Why is SC Worst in Smoking Prevention?

Thursday was The Great American Smokeout, an annual focus to get smokers to quit, at least for 24 hours. As that was happening, a recent report ranks South Carolina worst in the nation at spending tobacco settlement money on smoking prevention and cessation programs. The Campaign for Smoke-Free Kids report says South Carolina will generate $114 million from the tobacco settlement and cigarette taxes this year, but will spend just $1 million of federal money, and no state money, on prevention programs.

South Carolina was one of 46 states that sued tobacco companies for the cost of treating smokers for their smoking-related health problems. South Carolina was awarded $2.3 billion in the settlement. But in 2000, then-governor Jim Hodges and state lawmakers agreed to securitize the settlement, which means the state sold bonds for the money in exchange for a $912 million lump sum payment up front. That money created four trust funds. The largest of those, getting 73 percent of the money, was for health care: prescription drugs for senior citizens, tobacco prevention and cessation programs and Medicaid expansion. Another 15 percent went to assist tobacco farmers, 10 percent went for economic development in rural areas and 2 percent was set aside for local water and sewer projects.

But South Carolina has put very little of the money from the Health Care Trust Fund toward smoking prevention. Last year, it spent $2 million of state money on tobacco prevention along with $1.34 million of federal funds. This year, the state is spending $0 state dollars and $1 million in federal money on smoking prevention.

Rep. Dan Cooper, chairman of the House Ways and Means Committee, says he thinks there are bigger needs than stopping people from smoking. "I think, you know, in tough economic times it's really tough for us to look at spending a lot of money in that one area, and I don't know that you stop people from smoking by spending a lot of money," he says.

The state has had some success, even with the limited resources. In SC, 21.9 percent of adults smoke, which is higher than the national average. But 17.8 percent of high school students smoke, which is below the national average. Mary-Kathryn Craft, spokesperson for the state Department of Health and Environmental Control's Division of Tobacco Prevention and Control says it's important not to let up on the funding.

"We've seen in other states in the past rates go down, and then you stop doing prevention programs and rates will spike back up. So the numbers have been going down while we have been doing tobacco prevention efforts," she says.

One example of the effects of inadequate funding is the state's Tobacco Quit Line, a phone-based counseling service for smokers who want to quit. Research has shown that cessation programs work better when combined with counseling. But the state has had to limit most people to one counseling session over the phone. "We would love to be able to offer multiple calls and multiple counseling sessions to the whole state, and that's something we would be able to do with increased funding," Craft says.

While the state does have plenty of pressing financial needs, cutting tobacco prevention programs could cost more in the long run. According to the Campaign for Smoke-Free Kids report, smoking-related illnesses cost the state $1.09 billion a year, much of which could be prevented by getting smokers to quit and keeping teens from ever starting.

You can read the entire report from the Campaign for Smoke-Free Kids here.