Fighting tobacco use, state at No. 7

Spending ranked for suit-won cash

WASHINGTON - Alberta Faye Hires smoked for 37 years before she quit, using a 12-week cessation program paid for with the proceeds from a 13-year-old agreement resolving a lawsuit by states against tobacco companies.

On Oct. 21, 2008, the Maumelle, Ark., resident called the state’s quitting help line. Along with being offered nicotine patches to help replace cigarettes, Hires said, she spoke with counselors and used a computer program designed to motivate people to overcome the addiction.

“It helped tremendously, just the support that you get from them. If you have a weak moment, you know you can pick up the phone and call a counselor,” Hires said. “It’s a hard thing to do on your own. I still have their number in my phone. I could call them if I needed to.”

Since she quit, Hires, 57, has run two full marathons and 13 half-marathons, and in March she plans to run the Little Rock Marathon.

“I can honestly tell you that had it not been for the program helping me get through what I got through, after 37 years of addiction, I couldn’t see those medals on my wall,” Hires said.

Hires isn’t alone in her praise.

A report released this month by a coalition of public-health groups, including the American Cancer Society, the American Heart Association and the American Lung Association, ranked Arkansas seventh in the country for spending on cessation and prevention programs.

The report, titled “Broken Promises to Our Children: The 1998 State Tobacco Settlement Fifteen Years Later,” analyzes how states spend the millions of dollars they receive from tobacco companies each year compared with what the federal Centers for Disease Control and Prevention recommends they spend.

The landmark November 1998 tobacco-settlement agreement involved major tobacco companies, 46 states and five U.S. territories. Attorneys general from those areas went after tobacco companies with unprecedented coordination and zeal, in part for marketing tobacco products to youths.

Tobacco companies make annual payments nationwide. Overall, they’ve paid an estimated $246 billion.

How much Arkansas receives from the settlement fluctuates each year on the basis of tobacco companies’ revenue. In 2013, the state received $75.5 million, according to the Arkansas Tobacco Settlement Commission. Most years the amount is between $50 million and $60 million. Since 2001, Arkansas has received about $797 million.

How the state spends the money was laid out in an initiated act approved by 64percent of voters in 2000. Gov. Mike Huckabee and a group of the state’s leading health-care interests, called the Coalition for a Healthy Arkansas Today, asked voters to approve its spending plan after the Legislature initially failed to approve a plan.

The act spreads tobacco-settlement funds across several programs not directly related to tobacco or smoking, such as medical care for old people, members of minority groups, and rural communities; expanded Medicaid access for pregnant women, the elderly and people with low incomes; and bond payments for new medical facilities. Each program gets a percentage of the annual settlement payment.

This fiscal year the state will spend $17.5 million on cessation and prevention, less than half of the $36.4 million the Centers for Disease Control and Prevention recommends the state spend, according to the report.

Nationwide the majority of states consistently spend less than the recommended funding levels set by the CDC for programs to prevent tobacco use, according to the report.

The $481.2 million budgeted this year by the states for prevention equals just 13 percent of the $3.7 billion the CDC recommends for all states combined.

Only Alaska and North Dakota are funding tobacco prevention and cessation programs at the level recommended by the CDC. Delaware, Hawaii, Oklahoma and Wyoming provide half the funding CDC recommends. New Jersey is the only state with no state funds allocated for tobacco-cessation programs this year.

Although Arkansas is spending closer to the recommended CDC level than most states, Arkansas health experts say there is still a lot of work to do.

About 25 percent of adult Arkansans smoke, down from 30 percent in 2000, according to the report. Nationally, about 18 percent of Americans smoked in 2012, according to the report.

“If you just look at it on the surface, it doesn’t seem like we’ve done a lot,” said Jason Brady, the American Cancer Society’s Arkansas spokesman. “It’s harder to get adults to stop smoking.”

Brady said Arkansas chose to focus on keeping children from using tobacco.

According to the Arkansas Department of Health, 18percent of teenagers smoked in 2011, down from 43.2 percent in 1997. Nationally, about 18 percent of teenagers smoke.

To reduce the number of adult tobacco users and keep more children from picking up the habit requires more money, said Barbara Kumpe, the American Heart Association’s state advocacy director.

Still, she said she doesn’t expect to see the percentages set in the initiated act changed. If lawmakers intervened, she said, she would be worried about what changes they might make to where the money goes.

“We’re fortunate to have as much as we do,” Kumpe said. “There’s always a need for more money.” But “you can always lose ground.”

Brady, with the Cancer Society, said there is only so much headway the state can make with the resources it has. Tobacco companies spend $6.10 marketing their products in the state for every dollar Arkansas puts toward prevention and cessation, according to the report.

“The tobacco industry has not sat on their hands,” he said. “It’s almost like spitting into the wind, yet we’ve been successful in many regards.”

Dr. Gary Wheeler, the medical director for the Health Department’s Tobacco Prevention and Cessation Program, said the slow drop in the number of adult smokers doesn’t surprise him.

“We’re getting outspent. If this was a political campaign and we were electing candidates, who do you think would win?” he said.

Still, the state has learned a lot about what a cessation program needs to do to persuade tobacco users to quit, he said.

“We are making progress, it is slower than we want, and we want to accelerate that,” Wheeler said. “We are now armed with information and knowledge that we didn’t have when we started this, and I think we’re wiser.”

Front Section, Pages 1 on 12/26/2013

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