AMA Resolutions

Resolution: X (I-00)

Introduced by:
American College of Preventive Medicine

Subject: Recognizing Effective Use of State Tobacco Settlement Monies

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Whereas, In November 1998, 46 states and the tobacco industry agreed on a $246 billion settlement over 25 years, known as the Master Settlement Agreement (MSA), for states’ recovery of their Medicaid tobacco-related disease costs; and

Whereas, The Campaign for Tobacco-Free Kids (www.tobaccofreekids.org), National Conference of State Legislatures (www.ncsl.org), The Center for Social Gerontology (www.tcsg.org), and other organizations have been tracking how states are allocating their settlement dollars and have all concluded that most states are not using a significant portion of the settlement funds on tobacco prevention and control programming; and

Whereas, the National Conference of State Legislatures estimates that, in FY 2000 and FY 2001, the legislatures appropriated a total of approximately $168 million and $430 million, respectively, of the tobacco settlement money on tobacco prevention and cessation, out of a total of more than $8 billion they received (www.senate.gov/~commerce/hearings/1005rep.pdf); and

Whereas, in a 1999 report, the Centers for Disease Control and Prevention recommended that states use approximately 20 to 25 percent of their settlement funds to establish comprehensive tobacco prevention programs (www.cdc.gov/tobacco/bestprac.htm); and

Whereas, The Institute of Medicine in its March 2000 report, entitled "State Programs Can Reduce Tobacco Use," (http://books.nap.edu/html/state_tobacco/) and the Surgeon General in his August, 2000 report, entitled "Reducing Tobacco Use" (http://www.cdc.gov/tobacco/sgr_tobacco_use.htm), studied all of the available evidence and both concluded that we know how to reduce tobacco use and the harm it causes; and

Whereas, the October 2000 joint report of the Campaign for Tobacco Free Kids, American Cancer Society, American Heart Association, and American Lung Association, entitled "Show Us The Money: An Update On The States’ Allocation Of The Tobacco Settlement Dollars" (http://tobaccofreekids.org/reports/settlements/), showed that only five states – Indiana, Maine, Massachusetts, Minnesota, and Mississippi – have used settlement funds to meet the minimum funding levels recommended by the Centers for Disease Control and Prevention (CDC) for effective tobacco prevention programs; and

Whereas, only an additional 10 states have made substantial commitments to fund tobacco prevention and cessation, but they fall short of CDC’s recommended minimal funding levels; therefore be it

RESOLVED, That our AMA formally recognize the fifteen states cited in the October 2000 report, "Show Us The Money: An Update On The States’ Allocation Of The Tobacco Settlement Dollars," as having made substantial commitments to fund tobacco prevention and cessation programs using funds from their Master Settlement Agreement allotments, with special recognition provided to the five states meeting the recommended CDC funding levels for effective programming; and be it further

RESOLVED, That our AMA publicize this recognition as widely as possible, such as through its own medical journals, newsletters, web site, and media briefings as well as by encouraging and facilitating publicity by its Federation partners; and be it further

RESOLVED, That our AMA encourage and support the efforts of medical societies in those states currently not committing substantial funding for tobacco prevention programs to work with their public health partners, governors, and legislatures to increase spending for comprehensive tobacco prevention programs.

Relevant AMA Policy

Our AMA (1) strongly supports the position that all monies paid to the states in the Master Settlement Agreement and other agreements be utilized including research, education, prevention and treatment of nicotine addiction, especially in children, and adolescents and treatment of diseases related to nicotine addiction and tobacco use; (2) strongly supports efforts to direct tobacco settlement monies not directed to other specific tobacco control activities to increased patient access to medical services; (3) strongly supports legislation codifying the position that all monies paid to the states through the various tobacco settlements remain with the states; and that none be reimbursed to the Federal government on the basis of each individual state’s Federal Medicaid match; and (4) supports efforts to assure any tobacco settlement funds not supplant but augment health program funding. (Sub. Res. 431, I-98; Reaffirm: Res. 428, A-99)

The AMA actively seeks to ensure that a substantial portion of any local, state or national tobacco litigation settlement proceeds be directed towards preventing children from using tobacco in any form, helping current tobacco users quit, and protecting non smokers from environmental tobacco smoke. (Res. 422, A-98)

The AMA will assist in collecting data with the CDC on the level and extent of tobacco prevention education on the local, state, and national levels. (Res. 545, A-92)