To Anne Arundel County health officials, it hardly seems possible that there could be a downside to the county's declining cancer rates.
After all, they reported last week that cancer awareness and preventive health programs run by the county have helped reduce the annual number of cancer deaths since 1990, when a study found that Anne Arundel had the highest rates in Maryland and among the highest in the nation.
But local leaders fear the positive trend may hurt Anne Arundel as it makes a bid for a share of Maryland's $4.4 million settlement with big tobacco, money that will be doled out during the coming General Assembly session.
Because cancer rates have declined here, legislators said, other parts of the state may appear more needy.
"We're very concerned that our successes here will mean we won't see our fair share," said Del. Michael E. Busch (D-Anne Arundel). "There's going to be a significant battle over this money."
Busch and other key county legislators expressed those concerns at a recent meeting between top Anne Arundel County officials and Martin P. Wasserman, the former state secretary of health and mental hygiene who heads Gov. Parris N. Glendening's (D) task force to end smoking.
Wasserman will have substantial input on how county health departments slice up the money set aside for local efforts to end smoking and battle cancer. And he agreed that the county's success cuts both ways.
"What Anne Arundel has done puts it in an enviable position in many respects," he told the group of elected officials. "But jurisdictions that have had disproportionate resources in the past won't necessarily see the same results over areas with needs that have not yet been met."
This bind stems from Anne Arundel's particularly unpleasant history with cancer.
After the 1990 study came out, the county hired a team from the Johns Hopkins School of Public Health to help determine why rates were so high and to develop a strategy to reduce the numbers.
To the surprise of many, the Hopkins team found no evidence that environmental problems, such as contaminated drinking water or pollution, were at the root of the numbers.
Instead, County Health Officer Frances B. Phillips said, county residents suffer in large numbers from many of the most common cancers.
"One-third of cancer deaths here are lung cancer, and when a significant number of people smoke, you know that's a good place to start," Phillips said.
Her office developed a smoking cessation kit and hired a marketing firm to develop strategies to persuade people to quit and teenagers not to start. It was the beginning of an elaborate campaign to change habits in the county. And the health department says data indicate it is working.
In addition to 1997 data that showed Anne Arundel well below the state's average rate for cancer deaths, a poll of residents suggests that the county's publicity campaign has had some success.
The poll found that 80 percent of smokers who were aware of the campaign tried to quit. Of the smokers who had not heard of the campaign, only 39 percent tried to quit.
Sen. John C. Astle (D-Anne Arundel) argued that this kind of effort should "give us extra points in the contest" for a share of the settlement money.
County Executive Janet S. Owens (D) was even more emphatic as she pleaded with Wasserman.
"Mr. Secretary," she said, "please don't penalize us for the leadership we've exercised."
Wasserman, though, offered no promises.
"I'd like to see each jurisdiction working with the others to design a plan" for spending the money together, he said. "It's unfortunate that we won't have enough money to give everyone what they want, but at least we can expect a substantial increase in resources that will allow everyone to do more."