AMA Resolutions

Submitted by: American College of Preventive Medicine

Whereas, The Master Settlement Agreement between the tobacco industry and 46 State Attorneys General requires the tobacco companies to pay the States $196 billion over 25 years; and

Whereas, AMA policy on allocation of tobacco settlement funds is:

*AMA (1) strongly supports the position that all monies paid to the states in the Master Settlement Agreement and other agreements be utilized for 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.* (AMA Policy H-490.924)

Whereas, The U.S. Centers for Disease Control and Prevention (CDC) has identified that key elements for effective State tobacco control programs, including programs designed for communities, schools, and the entire State, and best practices in regards to cessation programs, counter-marketing, enforcement, surveillance and evaluation, and chronic disease programs to reduce the burden of tobacco-related diseases (http://www.cdc.gov/tobacco/bestprac.htm); and

Whereas, Approximate annual costs to implement all of the recommended program components have been estimated to range from $7 to $20 per capita in smaller States (population under 3 million), $6 to $17 per capita in medium-sized States (population 3 to 7 million), and $5 to $16 per capita in larger States (population over 7 million); and

Whereas, Of the 27 states which have dealt with the tobacco settlement money this year, only six have provided enough new funding for truly comprehensive tobacco prevention and cessation programs; 10 others have dedicated funds for tobacco prevention, but each of these will spend far less than the CDC recommends for an effective program; and the remaining states have not dedicated any funds to protect their children from tobacco (http://www.tobaccofreekids.org/html/1998_tobacco_settlement.html); and

Whereas, According to a poll of 868 registered voters conducted in April 1999 by Market Facts* TeleNation, 82% of the respondents said they would favor spending 25% of the state*s tobacco settlement money on a comprehensive plan to prevent tobacco use among kids and to help smokers quit (http://www.tobaccofreekids.org/html/releases.cfm?id=215);

Whereas, Political factors make it difficult to convince State legislatures and Governors to allocate settlement funds to tobacco control; therefore be it

RESOLVED, that the AMA quickly initiate discussions with appropriate national and State organizations and individuals about launching a multi-state effort to use ballot initiatives to direct allocation of tobacco settlement funding consistent, to the extent possible, with AMA Policy H-490.924.