Comprehensive Tobacco Control Funding for the State of Georgia

A Proposal by the Georgia Tobacco Task Force

If current patterns of smoking are not reduced in Georgia, CDC has projected that 184,000 youth currently aged 0-17 in the state will die prematurely from smoking.1,2  Each year, over 10,000 Georgians die from a tobacco-related death, resulting in more than 183,000 years of life lost which costs the state over $3.3 billion in lost productivity. 1,2  Additionally, CDC estimates that for each of these premature deaths caused by smoking, another 20 Georgians are living with a serious medical illness caused by smoking.3  Together these premature deaths and over 200,000 Georgians living with serious illnesses caused by smoking result in over $1.8 billion healthcare costs each year.  But the disease, death, and economic burden from tobacco use can be reduced by funding a comprehensive tobacco control program based upon the CDC recommendations.  
Even though Georgians smoke at about the same rate as the national average, Georgians suffer disproportionately from tobacco-related diseases.  Approximately 90 percent of lung cancer is caused by tobacco smoke and Georgia’s lung cancer death rates are substantially above the national average.  In fact, lung cancer is the leading cause of cancer deaths, killing more Georgians than breast, colon, prostate and pancreatic cancer combined.  At the same time tobacco use is taking a deadly toll on Georgia citizens, scientific understanding of ways to reduce tobacco use has greatly advanced.  Over the last ten years, rigorous scientific studies have unequivocally demonstrated that a state investment in evidence-based tobacco interventions will not only reduce tobacco use, but will also reduce the burden of diseases caused by smoking, and most recently have shown an actual reduction in overall health care expenditures of approximately 7 percent. 
While the evidence is accumulating that investment in tobacco control programs reduces smoking, disease and costs, the commitment to tobacco control has declined by over 90 percent over the last few years, despite the fact that Master Settlement Agreement funding has increased. Given these facts, the Director of the Division of Public Health requested Georgia State University’s Institute of Public Health to establish a Tobacco Task Force to make recommendations on the appropriate level of funding for tobacco control and to suggest an expenditure plan.  During August of 2008 a Task Force was assembled consisting of representatives from federal, state and local health agencies, voluntary associations, non-profit advocacy groups and academic partners to review the current literature and to make recommendations for approximately $20 million of Master Settlement Agreement funding.  The Task Force provides these recommendations in the following pages and notes that a $20 million investment is substantially less than the $116.5 million investment recommended by CDC, but represents an amount that will dramatically advance tobacco control efforts in Georgia and will result in demonstrable reductions in tobacco use. 
Following the CDC guidelines, the Task Force recommends the following level of expenditures for tobacco control in Georgia.
Specific Programs Recommended Budget (in millions): 
State and Community Interventions: $8.5
Health Communication Interventions: $4.5 
Cessation Interventions: $4 
Surveillance and Evaluation: $2 
Administration and Management: $1 
Total: $20 
In addition to detailing the optimal way of investing $20 million to reduce tobacco use in Georgia, the Task Force also made three policy recommendations for further accelerating the reduction of tobacco use in the state and that would position Georgia as a public health leader among Southern states.  Specifically, the Task Force recommends: 
1. Increase the cigarette excise tax by $1 to a total of $1.37, consistent with the recommendations of 
the Georgia Cancer Plan.  
2. Provide nicotine replacement therapy for Medicaid patients and utilize the Federal match that is 
being used by 43 other states. 
3. Strengthen the current Clean Indoor Air law to prohibit smoking in all public places, assuring clean 
indoor air for the approximate 10% or restaurants and bars that continue to allow smoking. 
The Task Force is convinced that a major financial investment in tobacco control that builds upon the scientific evidence established over the last 10 years will result in a demonstrable reduction in tobacco use, tobacco deaths and health care expenditures.  The success of the program is not only dependent upon a significant financial investment, but also upon strong leadership within the state, and a competent and accountable management structure.  Georgia has the expertise in the state to establish an exemplary model program and one that will serve as a model for other southern states.  It is our hope that the recommendations provided in this report will advance Georgia’s effort to protect the health of the public in a scientific and cost effective manner. 

Georgia PIRG Education Fund