Squandering the Chance to Stop Tobacco Epidemic in Texas

By Joel Dunnington, MD
Professor of Radiology, The University of Texas MD Anderson Cancer Center
Vice President, Harris County Medical Society

Dr. Dunnington comments on a new report that found U.S. state funding for tobacco cessation and prevention is at its lowest level in more than a decade. Texas ranks 39th.

Tobacco is the No. 1 preventable cause of death in the Texas and the United States; 24,500 Texans will die from tobacco-caused diseases this year. More than 300,000 Texas high school students smoke and 29,000 Texas children start smoking every year. Children in Texas purchase an estimated 73.4 million packs of cigarettes a year. More than 500,000 Texas children currently under the age of 18 will die from their smoking.

In 1998, Texas signed a landmark legal settlement with major tobacco companies following a lawsuit filed in 1996. As a result, Texas will receive around $14.1 billion over 25 years. The state of Texas also collects taxes on tobacco. So in FY 2012 (Sept. 1, 2011-Sept. 30, 2012), the state collected about $1.9 billion total in settlement payments and tobacco taxes combined. During this same period, the tobacco industry spent approximately $665 million marketing in Texas, to get more children and adults to smoke.

Meanwhile, lawmakers only allocated $5.5 million for tobacco prevention for FY 2012. Overall, Texas’s spending on tobacco prevention amounts to 0.3 percent of the estimated tobacco-generated revenue the state collects each year from settlement payments and tobacco taxes. Only 11 other states spend less than Texas on controlling the No. 1 preventable cause of death — tobacco.

Texas is not just wasting a lot of its tobacco settlement money and tobacco tax receipts on anything but tobacco prevention. Over the years, the legislature has systematically stripped the Texas Department of State Health Services Tobacco Control Section to a bare minimum. The office decreased staff from four members to two this year. The regional tobacco control staff was cut in half from 14 to seven members. The legislature also stripped the Texas Comptroller’s Office of funding for the Texas STEP program for enforcement of laws against selling cigarettes to children. The funding for the Texas Quitline, which helps smokers quit smoking, also was cut.

In 2000-04, a pilot project in East Texas sought to find out what is needed to encourage grade schools children not to use tobacco. The pilot project spent $3 per person, as recommended by the Centers for Disease Control and Prevention. This program demonstrated that by using $3 per person, a comprehensive tobacco control and prevention program can make a difference. It demonstrated a significant 37-percent drop in grade 6-12 smokers and a 26-percent reduction in smoking in adults aged 18-22. Only a concerted effort throughout the state, with an expenditure of at least $3 per person on a comprehensive tobacco control program, can maintain these impressive numbers.

It is one thing to fight the efforts of the tobacco industry in recruiting replacement smokers for the 24,500 that die each year in Texas. It is an even larger problem to fight the legislature over the wasting of $1.9 billion in tobacco income each year. The only thing more addicting than nicotine, is nicotine money.