Lessons from tobacco prevention (part 2): dedicated funds diverted to general fund

As our state starts implementing I-1183 (privatization of liquor sales and further deregulation of liquor and wine) and considers changing laws regarding illegal drugs, with proponents stating that tax revenue generated from these changes will fund prevention and other social services, it is interesting to consider lessons learned from similar promises made regarding tobacco prevention. 

From the Campaign for Tobacco-Free Kids:

Historically, Washington funded tobacco prevention largely through the Tobacco Prevention and Control Account, which included a portion of the revenue raised by a 2001 voter-approved 60-cent per pack cigarette tax increase. The ballot initiative dedicated the new revenue to the state’s Basic Health Plan, to tobacco prevention and cessation, and other existing programs that were already funded with tobacco tax revenue. The initiative required the state to spend at least $26.24 million a year on tobacco prevention and cessation beginning July 1, 2002. In the 2009 legislative session, the Washington State Legislature changed this law and diverted tobacco tax money to the general fund. After June 30, 2011, the Tobacco Prevention and Control Account had no remaining funds to sustain the program.

In FY2012, the state’s tobacco prevention program was essentially eliminated as the state will spend only $750,000 on tobacco prevention efforts.

As a result of the dramatic funding cut, Washington will no longer fund anti-tobacco media campaigns or local tobacco prevention and cessation programs in schools or through local governments or community organizations.

Washington is spending almost nothing on tobacco prevention despite the fact that the state is receiving more tobacco-generated revenue than ever before as a result of a $1.00 per pack cigarette tax increase, to $3.025 per pack, and increases in the tax rates on other tobacco products effective May 2010.

Lessons from tobacco prevention: well-funded programs work

According to a story I heard on the radio yesterday: States will rake in over $25 billion this year from tobacco taxes and tobacco settlement money.  However, less and less of that money will go toward prevention activities. 

One lesson we have learned from tobacco settlement dollars and tax revenue that have gone to fund tobacco prevention programs is that, when well-funded and comprehensive, prevention works.

Washington's success
Our state has had much success in preventing tobacco use among youth when our prevention programs were well funded.  In a report from the Campaign for Tobacco-Free Kids:

The Washington State Tobacco Prevention and Control program was implemented in 1999 after the state Legislature set aside money from the Master Settlement Agreement to create a Tobacco Prevention and Control Account.  Tobacco prevention and control received additional funds in 2011 when the state's voters passed a cigarette tax that dedicated a portion of the new revenue to tobacco prevention and cessation.

• Since the tobacco control program was implemented, Washington has reduced the adult smoking rate by one-third, from 22.4 percent in 1999 to 15.2 percent in 2010.  Washington's tobacco prevention efforts have also reduce youth smoking rates in half, saving additional lives and dollars. 

An earlier study in the CDC's peer-reviewed journal, Preventing Chronic Disease, found that although Washington made progress in implementing tobacco control policies between 1990 and 2000, smoking prevalence did not decline significantly until after substantial investment was made in the state's comprehensive tobacco control program. 

The following chart, from the Washington State Department of Health's most recent tobacco prevention progress report, shows the decline in youth smoking rates since 1999.  The chart indicates that while our state has seen a significant reduction in use rates, progress has stalled since funding for prevention has been reduced.

What does an effective prevention program include?
The U.S. Centers for Disease Control and Prevention has established Best Practices that recommend key elements of tobacco prevention and cessation programs.

Key elements include:

• Hard-hitting education and media campaigns;
• Community and school-based programs;
• Effective enforcement of laws prohibiting tobacco sales to minors;
• Affordable, accessible assistance for smokers trying to quit;
• Rigorous evaluation to ensure these programs are delivering results.

While these reports focus on tobacco prevention, the lessons learned may be applied to all youth substance abuse prevention programs.

Losing funding for school-based drug/alcohol counselors

As education and health and human services budgets are cut, many school districts are losing funding for their drug and alcohol counselors (Prevention-Intervention Specialists). Seattle Public Schools has been struggling with this issue for several years. Here is an article about how Anacortes is struggling with the issue.