremendous missed opportunity nationally and virtually on every state.
MAUREEN CAVANAUGH: On to ask the campaign for tobacco free kids but the report every two years, is there anything different about this year's report or is this attribute missing of the years?
DANNY MCGOLDRICK: What we've seen in the last five or six years is massive cuts to the program cuts of over $200 million for the program and last for five years, this year we saw a slight increase in spending a couple tiny increases, but for the most part we've seen it stabilize. We did lose more money this year but we're so far below what is recommended and what is needed, to protect her kids and help adults and smokers quit, we just do so much better. For every state to find the level recommended by the CDC, and only take 6 to 15% of of the funds. There are billions of dollars use the funds other issues. California falls in the back bill that report their twenty-third a report it 20% of the recommendations spent because they do that will because some a stick into poorly, but about half of the states are spending less than half half of the amount that the CDC recommends. That is despite the fact that the payments and tobacco payments that the state takes in the $1.59 in tobacco revenue, we know how successful the California program has been, it would know that you'll get into that. But we can do so much better in the program has lost so much money.
MAUREEN CAVANAUGH: What other examples of state spending in the money in the way it should be spent?
DANNY MCGOLDRICK: States nationally at the CDC level of that is Alaska and North Dakota, and a handful of others such as Delaware and Hawaii spending more than 50% of what the CDC recommends, that is as good as it gets.
MAUREEN CAVANAUGH: Are there any statistics say for the spending more money than towards preventing kids starting to smoke, do you see that actually bringing results, and other any statistics as to how smoking is tailed off or been curtailed in the states that are spending the appropriate amount of money on prevention programs?
DANNY MCGOLDRICK: That is a great question. We have a great evidence base for the programs. I my evidence comes from California which has the longest running tobacco frigid prevention program. This is sort of a model for other states. We know from research from across the straits, we know there's a gross relationship between what you put into the program so what you get out. We reduce smoking move kids and adults every save lives and save healthcare dollars about whether point. We are interested in the health impact of these programs but even if you're making budget decisions, cutting these programs to fit above budget deficit is not make sense they actually pay for themselves a bit more than pay for themselves as a shortsighted budget decision to cut venture on to Prevention. States save money on the long run.
MAUREEN CAVANAUGH: I have been speaking with Danny McGoldrick. Thank you a lot. And still here with me as Debra with the American lung Association in California, so we heard that California's only spending about 14% of what is recommended for prevention programs, what is the bulk of the tobacco's settlement money awarded to be used for instead of where it should be going?
DEBRA KELLEY: When you look at the state of California it's hard to say where it is going, it's really going to the Chad general operating budget, just about and it's building roads and paying salaries for elected officials and things like that, but California California's own award-winning it tobacco funding prevention program is being funded out of tax revenue instead of the prevention program. As slowed smoking did declines revenues decline. What could've happened is the state of California not deciding if they would shore up the tobacco program with the funds.
MAUREEN CAVANAUGH: Doesn't that go into against guidelines of how the money it should be spent? This was going to the general fund.
DEBRA KELLEY: It's not supposed to. With California we have a lot of different funds and so to be fair to the state of California a lot of it really is going into compensated healthcare to go back to the counties in public hospitals, and most people think of that is the general fund, but is very hard to follow the money when it comes to the state of California and exactly where it is going and what is buying.
MAUREEN CAVANAUGH: Talk about examples of tobacco cessation intervention programs, what are we talking about? One of these programs like. Are they in schools or advertising campaigns, what are these programs?
DEBRA KELLEY: People have seen these programs and currently the tobacco prevention program has budgeted close to sixty-three nine dollars. That is not a lot because the interesting Spencer million dollars in our temperament is proper product. Were going today be a campaign where people may see advertisements and remember when the smoker who stuck the cigarette in her next to spell, these days there as out there about secondhand smoke and in apartments and how it moves between units and endangers people, that is a part of that. About 20% of the money goes to our schools and goes to the Department of Education and so they go to our local schools, for example. Some high schools have large tobacco prevention programs funded away. Our local health departments missing about 19% of the money and they are responsible for providing leadership and conducting needs assessments, what is it that we need here in San Diego which can be different from what people need in San Francisco, then there is another 22% that goes to local community-based organizations and that could be the community clinics in this day could be health services it could be communities is substance abuse, it mainly with these agencies are doing is working on policies to protect people from exposure to secondhand smoke at helping apartments go smoke-free in passing laws that make during patio smoke-free and those are big impact policy things a local organizations working on and evaluations about 5% of the bunch.
