Fool Me Once, Shame on You. Fool Me Twice, Shame on Me. The Continuing Saga of the Decimation of Tobacco Prevention Efforts by Governor Strickland and the Ohio Legislature.
Volume 23 Issue 1

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A few months ago, I wrote about Ohio Governor Strickland’s actions to decimate funding for tobacco prevention and control in Ohio. He had decided to trade future payments from the tobacco Master Settlement Agreement (MSA) for a smaller lump sum payment. He then spent that lump sum payment on property tax cuts and school construction.¹ He made this decision despite the fact that the Ohio Tobacco Prevention Foundation (OTPF) had used MSA funds very effectively to lead efforts that reduced smoking rates from 27.6% in 2001 when these funds first became available to 22.4% in 2006. Strickland’s diversion of payments took away the funding the Ohio legislature had “promised” to use to repay the $568 million they “borrowed” from the OTPF endowment between 2002 and 2006. Strickland’s next move was to sign a law in April, 2008, that would divert $190 million of the remaining $270 million OTPF endowment to fund a jobs creation program. The irony of this move is that hundreds of employees in the agencies funded by the OTPF would lose their jobs when tobacco prevention funding was cut. Fearing that tobacco prevention efforts in Ohio were at risk, the OTPF board quickly voted to transfer $190 million of the endowment funds to the American Legacy Foundation. The Ohio legislature responded by passing another law to disband the OTPF and transfer about $40 million to the Ohio Department of Health to manage future tobacco prevention programs. The OTPF has been disbanded. The American Legacy Foundation has sued the State of Ohio to claim the $190 million. The case was still in the courts when I wrote this column.

I admire and support the resilience, positive energy, and gracious nature of the Ohio anti-tobacco community, especially Shelly Kiser, advocacy director for the American Lung Association of Ohio. Rather than dwell on the abuse they continue to be dealt, she is focusing efforts to raise support for a proposed state-wide tax on cigars, chewing tobacco, and other tobacco products.² I also applaud the efforts of Ohio Faith United Against Tobacco.³ They are building support for a new state-wide 75 cent/pack tax on cigarettes. If these two initiatives pass, the new taxes would raise $390.8 million per year, more than enough to fund the $145 million per year recommended by the Centers for Disease Control and Prevention to fight tobacco in Ohio.⁴ Of course, given the failure to protect MSA payments for tobacco prevention and control, who knows what would happen to these tax funds.

That said, it is about time we wise up. It is time to get personal. Politicians are going to continue to ignore us and steal our resources until we get serious with them. The evidence is compelling. I have not seen any investment that prevents more disease and death or saves states, employers, and individuals more money than tobacco prevention. Logically, there is no better investment a state government can make. Yet, most states continue to divert 95%+ MSA funding to other purposes. Why? Because we let them get away with it. I cannot tell you how many times I have heard legislators say that tobacco prevention is critical, that they will support tobacco prevention efforts going forward, but they must focus current resources on solving immediate budget crises. They say the same thing year after year. Of course it is all baloney.

Going forward, my new strategy is very simple. When I meet with a legislator who represents my district, I start by reviewing all the scientific and economic literature supporting the importance of tobacco prevention in my district and state. I ask them if they have any questions or concerns with the methodology or conclusions. If they do, I focus on those issues until they are resolved. Next, I tell them that their support for tobacco control is the only issue by which I will judge them in the current year. If they support tobacco control efforts, I will support their re-election. If they oppose it, I will do everything I can to work against their re-election. I tell them I am taking this stance because there is no better investment for the state, and any legislator who cannot see this is not capable of performing the analytical work required for the position. I also tell them this is my number one issue. I do not mince words, but I use very respectful language at all times.

I used this approach in Ohio. Senator Shirley Smith’s offered to introduce amendments to oppose Strickland’s efforts. Representative Eugene Miller responded by saying he would give the issues serious consideration. Strickland and his staff declined to meet with me. Going forward, I will support Senator Smith and oppose Representative Miller and Governor Strickland. By myself, I will have little impact. If we all use this approach, we will secure the funding we need to save hundreds of thousands of people from preventable deaths every year.

Michael P. O'Donnell, PhD, MBA, MPH

1. O’Donnell, MP, A Billion Deaths from Tobacco and Cuts in Tobacco Prevention Funding, 2008, 22,5,iv.
   
2. American Lung Association of Ohio website. http://www.OhioLung.org/Advocacy.htm
   
3. Ohio Faith United Against Tobacco website http://www.OhioFaithUnitedAgainstTobacco.org.
   
4. Centers for Disease Control and Prevention. http://www.cdc.gov/mmwr/pdf/wk/mm5644.pdf.