As legislators are faced with steep budget shortfalls and a looming war, they are looking to help balance the state budget with what is becoming a more and more tempting revenue source -- Hawaii's Tobacco Settlement Special Fund. Bills are currently being considered that would reduce the amount of money available for tobacco prevention and cessation programs. But in the long run, cutting funding for tobacco prevention and control programs will cost the state more -- in both lives and money.
Dont raid Hawaiis
Together with 46 other states, Hawaii fought hard against the big tobacco companies to win the $1.2 billion settlement. The primary purpose of the joint lawsuit was to recover part of the past, present and future health-care costs for tobacco-related illnesses that were being paid by taxpayers. Although the settlement does not place any restrictions on how the money can be spent, many states, including Hawaii, initially intended to use much of it for tobacco prevention and cessation. The failure to do so would ensure that Hawaii taxpayers will continue to subsidize tobacco-industry profits by paying for the health damages caused by its products.
In 2001, the amount of the settlement funds specifically allocated for tobacco prevention and control was reduced by half, from 25 percent of the settlement to 12.5 percent (approximately $5 million a year). The trust fund cannot sustain any more reductions if it is to support effective statewide programs.
According to the Centers for Disease Control and Prevention, an effective statewide comprehensive tobacco-control program in Hawaii will cost between $11 million and $24 million a year. In 2003, Hawaii has allocated approximately $9 million.
The statistics regarding tobacco use in Hawaii are staggering and well documented. Cigarette smoking is the single most preventable cause of death in Hawaii, and is responsible for more than 1,100 deaths here each year. Equally alarming, the percentage of young adults in our state who smoke is increasing. Tobacco use also costs our state more than $328 million in health-care and other associated costs annually. In short, tobacco use in Hawaii is a serious threat to our health and our economy.
A proven effective way to address both health and economic concerns is through well-funded, comprehensive tobacco prevention and control programs. Studies have shown that California and Massachusetts, which started their programs in 1990 and 1993 respectively, now save as much as $3 in health-care costs for every dollar spent on tobacco prevention. In order to save taxpayers' money in health-care costs, states must spend adequate amounts on prevention and education.
Evidence from Florida and California has shown that when funding for comprehensive tobacco prevention programs is cut, smoking rates rise. This should serve as a warning to other states.
Such programs must be adequately funded and sustained because they are fighting the tobacco companies' multibillion-dollar advertising and marketing campaign, which are designed to make smoking seem harmless and give impressionable young people the message that smoking is cool. The tobacco industry is estimated to spend $41.5 million a year in Hawaii alone to promote its deadly product.
Many of the measures being considered by the Legislature are important. But it is not appropriate to reduce the funds going to the tobacco prevention and control trust fund to pay for other programs. Too much work has been done and too many lives are at stake.
In these tough economic times and with less money to go around, we understand Hawaii must establish priorities and invest in programs that will provide the greatest return on our investment. In the effort to protect both the health of Hawaii's people and our economy, we believe a comprehensive, statewide tobacco prevention program is crucial.
Jay Maddock is chairman of the Coalition for a Tobacco Free Hawaii. He is an assistant professor in the Department of Public Health Sciences and Epidemiology at the University of Hawaii John A. Burns School of Medicine.
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