Tobacco Settlement: Half for Prevention Campaign
History
In 1996 Attorney
General Ryan filed suit for Illinois to recover costs paid through
Medicaid for smoking-related illnesses. On November 20, Illinois Attorney
General Jim Ryan announced his acceptance of a $9.1 billion settlement
with four major tobacco companies. This settlement was part of a
multi-state agreement finalized by nine other attorney generals in
cooperation with states that had filed individual suits.
HALF
--- for ---
TOBACCO
PREVENTION
Recommendations for Tobacco Settlement Funds
The Illinois General Assembly is strongly encouraged to allocate a minimum of 50% of the settlement proceeds for funding a comprehensive tobacco control program. An effective program in Illinois would fund each component at the level listed below. Combined, these six components constitute the foundation of a comprehensive tobacco control program that would reach Illinoisans of all ages with prevention efforts and cessation services in their workplaces, schools, communities and healthcare settings. Working in concert, these elements would help keep kids from starting to use tobacco, help adult and teen smokers quit, and reduce the health risks of secondhand smoke.
- Media/Public Education (20%)
Designing and implementing a media/public awareness campaign that deglamorizes tobacco use and raises awareness about its health and social consequences has proven to be effective in reducing tobacco use. An effective media campaign in Illinois would target youth, adults and people who work with these populations. It would also take care to include messages that would be appropriate for minority populations. The objectives of the media campaign are to reduce tobacco use (smokeless and cigarettes) among teens and adults by eliminating its appeal, and to prevent children and young adults from starting. The plan would include a multi-faceted approach utilizing traditional media outlets, free media, the internet and community-based initiatives. The campaign would rely on the ongoing use of focus groups to determine that the messages and the media are relevant to the target audiences. The campaign would also reinforce the existing community-based education and cessation programs. In order to achieve the goal of reducing tobacco use and the associated diseases, no restrictions should be placed on the media campaign s messages in Illinois.
- Community-Based Programs (35%)
Strengthening and developing community-based programs presents a number of opportunities to fight tobacco use by tailoring programs to local needs and taking advantage of local infrastructure. Partnership grants to state-wide organizations take advantage of existing infrastructure and reach a variety of populations. Attention must be given to targeting minority populations who are disproportionately affected by smoking related diseases. Programs run by state certified local health departments, schools, local coalitions and other health agencies should focus on youth tobacco education, teacher anti-tobacco training, cessation services, work site education and cessation interventions. School-based programs are also a valuable way to reach students. The enforcement of minimum purchase age, vending machine, and clean indoor air laws is vital. Enforcement of these laws decreases minors access to tobacco products and creates environments which are less conducive to smoking. Reducing exposure to environmental tobacco smoke also creates a healthier environment for non-smokers. Information must be made available through a resource center regarding the availability and effectiveness of existing programs.
- Cessation Services (31%)
Cessation activities need to incorporate a public health approach that includes state of the art tailored outreach to smokers of all ages. Proven cessation programs for teens must be available through schools, teen centers, and community health centers. Innovative approaches need to be used to reach adult smokers as well. Cessation programs need to be developed that are tailored to minority populations. Attention needs to be given to ensuring that they are language, culture, and gender appropriate. Programs need to be designed in ways that motivate the participation of healthcare providers and insurers.
- Policy (1%)
The enactment and enforcement of public policies restricting the marketing, sale, and use of tobacco is essential to reducing tobacco use in Illinois. Mandatory licensing of tobacco retailers facilitates the enforcement of youth access laws. Illinois clean indoor air law needs to be strengthened to provide greater protections against exposure to secondhand smoke and improve enforcement. Additionally, its preemption on local clean indoor air laws needs to be removed to make it easier for communities to pass their own ordinances. Laws also need to be enacted which would prohibit tobacco from being marketed in free standing displays.
- Research, Evaluation, & Surveillance (8%)
Instituting strong surveillance, research and evaluation components is key to a comprehensive tobacco control program. Good baseline data and surveillance of such things as smoking prevalence, exposure to secondhand smoke, and local policies is needed in Illinois. This data will help evaluate the success of programs and monitor the health of Illinois citizens. State certified local health departments already serve this function in the surveillance of other health conditions. Research is needed to better understand how to prevent tobacco use through the use of education interventions and public policies. These activities can help ensure that funds invested in tobacco use prevention and cessation are put to the best use.
- Administration of Settlement Funds (5%)
Settlement proceeds dedicated to tobacco control should be administered in a manner which will insure that they are secure, accessible and free from tobacco industry influence. The Illinois Department of Public Health (IDPH) will develop a comprehensive tobacco plan for the state and coordinate tobacco control policy through a Tobacco Control Coordination Committee (TCCC). IDPH will include representatives from government agencies with tobacco control programs, statewide voluntary health agencies, certified local health departments, and the attorney general s office on the TCCC.
