If you smoke and itch to quit, don’t look to the state for help. Despite an annual infusion of about $300 million from the landmark tobacco settlement, Illinois continues to spend less than most others on programs designed to prevent people from lighting up, according to a national ranking.
Illinois finished 41st out of the 50 states in the percentage of settlement money funneled into prevention and stop-smoking programs during the current fiscal year, the nonprofit Campaign for Tobacco-Free Kids recently reported. Tennessee was at the bottom, North Dakota at the top.
The Land of Lincoln’s lowly status was lamented by public health officials and some politicians, who describe a lost opportunity to use the pot of money to help cut the smoking rate.
“That money was supposed to help take care of the problems the industry had caused in all the states,” said Kathy Drea, vice president of advocacy for the American Lung Association in Illinois.
In 2002, $46 million from the settlement was earmarked for prevention and cessation programs, according to state budget figures. In 2004, it had dropped to $12 million. In the current fiscal year, it will be $9.7 million, a fraction of what the U.S. Centers for Disease Control and Prevention recommends. In its own state-by-state ranking, the agency recommended that Illinois spend $157 million on such programs.
By comparison, tobacco companies blanket the state with about $452 million in marketing and advertising annually, according to the Campaign for Tobacco-Free Kids.
The rate of smokers in the state’s adult population dipped only a percentage point in the last decade, from 22 percent in 2000 to 21 percent today, according to the CDC.
The money from the settlement is an easy, even a necessary target during an ongoing budget crisis, some lawmakers admitted. Under the 1998 agreement, tobacco companies were required to give billions to the states over 25 years.
“Legislators just use it to fill the budget gaps,” said Craig Johnson, mayor of Elk Grove Village. “It’s become just another source of revenue.”
Frustrated by the state’s dwindling support for programs to reduce smoking, Johnson took tobacco prevention into his own hands, sponsoring a 2006 ordinance that added a $1,000 annual fee for all village merchants with a tobacco license. It also specified that all proceeds — about $30,000 annually — go toward prevention and cessation programs for village residents.
Similar efforts exist in other municipalities. Cook County uses a portion of its tobacco tax on the Healthy Lungs Initiative, aimed at providing cessation counseling and quit programs to smokers.
But the patchwork of locally funded programs doesn’t substitute for a comprehensive statewide approach, Johnson said.
“If the state was doing its job, we wouldn’t have to be doing any of this,” he said.
The settlement agreement doesn’t specify where the funds go but recommends “significant funding” for public health causes related to smoking.
From the start, state lawmakers have taken advantage of that wiggle room. In 2000, most of the settlement in Illinois was spent on election-year property-tax rebate checks of up to $300; Illinois was one of just two states to use the funds for tax relief. Over time, funding for prevention and cessation has continued to dwindle.
State Sen. Jeff Schoenberg, D-Evanston, said that in the early years of the settlement, much of the money was diverted to pay for general government operations. After he and other legislators objected, he said, the bulk of the fund was reserved for health programs.
Today, most of the money helps pay for the state’s Medicaid program, which provides health care to low-income people, Schoenberg said. It’s a good use of the money, he said, because every dollar spent on the program brings in matching funds from the federal government.
“I’m sympathetic to the desire by the advocates to have more resources for tobacco-cessation programs,” he said. “But we’re dealing with an unprecedented budget crisis and need every available dollar to leverage that additional federal support to pay our health care costs.”
The money that does fund prevention and cessation efforts goes toward the state’s “quit line” telephone counseling service and to the state’s health department, which distributes the funds to local health departments via grants.
In Cook County, the Public Health Department receives about $750,000 a year from the settlement funds, about half what it received in 2001, said Gina Massuda Barnett, director of chronic disease prevention. The department has gone from 11 staffers dedicated to prevention and cessation to four, she said.
“It’s very challenging to take a comprehensive approach to prevention and control,” she said, noting that the four staffers serve more than 125 suburbs.
A successful cessation program encompasses a variety of approaches, she said, including education, counseling both in person and online, stop-smoking medications, support groups and marketing campaigns. She noted that the cadre of remaining smokers has persisted in their habit despite a decade of sharply higher taxes, severe limits on where they can light up and other restrictions.
“They’re the most difficult to get quit,” she said.
State Rep. Sara Feigenholtz, D-ChicagoChicago reviews
, knows the holdout smokers very well — she was one. After 30 years of smoking, she finally took her last puff Dec. 14, 2007, after multiple failed attempts to stop. Strict adherence to a quit-smoking medication and online counseling got her over the hump.
“It was an amazing experience,” she said.
Feigenholtz said she advocated the Legislature use the tobacco settlement funds for a comprehensive prevention and cessation program from the start, but now, with the state facing a potential $12.8 billion deficit by the end of the next budget year, the settlement funds may get raided further.
“We all know the prevention and cessation programs are tremendously valuable,” she said, “but in these times prevention of any kind becomes a luxury item.”
Georgia Garvey and John Keilman contributed to this report.
–Dan Simmons
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