WASHINGTON -- Maryland spent less than federal health officials recommend on tobacco prevention in 2014, but has seen a lower smoking rate compared to states that have spent a higher proportion, according to the Campaign for Tobacco-Free Kids and the Centers for Disease Control and Prevention.
Maryland’s adult smoking rate for 2014 was 16.4 percent, according to the Campaign for Tobacco-Free Kids.
Alabama, Alaska, Missouri and North Dakota have higher adult smoking rates than in Maryland. Anti-smoking efforts in Maryland are funded at a higher level than similar programs in Missouri and Alabama, but Maryland is spending less than Alaska and North Dakota.
The smoking rates for Alabama, Alaska, Missouri and North Dakota stayed between 21 percent and 22 percent in 2014.
Smoking rates across the nation have gradually decreased in the last decade, according to the American Cancer Society. Rates in the five mentioned states have decreased on average more than 3 percent since 2000, according to the CDC.
Alaska and North Dakota have state statutes that require them to spend the CDC-recommended amount, according to their respective state officials.
The proportion spent on prevention programs in each state is determined by the amount of funds given through the Master Settlement Agreement, CDC resources, and state tobacco taxes.
Officials in Alaska and North Dakota said poverty and less aggressive tobacco taxation create discrepancies in smoking rates.
North Dakota attributed little change in adult smoking rates to the oil industry and tobacco taxation within the state.
“The states with highest tobacco taxes have, on average, lower smoking rates when you group them together,” said Jeanne Prom, executive director for BreatheND.
North Dakota has the lowest tobacco tax in the nation, making cigarettes a desirable product for temporary residents working in the oil industry, according to Neil Charvat, director for the state’s Tobacco Prevention and Control Program.
“We’ve also had a large influx of people in the western part of the state because of oil development, and that traditionally has been a population, or group, that uses tobacco at a higher rate,” Charvat said.
While the oil industry brings more smokers into North Dakota, dropping oil prices correlate to sustained smoking rates in Alaska, according to Alison Kulas, program manager for the state’s Tobacco Prevention and Control Program.
Kulas said plummeting oil prices are placing economic strain on the state, causing concern over funds for the prevention program.
“Really, we hit CDC-recommended spending back in 2010, and since then we have trimmed our budget so we are just below the CDC-recommended spending,” Kulas said. “At this point, there is talk of, ‘Do we need more revenue for other things?’ Because we are in a budget crisis mode with the price of oil being so low for the last year and a half now.”
Funding issues not only concern Alaska, but Alabama as well, according to Diane Beeson, director of Alabama’s Tobacco and Preventive Control Branch.
“Alabama does not have a lot of money, and it’s a severe lack of funding across the board that has limited our spending,” Beeson said. “States are failing to come up with the dollars that would move these prevalence rates lower.”
Alabama spends its settlement money exclusively on youth prevention programs and is expected to receive $1 million in 2016, an amount it hasn’t seen in several years, according to Beeson.
Dawn Berkowitz, director for the Maryland Center for Tobacco Prevention and Control, attributes the program’s success to quit lines, resource centers, and media campaigns. The program models spending on CDC best practices, according to Berkowitz.
“Every other year there is a legislative report, and we have found a lot of success,” Berkowitz said. “I think our prevention efforts have really worked.”
While Berkowitz stresses the importance of tobacco prevention programs, much of Maryland’s funds are distributed to research and cancer prevention within the state, a form of treatment for those affected by smoking.
“A portion of that money goes into our breast and cervical cancer screening and treatment programs here in the state as well as other programs,” said Bonita Pennino, Maryland and D.C. government relations director for the American Cancer Society Cancer Action Network. “And yes, a portion of that money does go to our tobacco use prevention programs. Could we have more in there? Yeah, you bet we could.”
The CDC sets its minimum funding requirements based on the amount states need to stop each resident from smoking, according to its 2014 Best Practices for Comprehensive Tobacco Control Programs report.
The CDC’s evidence-based report suggests formulas and methods states could use to reduce and prevent tobacco use.