The President’s FY18 budget could reverse years of progress in tobacco control

The President’s proposed Fiscal Year 2018 budget is a reckless threat to defund essential programs that address the number one cause of preventable death in our country: tobacco use. While we have made significant progress in bringing youth and adult smoking rates to historic lows, now is not the time to abandon the proven strategies that have worked so well to combat the death and disease caused by tobacco. Time and time again, tobacco control has proven to be an investment that pays many times its value in health and productivity. Unwise cuts in tobacco control will only mortgage the future for the profit of those who benefit from the sale of the most dangerous consumer products in history. That isn’t wise fiscal policy, and it isn’t wise public health policy. 

Eliminating funding for the Centers for Disease Control and Prevention’s (CDC) Office on Smoking and Health threatens a crucial research and data source for understanding where and who the tobacco epidemic affects, potentially leaving government, as well as non-profit tobacco programs, rudderless. Although the budget recommends granting funds to states for tobacco control programs, these efforts are likely to be wasted stabs in the dark without data to inform and measure progress. The cuts would also eliminate the CDC’s highly effective public education program, “Tips From Former Smokers.” As experts in the power of public education programs to motivate smoking behavior change, we can say from experience that when public education investment is curtailed, progress is stalled and life years are lost.

The budget proposal also threatens to substantially undermine the ability of the National Institutes of Health (NIH) and the National Cancer Institute (NCI) to fund research into innovative treatments for tobacco addiction and tobacco-related diseases such as lung cancer and COPD, meaning that this budget will not only reverse our country’s efforts to prevent youth from starting to smoke and help adults quit, it will limit our ability to provide treatment to smokers when they inevitably suffer the devastating damage smoking does to their bodies. Lastly, the cuts to Medicaid threaten the ability of those most affected by the tobacco epidemic to seek treatment, as the epidemic is increasingly concentrated among those who are least advantaged in our country.

Moreover, the strategy of providing block grants to states hoping for support of tobacco control is fundamentally flawed. We know from a long history, that money from tobacco taxes and settlement funds have not translated into spending on tobacco prevention and cessation programs. Last year, the states collected over $26 billion in tobacco-related revenue, yet spent less than $500 million. The country continues to require strong leadership at the federal level to stay on track.

The continuing battle against tobacco has produced some of the most effective approaches to improving the health of all Americans. In 2000, 23.4 percent of adult Americans smoked. Today, it is 15.8 percent. The progress among youth is even more stunning, dropping from 23.6 percent to under 6 percent. Not only is that the result of the work done by CDC, NIH and others, their data are the reason we know it. Without the research, surveillance, program and education funding provided by the federal government to CDC and NIH over the last decades, many hundreds of thousands of Americans would lose their lives far too early. We have come too far to walk away from what could be the greatest public health victory in modern times.