Broken Promises to Our Children

A State-by-State Look at the
1998 Tobacco Settlement 19 Years Later

Despite receiving over $27 billion from the tobacco settlement and tobacco taxes, the states continue to severely underfund tobacco prevention and cessation programs proven to save lives and money.

Since the states settled their lawsuits against the major tobacco companies in 1998, our annual reports have assessed whether the states are keeping their promise to use a significant portion of their settlement funds – estimated at $246 billion over the first 25 years – to attack the enormous public health problems caused by tobacco use in the United States.
Despite receiving huge sums from the settlement and collecting billions more in tobacco taxes, the states continue to shortchange tobacco prevention and cessation programs that we know save lives and money.
In the current budget year, Fiscal Year 2018, the states will collect $27.5 billion from the settlement and taxes. But they will spend less than 3 percent of it – $721.6 million – on programs to prevent kids from smoking and help smokers quit.
Meanwhile, tobacco companies spend $8.9 billion a year – $1 million dollars every hour – to market their deadly and addictive products. This means tobacco companies spend $12 to market their products for every $1 the states spend to reduce tobacco use.
This enormous gap undermines efforts to save lives and health care dollars by reducing tobacco use, the No. 1 cause of preventable death in the United States.

This report is issued by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Cancer Action Network, American Lung Association, Robert Wood Johnson Foundation, Americans for Nonsmokers’ Rights and Truth Initiative.

Other key findings include:

  • The $721.6 million the states have budgeted for tobacco prevention amounts to a small fraction of the $3.3 billion the Centers for Disease Control and Prevention (CDC) recommends for all states combined. Not a single state currently funds tobacco prevention programs at the level recommended by the CDC.

  • Only two states – California and Alaska – provide over 90 percent of the recommended CDC funding. Twenty-nine states and the District of Columbia are spending less than 20 percent of what the CDC recommends.

  • States with well-funded, sustained tobacco prevention programs continue to report 

  • significant progress. Florida, with one of the longest-running programs, reduced its high school smoking rate to 5.2 percent, one of the lowest ever reported by any state.

  • The United States has made great strides and reduced smoking to record lows – 15.1 percent among adults in 2015 and 8 percent among high school students in 2016. But tobacco use still kills more than 480,000 Americans and costs the nation about $170 billion in health care expenses each year.

    There are also large disparities in who still smokes and who suffers from tobacco-related diseases in the U.S. Smoking rates are especially high in a swath of 12 states in the Midwest and South, an area called “Tobacco Nation” in a recent Truth Initiative report. Nationwide, smoking rates are highest among people who live below the poverty level and have less education, American Indians/Alaska Natives, LGBT Americans, those who are uninsured or on Medicaid, and those with mental illness. These differences are in large part due to the tobacco industry’s targeting of vulnerable populations through advertising, price discounting and other marketing strategies.

    By fully implementing proven strategies, the states can reduce tobacco use among all Americans and make the next generation tobacco-free.