Report: States short-changing tobacco prevention for kids
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* Sophia Meador

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/54/2/7.2/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/54/2/7.2/F1)

Income from taxes and court settlements should be used to keep youth from using tobacco.

Photo courtesy Ruizluquepaz, iStockphoto

Most states continue to under-fund programs to prevent tobacco use among children, despite receiving billions of dollars annually that could be used for that purpose, a new report finds.

Released in January, the report from Campaign for Tobacco-Free Kids, American Cancer Society Cancer Action Network and other health groups examines how much states spend on tobacco prevention for kids. It then compares those amounts to funding recommendations from the Centers for Disease Control and Prevention, finding wide variations between states.

Maine is the only state fully funding tobacco prevention and cessation programs at levels recommended by CDC, which is 22% of the revenue generated from tobacco revenue and legal settlements. In 2023, Maine spent $15.9 million on tobacco prevention, according to the report.

Eight more states — Alaska, California, Delaware, Hawaii, North Dakota, Oklahoma, Oregon and Utah — spent at least half of the CDC’s recommended funding for prevention, while 31 states and the District of Columbia allocated less than a quarter.

Other states fared even worse. In 2023, Alabama had a state revenue from the tobacco industry of over $275 million, the report said. Based on that total, CDC recommends Alabama spend $60 million a year on tobacco prevention, but the state only spent $1.7 million on prevention last year. Alabama’s health care costs related to smoking topped $2 billion in 2023.

“States have long short-changed tobacco prevention programs, and that’s a not a wise decision, not only for the health of state residents, but also economically,” Meg Riordan, director of policy research at the Campaign for Tobacco-Free Kids, told *The Nation’s Health.* “Tobacco use is a huge economic drain for states, given the high costs of smoking-related health care costs.”

Since a landmark multi-state legal settlement was reached in 1998, major tobacco companies have paid out a total of $250 billion to state governments. States also collect billions of dollars in excise taxes from tobacco companies. In fiscal year 2024 alone, states are expected to collect $25.9 billion in tobacco settlements and taxes, the report said.

On top of that, most states and some cities will receive part of a $1 billion legal settlement involving Juul, an e-cigarette maker, for its marketing to adolescents.

Tobacco monies could go toward tobacco prevention and cessation efforts to undo the harm of tobacco use, particularly for youth, the report said. Yet on average states spend less than 3% of collected revenue on prevention.

At the same time, tobacco companies are spending generously on marketing campaigns, Riordan said. For every $1 states spend at tobacco prevention, tobacco companies spend $12 to market tobacco products. She called on policymakers to support more funding and legislation for prevention and cessation programs.

“We have the evidence, we have the solution,” Riordan said. “Comprehensive programs work, tobacco taxes work, eliminating flavored products are proven solutions where they’ve been implemented.”

For more information on “Broken Promises to Our Children: A State-by-State Look at the 1998 Tobacco Settlement, 25 Years Later,” visit [www.tobaccofreekids.org](http://www.tobaccofreekids.org).

*   Copyright The Nation’s Health, American Public Health Association