Iowa must stop using only a fraction of tobacco settlement dollars for prevention

We know that adequately funding evidence-based tobacco control programs is effective at preventing and reducing tobacco use. Iowa must finally use the MSA settlement funds for their intended purpose.

While tobacco use has been declining for decades, tobacco is the leading cause of preventable death and disease in Iowa, and 14.6% of adults in Iowa still smoke. Iowa has had mixed progress when it comes to making investments to prevent and reduce tobacco use. Despite receiving more than $256 million from tobacco Master Settlement Agreement (MSA) payments and tobacco taxes, the state spent just $4.2 million on tobacco prevention and quit smoking programs.

That’s why MSA funds are so critical to reducing the tobacco burden in Iowa. In 1998, 52 state and territory attorneys general reached the MSA with the four largest tobacco companies in the U.S. to settle state lawsuits brought to recover billions of dollars in health care costs associated with treating tobacco-related illness. One of the MSA’s main purposes was to reduce tobacco use in the U.S., especially among youth.

Last month, Attorney General Brenna Bird announced an additional $171 million in additional payments to Iowa from tobacco manufacturers over the next six years; however, due to state law, none of these funds will go to reducing the death and disease caused by tobacco in Iowa, despite smoking cigarettes causing an estimated $1.49 billion in health care costs each year.

The Centers for Disease Control and Prevention recommends the state of Iowa invests a minimum of $21.3 million to $30.1 million annually for a comprehensive tobacco control program. Iowa falls drastically short of this recommendation. At the height of the program’s funding in 2008, the Legislature appropriated $12.8 million, and, as a result, the state saw its most significant reduction in youth and adult tobacco consumption rates. Unfortunately, funding has been cut, and overall tobacco use among youth remains high.

At just 18% of CDC’s maximum funding recommendation, Iowa’s program lacks the comprehensive approach needed for meaningful impact to reduce the financial and human toll tobacco takes on our state.  According to the Campaign for Tobacco-Free Kids, Big Tobacco spends $106 million in marketing in Iowa each year to addict a new generation of smokers and keep adults using. That means we are outspent approximately $24 to $1 in our efforts to prevent kids from getting hooked and helping Iowans who want to quit.

We know that adequately funding evidence-based tobacco control programs is effective at preventing and reducing tobacco use. Iowa must finally use the MSA settlement funds for their intended purpose. We cannot afford to lose another generation to tobacco-caused addiction, disease and death due to poor investment in proven-effective public health programs.

Alicia Gerke, MD, MBA, is chair of the Iowa Local Leadership Board for the American Lung Association. Contact: alicia-gerke@uiowa.edu.