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Tennessee last in preventing tobacco use

Leigh Ann Laube • Dec 30, 2009 at 12:00 AM

Tennessee ranks last in the nation in funding programs to prevent kids from smoking and help smokers quit, according to a national report released earlier this month by a coalition of public health organizations.

Tennessee’s ranking fell from 40th a year ago after cutting state funding for its tobacco prevention program by 96 percent.

“We are still out there doing school presentations and won't let lack of funding stop our efforts, but it was certainly easier to do our job with a little extra money,” said Delores Bertuso, chairperson of Nicotine-Free Mountain Empire, a volunteer organization under the auspices of Kingsport Tomorrow that is committed to reducing youth tobacco use in this region.

Tennessee this year is spending $1.5 million a year on tobacco prevention and cessation programs, including $200,000 in state funds and a $1.3 million federal grant. This total is just 2.1 percent of the $71.7 million recommended by the U.S. Centers for Disease Control and Prevention (CDC). Last year, Tennessee ranked 40th, spending $6.1 million on tobacco prevention ($5 million in state funds and $1.1 million in federal funds).

The annual report on states’ funding of tobacco prevention programs, titled “A Broken Promise to Our Children: The 1998 State Tobacco Settlement 11 Years Later,” was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society, Cancer Action Network, American Lung Association and the Robert Wood Johnson Foundation.

The Sullivan County Regional Health Department’s Tobacco Use Prevention Program has been untouched by funding cutbacks.

“My program at the health department is still funded, but the funding that the Kingsport Tomorrow group was receiving from the state was cut out. That’s unfortunate because that group is so instrumental in doing so much good for the community,” said Kristin Harmon, program coordinator. “It’s unfortunate. In our area, traditionally we have had one of the highest rates of youth smoking. At one time, one out of every two students in Sullivan County had smoked in the last 30 days. With rates that are that high, we’ve got to do something. We’ve got to keep working.”

Starting in 2007, the state of Tennessee took some important steps to reduce tobacco use, including allocating funding for tobacco prevention, increasing the state cigarette tax and passing a law requiring that some workplaces be smoke-free.

“In recent years, Tennessee has made progress in the fight against tobacco, but unfortunately the state has taken a giant step backward this year,” said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids. “To reduce tobacco’s devastating toll in lives and dollars, Tennessee must increase funding for tobacco prevention. Even in these difficult budget times, tobacco prevention is a smart investment that reduces smoking, saves lives and saves money by reducing tobacco-related health care costs.”

The Tennessee Non-Smokers Protection Act of 2007 banned smoking in enclosed places. Tennessee, among the leaders in tobacco production, also tripled its tobacco tax. Eleven years after the 1998 state tobacco settlement, the new report finds that states this year are collecting record amounts of revenue from the tobacco industry, but are spending less of it on tobacco prevention.

“I think each individual state has kind of looked at their tobacco funding money and spent it in some interesting ways,” Bertuso said. “Some of it in Tennessee is going toward treatment, which is great, but it would sure be nice not to have to treat people because they didn’t get started smoking in the first place.”

When Nicotine-Free Mountain Empire was founded in 1992 (as the Kingsport Youth Tobacco Prevention Project), it had little in the way of funding.

“We’ve always relied on what we could get, where we could get it,” Bertuso said. “We started out with some money from the Physicians’ Wives Auxiliary — it’s not called that anymore — but we just kind of functioned on whatever happened to be available.”

The report also found that in the past year:

• Tennessee has cut state funding for tobacco prevention by 96 percent, from $5 million to $200,000.

• Tennessee’s total spending on tobacco prevention amounts to just 0.3 percent of the $445 million it will receive this year from the 1998 tobacco settlement and tobacco taxes.

• Tobacco companies spend $405.5 million a year to market their products in Tennessee, which is 274 times what the state spends on tobacco prevention.

The report found that only one state — North Dakota — funds a tobacco prevention program at the CDC-recommended level. Only nine other states fund prevention programs at even half the CDC-recommended amount, while 31 states and the District of Columbia are providing less than a quarter of the recommended funding.

In Tennessee, 25.5 percent of high school students smoke, and 7,100 more kids become regular smokers every year. Each year, tobacco claims 9,700 lives and costs the state $2.2 billion in health care bills.

The Northeast Tennessee region, which includes Carter, Greene, Hawkins, Hancock, Johnson, Unicoi, Washington and Sullivan counties, has the highest rates of current tobacco use in the state among middle school students (32.7 percent) and high school students (51.1 percent), respectively. Additionally, Northeast Tennessee has the highest rate of current middle school smoking (23.6 percent), while Sullivan County has the highest rate of current high school smoking in the state (41.1 percent).

The numbers are disheartening to the volunteers with Nicotine-Free Mountain Empire, but their work is worth it if they can affect one young person.

“Those of us who go to the schools and talk to the students, if one kid understands this is something they shouldn’t do, or if the light comes on and they say, ‘I’m going to go home and talk to Papaw and that’s what I want for Christmas (is for him to quit smoking),’ if we can get the message across to some of those kids, then it’s worth it.”

Harmon said it’s important to not get bogged down in the fact that state funding dollars are gone.

“If we’ve kept one kid from smoking, it’s been worth it. We’ve just got to stay at it. The problem with any health education program ... is it’s very hard to see a lot of short-term results. It typically takes years to see the fruits of our labor.”

Tobacco use is the leading preventable cause of death in the U.S., killing more than 400,000 people and costing $96 billion in health care bills each year. Every day, another 1,000 kids become regular smokers — and a third of them will die prematurely as a result.

More information, including the full report and state-specific information, can be obtained at www.tobaccofreekids.org/reports/settlements.

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