More money needed for smoking prevention

One of the most effective ways South Carolina could improve the health of its residents would be to help them quit smoking or prevent them from taking up the habit in the first place. But the state spends almost no money to do that.

Anti-smoking groups are upset at the fact that, of the $68 million the state receives from the Tobacco Master Settlement Agreement, not a penny goes to smoking cessation or prevention programs. The anti-smoking groups plan to press the case with the Legislature for devoting more money to smoking prevention.

With the 1998 court settlement of an anti-smoking lawsuit against the tobacco industry filed by 46 states, including South Carolina, the industry agreed to pay the states more than $200 billion. South Carolina’s share of that money is projected to be $3.2 billion.

In 2001, rather than wait for the annual tobacco industry payments, the state chose to borrow $800 million against the settlement up front. But the state paid off that loan early and, last year, began receiving the tobacco settlement payments again.

Some of that money went for a program to market state crops other than tobacco, a telemedicine program at the Medical University of South Carolina and a child-support enforcement system. But nearly $58 million of the total went to the Medicaid program for the poor and disabled.

This year again, most of the money is slated to go to Medicaid, and no new money is budgeted for smoking cessation or prevention programs.

The state’s only anti-smoking program is its Quitline, a phone number that residents can call to get help to stop smoking. The state provides $5 million a year for the phone line.

The Quitline averaged between 500 and 1,500 calls a month in 2013. But in December, when the state Department of Health and Environmental Control launched an ad campaign to promote the program, calls jumped to more than 3,500 a month.

That demonstrates the public demand for advice and counseling on quitting, but anti-smoking activists say the demand will be hard to manage with only $5 million from the state. The Tobacco-Free Collaborative wants the state to spend an extra $8 million on the Quitline.

But the state needs to do more.

The American Lung Association consistently ranks South Carolina as among the worst states in the nation in smoking prevention efforts. Failure to invest in prevention programs or to pressure private insurers to cover smoking cessation figured prominently in the ranking.

The federal Centers for Disease Control and Prevention recommends that South Carolina spend between $35.5 million and $51 million a year on smoking cessation programs. While tobacco use is falling in the state – thanks in part to a long-overdue 50-cent increase in the state cigarette tax – the state needs to invest a lot more in prevention, especially targeting young people before they take up the habit.

It’s also worth noting that if the state had agreed to expand Medicaid under the Affordable Care Act, a substantial part of the tobacco-settlement money could have been used for cessation and prevention programs. An estimated 344,000 additional adults in South Carolina would have been covered by Medicaid, with the federal government paying 100 percent of the added cost for the first three years, and 90 percent thereafter.

If the state had expanded Medicaid coverage, instead of using tobacco-settlement payments to treat sick people, the money might have been used to help keep many of them from getting sick in the first place.

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