A Failing Grade: Massachusetts Spends Less than 1% of Cigarette Revenues on Tobacco-Related Programs

Massachusetts was once a leader in the tobacco control movement. In 1992, voters approved a ballot initiative - Question 1 - which increased the excise tax on cigarettes by 25 cents per pack and allocated the revenues towards a comprehensive statewide tobacco control program. In its heyday, the program funded education, prevention, research, and treatment programs to the tune of more than $50 million per year. The state's anti-smoking media campaign alone - at $13 million per year - was responsible for cutting the smoking initiation rate among Massachusetts adolescents in half.

Thanks to a trio of governors who subverted the voters' intentions in passing Question 1 - William Weld, Jane Swift, and Mitt Romney - the program was decimated: it was cut by more than 95% and now exists in merely skeleton form at about $4.5 million per year.

An article in Monday's Lowell Sun reveals that despite having one of the highest taxes on cigarettes in the nation, Massachusetts spends less than a paltry 1% of cigarette revenues on tobacco control programs. Thus, the state has gone from having a model tobacco control program to having a mere skeleton of a program. Accordingly, progress in reducing youth and adult smoking in the Commonwealth has been stunted.

According to the article, the state receives a whopping $815 million per year from tobacco taxes and Master Settlement Agreement payments, yet allocates less than 1% of these funds for tobacco control. And although the administration has proposed a further $1 per pack cigarette tax increase, none of the resulting revenue would be devoted to tobacco-related programs.

The Rest of the Story

The decimation of the Massachusetts Tobacco Control Program corresponds directly with the initiation of the Campaign for Tobacco-Free Kids' new strategy of promoting and supporting any and all cigarette tax increases, without an insistence that a substantial proportion of the revenue be allocated for tobacco control. In my opinion, it was the Campaign for Tobacco-Free Kids that destroyed the previous wisdom in the movement that cigarette tax revenue allocated to comprehensive statewide tobacco control programs was the model and should be pursued in all states.

I have pointed out a number of reasons why this change in tobacco control strategy was destructive, in addition to its having resulted in the states realizing that they no longer needed to worry about allocating cigarette tax money towards cigarette prevention, education, research, and treatment programs. First, for the majority of lower-income smokers, tax increases will result not in smoking cessation, but in continued smoking at a greater expense and at a higher proportion of overall income. This may have adverse consequences -- and even adverse health consequences -- and may be particularly problematic for the families and children of lower-income smokers, who may actually suffer as a result of these policies.

Second, these policies make essential government programs dependent upon continued high levels of cigarette consumption for their solvency.

Third, they create a financial partnership between the states or the federal government and Big Tobacco.

Fourth, they reduce (if not eliminate) the incentive for state legislatures to enact any policy that would actually make a serious dent in smoking prevalence, because such policies would severely harm the budget, which (now) relies upon cigarette sales to fund its most essential programs and services.

It was the Campaign for Tobacco-Free Kids that developed the mindless mantra that using cigarette taxes to fund essential government programs is a "win-win-win" proposition. But as I have argued:

"These are not win-win-win propositions. There is a win, but unless the policy is properly crafted, that win comes at the expense of a number of losses: regressivity, lack of fairness, increased burdens upon lower-income populations, increasing health disparities, a government dependence upon continued cigarette consumption to fund critical programs, an unhealthy fiscal partnership between the states and Big Tobacco, and the elimination of any incentive to enact meaningful tobacco policies that would actually make a serious dent in smoking prevalence. The cigarette tax policies may actually be making it more difficult - if not impossible - for the more effective non-price policies to be implemented."

What is the solution? How can tobacco control be restored at the state level?

The problem is not going to be resolved until the Campaign for Tobacco-Free Kids ends its knee-jerk support for all cigarette tax increases and withdraws its support from proposals unless they allocate a substantial portion of the revenues to comprehensive statewide tobacco control programs.