Washington state government spends a surprisingly small amount helping cigarette smokers quit their deadly habit.
The Evergreen State forks out about $320,000 a year from a federal Centers for Disease Control grant to keep its Quit Line going for an estimated 900,000 smokers in the state, according to a recent news report by The Spokesman-Review newspaper in Spokane.
On the upside, the Legislature increased its outlay to $3.2 million overall this budget year for prevention and treatment, most of that targeting youths. Gov. Jay Inslee has backed raising the smoking age to 21 years, which also might deter smoking.
But the prevention and treatment investments are well below the $29 million level in 2008, just before the Great Recession, according to data kept by the state Office of Financial Management.
The state Quit Line typically runs out of money before the budget year ends for help not covered by insurance – including nicotine gum used to wean addicts off their habit, according to the state Department of Health.
This situation persists despite some $157 million our state received last year from the national tobacco settlement reached with major tobacco companies 20 years ago. The Quit Line cost is a fraction of the $537 million Washington received from the settlement, grants and cigarette taxes for 2017.
The settlement dollars were supposed to reimburse states for health costs related to smoking, and to some extent that investment happens because the money goes into the state’s general fund.
The general fund pays for basic government operations that include health programs, prisons, state parks, and – especially relevant in recent years – K-12 public schools. Public schools now account for half of state general fund outlays.
The Legislature – which has been recently obsessed with fully funding K-12 schools in response to a Supreme Court order – is to blame. Lawmakers have been reluctant to enact tax reforms or tax increases that would have eased their budgeting.
The result is they grab every dollar they can for schools.
But it is smart to help smokers quit. Consider:
• About 8,300 people die every year in our state from smoking-related causes, Spokesman reporter Rachel Alexander’s story noted.
• And the cost of smoking for Washington’s Medicaid program, which splits costs with the federal government to cover eligible poor residents, is estimated at $790 million.
• The taxpayer share in Medicaid is less than a third of the roughly $2.8 billion a year in direct medical costs statewide that are linked to tobacco-related illnesses. Some of that cost is picked up by insurers or charity care.
The state's investments pale next to the $63.6 million recommendation by the federal Centers for Disease Control, which thinks $16 million should go into cessation efforts alone.
The state’s low investment in programs to discourage the deadly smoking habit is why Washington, 39 other states and the District of Columbia earned an F grade in the American Lung Association’s “State of Tobacco Control 2018” report.
The association has long advocated that Washington boost the share of funds it receives from the national settlement to offer more robust tobacco cessation programs.
Candidates begin filing in May to run for state legislative seats, and this issue is one of dozens voters may want to ask them about. Doesn’t it make sense to spend a bit on preventive strategies, to the extent they work, if they save millions or billions down the road?
Knuckleheads may want government to stop paying medical costs for addicts. But that’s not really an answer. Preventing new addicts is important.
As Washington state and local governments like Thurston County sue opioid manufacturers and distributors to try recover some of their costs from dealing with the addiction scourge, they should keep in mind the spotty track record on using the tobacco settlement. That assumes they ever cash in from their opioid suits.
Weaning Washingtonians off addictive substances is a smart strategy and the right thing to do. But it takes even smarter politics to keep on track.