Fifteen years after a groundbreaking settlement between 46 states reached an historic settlement with the country’s largest tobacco companies, states are spending just a fraction of the amount recommended by the Centers for Disease Control on anti-tobacco programs.

A new report from the Campaign for Tobacco-Free Kids found that states will collect $25 billion in revenue from the 1998 tobacco settlement in Fiscal Year 2014, but they will spend just $481 million — less than 2 percent — on prevention and cessation programs. And that percentage is dropping.

Only two states — North Dakota and Alaska — are funding tobacco-related programs at CDC-recommended levels. North Dakota will spend $9.5 million next year to keep kids away from cigarettes, slightly higher than the $9.3 million the CDC has recommended. And Alaska will spend $10.1 million, about 95 percent of the CDC suggestion; Alaska also gets a federal grant for cessation programs that puts the state over the 100 percent mark.

Delaware, Wyoming, Hawaii and Oklahoma fund anti-tobacco programs at just over half the CDC-recommended levels.

Percentage of CDC-recommended levels of state anti-tobacco programs

Thirty-one states and the District of Columbia provide less than one-quarter of the funds recommended by the CDC. Rhode Island, Washington State, New Hampshire, Alabama and Missouri spend less than $1 million annually on smoking prevention, while New Jersey doesn’t spend a dime of state funds on anti-smoking programs.

By contrast, the Campaign for Tobacco-Free Kids cited Federal Trade Commission data showing tobacco companies spent $8.8 billion in 2011 on advertising.

State spending on anti-smoking programs plummeted during the Great Recession. States spent $717 million on the programs in Fiscal Year 2008, almost 50 percent more than will be spent in the current fiscal year.

FY 2014 spending on anti-tobacco programs

The percentage of Americans who smoke has declined steadily since 1964, when Luther Terry, Lyndon Johnson’s surgeon general, issued the first report linking smoking to cancer and other diseases. In 1965, the Centers for Disease Control found 42 percent of Americans, and 45 percent of 18-24 year olds, were current smokers. By 2009, CDC reported that number had been cut in half; 20.6 percent of Americans called themselves smokers, including 21.8 percent of 18-24 year olds.

In the 15 years since the state attorneys general settled with tobacco companies, the numbers have fallen farther. In 1999, the CDC said 34.8 percent of high school students had smoked cigarettes in the past 30 days; by 2011, the number was down to 18.1 percent.

Source: Centers for Disease Control
Source: Centers for Disease Control

Higher state spending on anti-tobacco programs don’t always correlate with lower tobacco use. Several of the states that spend close to the CDC-recommended amounts on cessation and prevention programs still have the highest percentages of youths who smoke, including North Dakota, Wyoming and Oklahoma, according to [pdf] the Substance Abuse and Mental Health Services Administration.

Conversely, New Jersey, which doesn’t spend any money on anti-tobacco programs, has one of the lower rates of youths who smoke, along with Northeastern states and states with high Mormon populations like Utah and Idaho.

Source: Substance Abuse and Mental Health Services Administration
Source: Substance Abuse and Mental Health Services Administration