Isles get D for spending on tobacco

The state got low marks for falling short of spending guideline set by the feds

The American Lung Association gave Hawaii a low mark for its investment in tobacco prevention programs in a report released today.

The state got a D grade for falling short of the spending guideline set by the federal Centers for Disease Control and Prevention.

DROPPING GRADES The American Lung Association gave Hawaii these grades for anti-smoking efforts: Tobacco prevention and control spending D Smoke-free air B Cigarette tax B Youth access C

The annual report card from the national association also gave the state B grades for its relatively high tobacco tax and for laws providing for smoke-free workplaces, schools and retail environments.

Too many youths are still able to purchase cigarettes here, earning the state a C grade in a youth access category, said Sterling Yee, president of the American Lung Association of Hawaii.

The total state spending for prevention and control of tobacco in the current fiscal year will be about $6.8 million, while the Centers for Disease Control and Prevention calculated that the "best practices minimum spending" should be about $10.8 million.

According to the federal centers' calculations, smoking and secondhand smoke cost the state $553 million annually in health-care costs and lost worker productivity.

Yee said the amount the state is paying to curtail smoking "is not acceptable and threatens the good health of Hawaii's citizens. Both the administration and the Legislature should be doing more to fund tobacco programs. Despite growing evidence that tobacco prevention programs are effective and save lives, Hawaii is falling short of its potential to fund those programs," he said.

Smoking bans set by all four counties in recent years were not taken into account in the national survey, which only measures state laws. Hawaii fell short of the A grade given to nine other states for smoke-free environments because "it could be doing more to protect its citizens from the dangers of secondhand smoke," the report said. For example, a 1978 state law intended to curtail smoking in government workplaces allows for a smoking zone within the same premises as a no-smoking area. Smoking is not restricted in free-standing bars and some other private-sector workplaces.

Hawaii came in at 11th highest for its $1.40 tax per pack of cigarettes, one of 20 states and territories with tax rates over $1. But by CDC standards, it would take a $2 tax to get an A.

Yee said the state's high asthma rate is just one reason that curtailing smoking and exposure to secondhand smoke is imperative.

"There is increasing indication that tobacco remains the biggest preventable cause of death and disease in Hawaii and in the United States," said Bertrand Kobayashi, American Lung Association of Hawaii director of advocacy and partnerships.

Government and private agencies receive money to fund tobacco prevention programs from a settlement awarded in a 1998 lawsuit against tobacco companies to recoup costs in caring for sick smokers. Hawaii won a $1.3 billion settlement spread over 25 years after joining 45 other states in the lawsuit.

The 1999 Legislature established the Hawaii Tobacco Prevention and Control Trust Fund, allocating 60 percent of scheduled payments from the master settlement agreement to public health efforts. The Department of Health gets 35 percent for the Children's Health Insurance Program and other health-related activities, and 40 percent goes into a state "rainy day" emergency and budget reserve fund.

The trust fund, administered by the Hawaii Community Foundation, receives 25 percent of the settlement agreement. Kobayashi said some of each year's amount goes to build up the endowment, and the rest is dispensed to programs of dozens of other nonprofit agencies, such as community health centers.

Hawaii was mistakenly given an A grade on last year's report card, based on incorrect information provided to the national association, Kobayashi said. The total amount going into the trust fund was used, rather than the amount actually being spent on prevention as reported this year.