Anti-tobacco advocates fear that smoking rates have stopped falling because many states, facing large deficits, have cut funding for tobacco prevention, The Wall Street Journal reported Nov. 9. 

An anti-smoking coalition led by the Campaign for Tobacco Free-Kids and the American Lung Association said that state spending on tobacco prevention dropped 28 percent between fiscal years 2008 and and 2011, to a combined total of $517 million.

The 2011 figure is the lowest allocation for prevention programming since 1999, when states set aside a total of $300 million for this purpose in the wake of the 1998 Tobacco Master Settlement Agreement between cigarette companies and 46 states. The settlement arranged payments of $246 billion to states by tobacco companies over 25 years.

Tobacco-related illness is the leading preventable cause of death in the United States, according to the CDC, which estimates that tobacco kills about 443,000 Americans every year.  In 2009, approximately 46.6 million adults were smokers – or 20.6 percent of the population — according to the Centers for Disease Control and Prevention (CDC).  Adult smoking rates have remained fairly steady since 2004, and youth smoking rates have declined at a slower rate since 2003.

Thomas Frieden, director of the CDC, spoke against state cuts in tobacco prevention programming. “There's a risk of a setback,” he said. “The data are very clear. The more we invest in tobacco control, the fewer people smoke, and that prevents illness, disability, deaths and healthcare costs.”

Frieden pointed to several states, including California, that implemented comprehensive tobacco-use prevention programs after 1999 and cut smoking rates by 30% or more. Other states, such as Ohio, have seen their smoking rates stall out as prevention funding evaporated.