UPDATES:
Other Links
- Campaign for Tobacco-Free Kids - http://www.tobaccofreekids.org/
- Advocacy Institute - http://www.advocacy.org/index.htm
- American Cancer Society - http://www.cancer.org/
- Centers for Disease Control and Prevention - http://www.cdc.gov/
"Who
are the beneficiaries of the multi-state tobacco
settlement?"
The parties to the settlement include 46 states (Florida,
Minnesota, Mississippi, and Texas had previously settled with the tobacco
manufacturers), Puerto Rico, the U.S. Virgin Islands, American Samoa,
Guam, the Northern Mariana Islands and the District of
Columbia.
"Where is the settlement
money coming from?"
Brown & Williamson Tobacco Corporation, Lorillard Tobacco
Company, Phillip Morris Incorporated, R.J. Reynolds Tobacco Company,
Commonwealth Tobacco, and Liggett & Myers will collectively pay
according to the terms of the settlement.
"When do states recover the
settlement funds?"
Although tobacco manufacturers began making payments in December
1998, no funds can be dispersed to the states until final approval by the
state court is attained and all opportunities for appeal of the approval
expire. If the requisite number of states have not reached state specific
finality before June 30, 2000, the funds will become available to all
states that have reached state specific finality on June 30, 2000. If a
state fails to obtain state specific finality by December 31, 2000, its
participation in the settlement is terminated. Until this final approval
date, the payments being made by the tobacco manufacturers will be
deposited into an escrow account, where the funds will accrue interest and
will become available to the state on the final approval date.
"What will state
legislatures need to do to implement the tobacco settlement
agreement?"
State
legislatures are encouraged, but are not required, to enact the model
statute included in the Master Settlement Agreement , regarding the
treatment of non-participating manufacturers, before the state begins
receiving its allotment from the settlement. In addition, if there is any
question about the legislative appropriation of the settlement funds,
legislatures may want to enact laws to clarify the treatment of the funds
under state law. The settlement agreement is silent on that issue.
Finally, the legislature should probably review the state s consent
decree, the document that implements the settlement agreement in the
state.
"What is the purpose of the
model statute included in the Master Settlement
Agreement?"
The
model statute creates a reserve fund for non-participating manufacturers
to pay future claims, establishing a level playing field between
participating manufacturers to pay future claims, establishing a level
paying field between participating and non-participating manufacturers.
The model act must be enacted by states exactly as it is drafted in the
Master Settlement Agreement and as a stand-alone piece of legislation or
the state must alternatively enact a "qualifying statute," as determined
by a firm jointly retained by the settling states and the original
participating manufacturers. The ruling of the firm is final. The
"qualifying statute" will effectively and fully neutralize the cost
disadvantages that the participating manufacturers experience as a result
of the Master Settlement Agreement. Under the Master Settlement Agreement,
if in any year the total aggregate market share of the participating
manufacturers decreases due to the provisions of the Master Settlement
Agreement, payments to states may be reduced. A state s enactment of the
model statute is significant because if there is a market share loss and
the state has passed and has in force the model statute, that state s
payment will not be reduced at all.
"How are the amounts each
state will receive determined?"
The state allotments were established by a
formula developed by the Attorneys General. These allotments are subject
to a number of adjustments, reductions and offsets. In addition, the
federal government is laying claim to more than half the settlement
dollars. The exact amount a state will receive is the net of the listed
allocation minus any adjustments, reductions and offsets and may also be
subject to recoupment of any settlement funds attributable to
Medicaid.
"What is the basis of the
federal claim on state tobacco settlement funds?"
The U.S. Department of Health and Human
Services contends that existing Medicaid law compels it to recover its
share of third party payments, collected by states on behalf of Medicaid
clients, and argues further that state tobacco settlement funds are
third-party recoveries under the provisions of the Medicaid.
"Does the Master Settlement
Agreement restrict or earmark the settlement
funds?"
No. States
will determine how the funds will be spent.
"Aside from determining
funding priorities and enactment of the model statute, are there other
legislative actions related to the tobacco settlement state legislators
might consider?"
Yes. The settlement agreement prohibits manufacturers from opposing
state legislation prohibiting the sale and manufacture of cigarettes in
packages of less than 20 cigarettes. If a state wants to continue the ban,
considered a key provision to discourage youth access to cigarettes, state
legislation would be required. In addition, the settlement agreement
identifies areas of state legislation, law and administrative rule related
to youth access to tobacco products, that the tobacco industry is
prohibited from opposing. That list provides a starting point for
considering future legislation. Finally, there is a wide range of youth
access issues that are not addressed in the settlement agreement that
could be the subject of state legislative initiatives.
Please contact your legislator to let them know you support allocating 50% of the tobacco settlement proceeds to a comprehensive tobacco control program. For up to the minute information on the tobacco settlement, please call 312/243-2000.