Only a small fraction of revenues that states collect from the sale of tobacco products goes toward smoking prevention programs, according to a report by the Centers for Disease Control and Prevention (CDC).

Tobacco manufacturers agreed to reimburse states for Medicaid costs related to tobacco use, under the 1998 Tobacco Master Settlement Agreement. The intent of this agreement was for states to also use this money to help prevent youth smoking, HealthDay reports. However, the agreement did not require money be used for this purpose.

The new study revealed that between 1998 and 2010, states collected a total of almost $244 billion in payments from the tobacco industry agreement, as well as from cigarette excise taxes. They have only invested about $8 billion in effective state tobacco control programs, the report notes.

The rest of the funding has gone toward general expenses, or to pay for programs other than tobacco control. If states had followed the recommendations of the CDC, they would have spent more than $29 billion in tobacco control programs during that time.

The CDC noted that many states face extensive cutbacks to tobacco control funding, resulting in the near elimination of tobacco control programs in those states. According to the report, states that have made larger sustained investments in comprehensive tobacco control programs have seen cigarette sales drop approximately twice as much as in the United States overall. “Smoking prevalence among adults and youths has declined faster as spending for tobacco control programs has increased in Arizona, California, Massachusetts, Minnesota, Maine, New York, Oregon, and Washington,” the researchers note.