Ohio ranks last in the nation, tied with three other states, for least amount of state funding for tobacco prevention programs in an annual study released this week.
Meanwhile, one in four Ohio adults smoke, putting Ohio in the top 10 with states such as Mississippi and Kentucky. Local public health advocates say state funding — any amount — would be put to good use with outreach to youth and at-risk populations.
Ohio doesn’t come close to spending the $145 million on prevention recommended by the Centers for Disease Control and Prevention. For the third year in a row, Ohio does not plan to provide any state funding for efforts against tobacco use, relying on $3.3 million in federal grants and local health districts to tackle the problem.
The study by Tobacco Free Kids, the American Lung Association and other nonprofits shows a pattern of drops in state spending on tobacco cessation and education programs. State spending peaked at 749.7 million in 2002, one year after 46 states began receiving millions from Phillip Morris and other big tobacco companies as part of a settlement to end state lawsuits.
States will collect $25.7 billion from the tobacco settlement and tobacco taxes, the report says, and less than 15 percent of this revenue would fund prevention programs in every state at the CDC-recommended levels.
But Ohio has no tobacco settlement money to spend.
In 2008, the state opted to use the settlement money to patch expanding holes in the budget. Then-Gov. Ted Strickland shuttered the Ohio Tobacco Prevention Foundation, which operated prevention programs using settlement cash, and used its $230 million toward a jobs stimulus plan.
The state traded all future settlement payments — $18 billion over 40 years — in exchange for $5.5 billion to fill an expanding hole in the state budget. Money from the bond sale went to school construction and higher education and the funds for both were exhausted in June 2012.
Local public health districts were left to pick up the bill or end services.
Kettering Medical Center received a $1 million grant from the foundation to offer a free program that helped hundreds of Miami Valley residents quit smoking. The program provided nicotine patches, gum and other quit aids free of cost and boasted a 75 percent success rate, according to past news reports
Bruce Barcelo, the district healthy communities manager for the Dayton-Montgomery Public Health District, said quit rates are 50 percent higher with medical help but providers don’t have the money to include it.
“Really, you need both to have the biggest quit impact and right now there’s not the funding,” Barcelo said. “We do counseling, but they’re responsible for purchasing whatever type of quit aid.”
Montgomery County received $78,624 in state funding in 2004 and spent another $13,519 from the human services levy revenues toward tobacco prevention. This year, the county spent $113,000, all from the human services levy.
The Ohio Department of Health held onto about $40 million, of which only $1.5 million remains, according to department spokesperson Tessie Pollock. The $1.5 million funds the state telephone quit line, which Pollock said has been scaled back due to loss of funding and now covers only unemployed, uninsured or pregnant Ohioans.
Barcelo and others have suggested the state raise tobacco taxes, currently $1.25 per pack of 20 cigarettes and 17 percent of wholesale cost for other tobacco products.
Ohio still receives about $800 million each year from taxes on cigarettes, cigars and other tobacco products, according to the state Office of Budget and Management. Tobacco tax revenue goes to the General Revenue Fund, the state’s primary account that funds education, law enforcement and other public services.
Barcelo said raising the other tobacco tax to the same level as the cigarette tax would generate $50 million each year, and a small percentage could improve tobacco prevention statewide.
“We spend zero state dollars when there’s a constant flow of revenue from tobacco tax — it’s inexcusable,” Barcelo said.
Clark County Combined Health District used a prevention fund grant to employ two full-time staff members who visited every third- and fourth-grade classroom in Clark County. Anita Biles, a district health educator, said Ohio’s indoor smoking ban has helped reduce smoking, but it’s not enough to stop smoking.
“We have the enforcement piece, but when you take away the education and prevention piece, it just kind of leaves you empty,” Biles said.