Monday, November 19, 2001


UH school wins
out over Lanai fluoride

46 state lawmakers write a letter
making their case for how
to use tobacco money

By Helen Altonn

State legislators apparently believe funding a medical school is a healthier use of tobacco settlement funds than fluoridating Lanai's drinking water to prevent tooth decay, according to their recent actions.

The Legislature approved $150 million from the tobacco funds for the University of Hawaii's planned medical school complex at Kakaako. But 46 of the 76 state lawmakers do not feel the fund should be used to support fluoridation.

In a letter to state Health Director Bruce Anderson, they wrote: "We believe that those moneys would be better spent on compensating dentists who serve children on Lanai or to implement a dental sealant program in the schools."

They said the law governing use of tobacco settlement money appropriated to the Health Department "was not intended to include fluoridation of water supplies for 'health promotion and disease prevention programs' or 'prevention oriented public health programs.'"

Of Hawaii's $1.3 billion share of the national tobacco settlement, 35 percent of the money is earmarked to the Health Department for the Children's Health Insurance Program and other health-related activities.

Health officials announced in August they would use tobacco settlement funds to help Lanai fluoridate its water system, costing $100,000 for installation and chemicals.

"As the only recourse for the Legislature," the Oct. 23 letter said, "if the Department of Health persists with fluoridation of Lanai's water supply, there could be legislation proposed in the next session to exempt fluoridation from the permissible uses of tobacco settlement moneys."

In response, Anderson said he told legislators no tobacco settlement funds or state general funds are being used for the Lanai fluoridation program.

"We will support the community initiative on Lanai with federal funds if the community continues to support the effort," Anderson said.

"Obviously, we think it's an appropriate initiative given the high rate of tooth decay on Lanai. It has the highest rate of tooth decay of any place in the state, and Hawaii has the highest rate of tooth decay in the country.

"It would be a great place to demonstrate the effectiveness of fluoridation."

Opponents argue that fluoridation is dangerous and they have criticized use of state money for Lanai's system.

Anderson counters that the initiative has broad-based support on Lanai, adding that most anti-fluoridation activists are from other islands.

Sen. Jan Yagi Buen (D, North and West Maui-Molokai-Lanai), heads the list of signatures on the letter to Anderson, followed by Sen. Suzanne Chun Oakland (D, Alewa Heights-Kalihi-Liliha-Nuuanu-Palama-Puunui).

Buen said she would not sign the first draft of the letter which was "opposing fluoridation, period," because such decisions should be left to communities. But legislators want the tobacco settlement money used to stop smoking, especially among teenagers, she said.

Asked how using the tobacco fund to build a medical school will curb smoking, Buen said UH President Evan Dobelle and Medical School Dean Edwin Cadman told legislators the money will help cancer research.

"I had a lot of hesitation," she said. "I was one who had objections. I questioned that quite a bit. We are certainly going to monitor that and just make sure they do that.

"They made me believe they are going to help all those people dying of cancer and getting illness from tobacco problems. It's really going to hurt them ... if they don't follow through."

Among lawmakers who did not sign the letter to Anderson was House Health Committee Chairman Dennis Arakaki (D, Kamehameha Heights-Kalihi Valley).

"I think when it comes to fluoridation, considering Lanai has one of the worst cavity rates in the state and Hawaii has one of the worst rates in the country, it is very appropriate to use tobacco moneys for that," Arakaki said. "I think we will be able to show direct correlation from use of that money for health."

Hawaii has been praised as one of few states spending tobacco settlement funds responsibly -- to discourage smoking and encourage healthier lifestyles.

However, legislative approval to use the funds to help build the medical school "opened the floodgates for what it could be used for," Arakaki said.

Ka Leo O Hawaii
University of Hawaii

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