Although Gov. Deval Patrick's budget proposes spending $34.8 billion in the fiscal year starting July 1, lower-than-expected tax revenues are prompting cutbacks. So it may not be a surprise that millions of dollars originally intended for smoking cessation programs in Massachusetts have been diverted to offset budget deficits.
Now the Massachusetts Department of Public Health is struggling to fund quit-smoking hotlines, treatment programs and anti-tobacco advertising.
On a cold, sunny weekday morning, 52-year old Austin Duffy is standing in the middle of Davis Square in Somerville. He's smoking an L&M cigarette, which he says isn't his usual choice.
"[Not] since Double Diamonds came out at $2 a pack,” he said. “They're a mini-cigar that smokes like a cigarette, and they're really inexpensive, obviously [compared] to the $10 packs of Marlboro which I used to smoke. And they are much harsher on your body."
Duffy said he's tried to quit. Once he went nine months, but then started smoking again. He always has plans to quit.
"I'm going to try the new products that are out,” he said. “Chewing the gum, or eating more.”
States have been helping people like Duffy quit smoking for years. But money for smoking cessation programs is being slashed. Last year, Massachusetts received $815 million in tobacco-related legal awards and taxes. But spending on anti-smoking efforts has dropped from $54 million in 2000 to $4 million this year.
"For example, we had a South Shore collaborative that was up to a dozen towns on the South Shore, which no longer exists," said D.J. Wilson, tobacco control director for the Massachusetts Municipal Association.
"But when it did exist, they did policy, they did education, they did health fairs, they were in the schools,” Wilson said. “And so they had a whole menu of different ways to attack the problem of smoking which we recognize needs that kind of umbrella approach."
Wilson explained that in the past, Massachusetts had money to give out free nicotine patches to people trying to quit. And it ran a range of ads that warned people — especially teenagers — of the dangers of smoking, and drove them to the support hotline.
"Once you start smoking, you might not be able to stop,” one 1990s ad said. “You'll need another cigarette like you'll need your next breath."
This media campaign was credited as part of what brought smoking down more than 60 percent among high school students between 1993 and 2011. But in the throes of a Massachusetts fiscal crisis, revenues have been diverted to the general fund. And that's a problem for Democratic State Rep. Jonathan Hecht of Watertown.
"Ultimately, the cost that the state will bear for healthcare for people who develop tobacco-related diseases, and of course those costs will also be born by the individuals themselves and their families and their employers,” Hecht said. “Those are going to far outweigh the investment that we could be making up front right now in order to prevent people from becoming tobacco users in the first place."
And — perhaps surprisingly — tobacco giant Philip Morris agrees.
"Today there is more tobacco-generated revenue available to the states and the federal government than ever before to fund proven, effective efforts to prevent underage tobacco use,” said Phillip Morris spokesman Brian May. “Philip Morris alone has made tobacco settlement payments of more than $59 billion to the states since 1997."
State public health officials say they'll use this year's $4 million dollars to keep the quit smoking hotline going, and continue prevention and awareness programs in hospitals and schools. They'll continue to focus on children and teens, who are finding access to smokeless products, such as nicotine-infused gum and candy -- even nicotine hand gel. But for smoker Austin Duffy, lower funding for cessation programs is forgivable if state government does more to get people back to work.
"The state programs, they need to work on jobs,” Duffy said. “If you put people to work, they smoke less. Smoking relieves stress."
The New England Center for Investigative Reporting is a nonprofit investigative reporting newsroom based at Boston University. Reporter Beverly Ford also contributed to this story.