MAUREEN CAVANAUGH: Wondering since the idea that we're speaking about is and the reason we're speaking that this is because a lot of programs are not funded up to love real that the CDC would recommend with the settlement money from tobacco companies, have we seen an increase in smoking or a leveling off of the decline because the prevention programs are not being adequately funded?
DEBRA KELLEY: Exactly. For the first ten years of the program we saw us a huge drop in smoking from adults and teens but these days it has doubled off and in the industry it has not been sitting on the sidelines during its funds,, the tobacco industry has been created critic new products and strategies going around bars getting young adults to use the products and they're all kinds of nicotine containing products on the market, and nicotine is nicotine. What we're seeing is the decrease is leveled off where we're seeing an increase in smoking with human adults and nine of the highest rate of tobacco use it at any age group and so if we are not to mention that we have formally to people whose bulk in California we need to do more to help them. Important program is California help smokers. There's a lot more that we could do that we need to do but we are shortchanging kids and people who smoke and in our communities.
MAUREEN CAVANAUGH: With this huge tobacco settlement I love the time there are many people who said that this would be too tempting for states, they will not be able to follow this money the way in this was the spent and there'll be a lot of smokers who are not going to get the help they need and a lot of prevention programs are just going to follow either way sites, have those processing prophecies come to pass?
DEBRA KELLEY: They have and it is protectable. I wish that as a part of the metal master agreement there had been a provision that required states to at least invest a certain portion of the money into these programs that work. They were going on the basis of recovering some of the taxpayer dollars. But it's definitely a lost opportunity.
MAUREEN CAVANAUGH: We invited a representative of San Diego County to join our conversation to talk about the county's smoking cessation and soaking prevention programs but no one was available to join us today, Deborah, which you know and how would you grade what San Diego County is doing in his prevention programs, he talked about something going on at Sweetwater School District and Vista Community Clinic, but overall it was San Diego handling the money for the tobacco settlement?
DEBRA KELLEY: There is some good news but it's all relative. Back in 1998 we had a battle with this, and the city Council. At San Diego city Council. The city is getting money and the county is getting more and we were not terribly successful in getting the city to invest any of that money into anything that would help families are people who smoker you get the word out, and to his credit Ron Roberts the county board supervisor Carter contacted us and said that they wanted you a better job of that. At least the money at the county's money is going to health programs and not going to potholes or crazy, I do want tobacco money to fix potholes. I want to help kids and people who smoke.
MAUREEN CAVANAUGH: A lot of people who do smoke five that with this money they would be able to go in and have free programs to help. Smoking and free nicotine hatches or free packaging, or all the stuff that would be paid for by the kind of settlement and that isn't there.
DEBRA KELLEY: I will say that California smokers helpline actually is free and -
MAUREEN CAVANAUGH: But it's counseling and not physical help.
DEBRA KELLEY: I have to say that the 5% of people who smoke are interested going to group programs that are in there are number of crew programs but I think you're right, there is very little access to nicotine replacement therapy and drones that can help people, help them deal with the withdrawal possible process from nicotine, we could be a doing a lot more than we know that even a lot of doctors have doctors have counseled patience where to quit smoking and this they don't know where to her for people even though this program has existed for fifteen years. There are ten of additional things we can beginning with this money to help every smoker.
MAUREEN CAVANAUGH: If there's anything else that could be done, a new program that could be started but would you like to see and how would you like to see this money use?
DEBRA KELLEY: I guess that would divide it up. I think they need to educate and do a better job of educating parents and elected officials about what the threats are and do a better job of protecting non-smokers in their apartments with a work and do a better job of reporting people about some of the products. The second hand smoke and kids and E cigarettes and people have no idea what is happening with us. We do need to help people quit smoking. There's a lot more that could be done there. We need to provide more assistance.
MAUREEN CAVANAUGH: I have been speaking with Deborah Kelley with the American Lung Association, thank you very much.