New Jersey is in trouble. Like others in a fiscal pickle, the state has a projected $767 million shortfall over the next 13 months. So Gov. Chris Christie isn’t fooling around. His proposed nearly $30 billion budget includes deep cuts for schools, towns and property tax rebates. But more direct service cuts are going to be too hard to swallow, so he’s doing the next best thing: finding a few million here and there — deep in the weeds — to make up the shortfall. That includes zeroing out programs like New Jersey’s anti-smoking campaign, which got more than $7.5 million this year.
State health authorities say they will do their best to make use of federal money and other funding, but “we are very much hoping that we don’t lose much ground” in New Jersey’s fight against the nation’s most preventable cause of death, says Susan Walsh, the state’s deputy commissioner of health and senior services.
According to an April report from the Centers for Disease Control and Prevention, no state has met its recommended funding for tobacco control and prevention programs set in 2007, the latest available data. Across all states, median funding was just 17.2 percent of the recommended level. But cutting an anti-smoking program may be bad business. According to Terry Pechacek, associate director for science in the CDC’s office on smoking and health, the return on investment of tobacco prevention programs "far exceeds almost every other publicly financed program.” California’s program, one of the nation’s oldest and largest, resulted in a 68 percent decline in adult smoking rates and saved the state $86 billion in health care expenditures from 1989-2004, according to one study.
Now even California, which funds its program through state and federal money and a dedicated portion of cigarette taxes, is feeling the pinch. Their anti-smoking campaigns have obviously had an effect, since fewer Californians are smoking. Sounds like a win, but the down side is that cigarette tax revenues are falling, and the program’s budget has shrunk to $79 million this year from about $95 million in 1989.
In the CDC survey, Maine ranked first, with a funding level of 85.5 percent of the recommended amount, and Tennessee ranked last, at 1.1 percent. After the numbers were collected, Tennessee enacted a $10 million anti-tobacco initiative, including a nonsmokers’ protection act, a hike in tobacco taxes and statewide training for health workers. But now that effort has stalled with the slowing economy. Funding for 2010 is a mere $200,000.
It’s hard to get state politicians to dedicate money to tobacco prevention unless voters push the issue, as they do for breast cancer and HIV/AIDS, says Ken Warner, dean of the University of Michigan’s School of Public Health. Politicians are also looking for short-term impact, while the greatest benefits from tobacco control programs come over five to 10 years, instead of one or two, experts say. “It’s kind of a shortsighted view that’s dictated by the very tight economy,” says Wendy Max, professor-in-residence of health economics at the University of California, San Francisco.
But there are other ways to get results. Lawmakers could enact smoke-free zones, which Pechacek says can reduce the hospital admissions for acute heart attacks and heart problems by up to 20 percent. And citizens can do the same, at least in their own homes.