Spending money on 
anti-smoking programs is a wise investment for states, even in tough economic 
times, according to a new study.
In 
fact, the return on a tobacco control program can be as much as 14 to 20 times 
the initial investment, according to a paper published online in the journal 
Contemporary Economic 
Policy.
When the major U.S. 
tobacco companies settled litigation with the states in 1998 in what is known as 
the Master Settlement Agreement, expectations ran high that the 
cash windfall would fund tobacco control and cancer research programs, explained 
study authors Sudip Chattopadhyay, PhD, and David Pieper, PhD, economists at San 
Francisco State University.
The 
settlement required the tobacco companies to pay out $206 billion to the states 
over 25 years, but the agreement had no power to compel the states to spend the 
money in any particular way. Halfway through the 25-year payout period, states 
have increasingly shifted that money out of anti-tobacco activities, using it to 
pay for things like roads and college scholarships, and to cover budget 
shortfalls.
But 
even before the Master Settlement Agreement, some states had already embarked on 
tobacco control programs, starting with a 25-cents-per-pack tax on cigarettes to 
fund their anti-smoking efforts. Other states soon followed suit, and the 
average state cigarette tax in 2010 was $1.45 (with a high of $4.35 in one state 
-- New York).
The 
authors wanted to see if there was a connection between how much states spent on 
tobacco control and how that impacted tobacco demand, and whether that impact 
became greater over time.
They used a variety 
of sources, including state data on tobacco sales from 1991 to 2007, tobacco use 
survey data, U.S. Census figures, and labor statistics, and found a 
statistically significant long-term impact of tobacco control spending on 
cigarette demand.
The 
results suggest that funneling the tobacco settlement money away from 
smoking-prevention programs may be "short-sighted," the study authors 
wrote.
The 
economists found that despite the CDC recommending that states spend, on 
average, $12.34 per resident on tobacco prevention efforts, the average state 
was spending about $2.00 per resident instead.
Using a variety of 
economic models, the economists projected that if a given state spent the CDC 
average recommended amount of nearly $74 million on anti-tobacco policies, the 
estimated benefits -- from reduced medical costs, reduced Medicaid payments, and 
increased productivity -- would range from about $853 million to more than $1 
billion. And the savings increased over time, the authors 
noted.
Even if a state 
devoted just an additional $1 million to combat smoking, it would result in 1.4 
million fewer packs of cigarettes being smoked by residents and save $7 million 
in avoided healthcare costs, $7 million in lost productivity costs, and $2 
million in Medicaid payments.
Adding those savings 
up means that for every $1 million a state spends on smoking prevention, it 
could save at least $16 million down the road, the researchers concluded. And 
the savings are greater the more a state spends, they said. For instance, if a 
state were to spend $50 million, it could eventually reap a savings of $737 
million.
"In 
short, the benefits of the control programs far outweigh the costs," the authors 
said.
Source: http://www.medpagetoday.com/PrimaryCare/Smoking/29918