Tobacco case leader: States misusing funds

SOUTH PORTLAND – The Mississippi attorney general who organized the states that forced big tobacco companies to pay millions toward medical costs caused by smoking-related illnesses said Monday his coalition was in danger of winning the battle but losing the war.

Across the country, states have been using tobacco settlement funds as money from heaven for everything from road repairs to Medicaid deficits, while often ignoring the opportunity to spend the windfall on prevention of smoking, said Michael Moore.

“I call it moral treason,” Moore told more than 100 people gathered for the annual meeting of the American Lung Association of Maine. “It’s no victory at all if you don’t take the money we got and apply it to the public health and to protect children.”

Moore said he initiated the battle with Big Tobacco because there is a cost to states for the care of those exposed to cigarette smoke. Tobacco-related illnesses are the No. 1 cause of preventable disease in the United States.

Moore counts Maine’s tobacco spending plan as among the best of those states that benefited from the $240 billion settlement because it devoted a huge chunk of the estimated $55 million per year it will receive from the 13 tobacco companies to prevention and public health programs. No expenditures are for nonhealth programs.

But even in Maine prevention program spending has come under attack and will continue to face challenges, Moore said. Last year, Gov. Angus King received permission to divert about 25 percent of the money previously dedicated to prevention to the state’s Medicaid expenses.

“Pretty soon you’ll get rolled back – rolled back,” Moore said.

In an interview after the address, Bureau of Health director Dora Ann Mills said she intends to advocate against any additional cuts in Maine. Additional trimming could endanger the effectiveness of the program and put the state below Centers for Disease Control and Prevention guidelines on effective campaigns, she said.

But Maine Attorney General Steven Rowe, who helped craft Maine’s plan for the tobacco money, said more challenges will come.

“Not only this past year but every year there will be efforts to take those funds and divert them,” Rowe said. He called Moore “a real-life hero” who today is probably the most respected attorney general in the nation.

Moore said he didn’t always think he’d have such support. After he filed against tobacco companies in 1994 the governor of Mississippi said Moore’s suit made him “want to throw up.” A key state lawmaker told Moore there would be no public money to support his suit. His own mother questioned him.

“There weren’t a whole lot of people who stood behind us,” he said.

When he went to the first court hearing he had three lawyers on his side and 63 on the tobacco side, he said. Moore took two years to line up other states for the fight.

Now he said he doesn’t want to see his seven-year battle go for naught as those who didn’t fight spend money on other issues. He said outrage is necessary.

Moore cited the settlement following the spill of oil into Alaska’s Prince William Sound by the tanker Exxon Valdez. Imagine what would have happened had the governor of Alaska suggested the money be used on nonrelated budget items, he said.

“The difference is people would have been outraged,” he said.

Even the dangers of smoking aren’t gaining the outrage they deserve, he said. Doctors and nurses who see the effects of tobacco use daily only “make a squeak.” Other health advocates do little more, he said.

In Mississippi, the poorest state in the nation, every dollar was devoted to prevention programs. Now, he said, teen smoking has been reduced 30 percent in two years. California has had a 10-year prevention effort that has reduced smoking by 50 percent.

“We know prevention-based programs work,” he said.

Moore said in an interview he thinks tobacco companies recently have shifted their attention from the youngest Americans to those ages 18 to 25. Tobacco promoters work on college campuses at nightclubs and at rock concerts by giving away gear with logos and by sending other messages.

To Maine, Moore offered advice.

He said more churches should be engaged in the battle “because that’s a low cost investment and a big-bang return.”

School nurses, already part of Maine’s prevention effort funded by the settlement, should be given additional resources to fight smoking.

Moore said that in Mississippi students actually had been drawn into the creation of anti-smoking legislation. Their involvement improved results, he said.

He recommended that efforts against tobacco be built into all substance abuse efforts.

Reducing smoking by half will cut U.S. health care costs by more than half and save many lives, he said.