Gazette opinion: Tobacco prevention gains may go up in smoke

2011-06-29T00:00:00Z Gazette opinion: Tobacco prevention gains may go up in smoke The Billings Gazette
June 29, 2011 12:00 am

Last week 100 teens from across Montana converged on the Carroll College campus in Helena for the Sixth Annual reACT Teen Summit. There won’t be another gathering of teens involved in tobacco use prevention policy next year or the year after.

The teen leadership training will be cut back along with the rest of Montana’s Tobacco Use Prevention Program because the 2011 Legislature slashed its funding.

In the year ending Thursday, the Montana Department of Public Health and Human Services had a budget of $9.2 million. With the state appropriation cut by over $3 million for next year, the budget will be $5.6 million, according to Todd Harwell, chief of the Chronic Disease Prevention and Health Promotion Bureau in Helena.

If $9 million or even $5 million seems like a lot to spend on persuading youth not to use tobacco and helping users quit, consider:

Montana spends more than $277 million annually on tobacco-related health care costs.

Although only 17 percent of all Montana adults smoked in 2009, the number is higher for Medicaid enrollees. Thirty-eight percent of Medicaid enrollees ages 18 to 64 smoke.

Even more worrisome is the 32 percent of women covered by Medicaid who smoked during pregnancy, an activity that puts their babies at higher risk for expensive, lifelong health problems. About 40 percent of all Montana births are covered by Medicaid. That’s a lot of babies born to smoking moms.

The tobacco prevention program was cut despite demonstrated success. Bad as the effects of tobacco are now, they used to be much worse for Montana. In 2001, before the comprehensive program started, 28.5 percent of Montana youth surveyed said they had smoked cigarettes in the previous month. This spring’s survey found only 16.5 percent reporting they had smoked within the month.

An amazing 15,600 callers to the Montana Quit Line actually quit. Starting Friday, Quit Line medication benefits will be drastically reduced.

The Alliance for Health Montana, which includes the Montana chapters of the American Cancer Society and American Lung Association, Montana Public Health Association and 20 other Montana organizations, had recommended that the state cut back components of its comprehensive prevention program instead of eliminating any of them.

That’s what DPHHS has done. About half of the program money is put into grants to counties and tribes for community prevention programs. Those programs will see a 15 percent cut in their grants, Harwell said.

Cuts will be deeper in statewide programs, including Quit Line, and funding for the Office of Public Instruction to work with schools on enforcing minor tobacco laws. Marketing the tobacco-free message will be cut back, and the program staff of 10 full-time-equivalents is being pared to six.

“We will have to rethink how we do things,” Harwell said.

Unfortunately, the trends toward fewer smokers may reverse with deep reductions in the prevention program. Other states, notably Minnesota and Indiana, saw gains quickly stall or reverse when they slashed prevention programs several years ago, according to the Alliance for Healthy Montana.

The appropriation ax that fell on prevention didn’t free up money to pad the general fund or finance other government spending; the unused prevention dollars will sit in the prevention account.

The prevention program was mandated by voters in 2002 when they directed that 32 percent of tobacco lawsuit settlement money go into a special fund to help reduce tobacco use in Montana. Most readers will recall that the reason for Montana and other states to sue tobacco companies was to recover some of their Medicaid costs of treating smoking-related illnesses.

The legislative majority also passed House Bill 633, which would have transferred millions of dollars that voters had designated for smoking prevention and children’s health care into the general fund. Gov. Brian Schweitzer used his veto pen to stop that raid on voter-approved funds.

Voters see the wisdom of prevention to keep Montanans healthier and to save the state money. So do the teens who met in Helena last week.

It’s a shame that the 2011 legislative majority was so unwise about the value of prevention.

Copyright 2014 The Billings Gazette. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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