The slight increase in smoking prevalence detected by the National Health Interview Survey is cause for concern but probably not alarm. The upward trend was small (less than 1%) but it should definitely give us pause. Smoking prevalence has reduced over the years due to a number of factors. The increasing cost of smoking from excise taxes and price increases, as well as smoke-free indoor air restrictions, have both led to reductions in smoking prevalence. As smoking becomes more expensive and less convenient, smokers try to quit. Some smokers quit on their own, but others need help.

Certainly tobacco dependence treatment resources have been a valuable resource for those unable to quit on their own. However treatment programs such as State Tobacco Telephone Quit Lines and face-to-face programs have been underfunded for years. In 1998 there was hope that the money from the Master Settlement Agreement fund (over $300 Billion) would provide the necessary help for smokers to quit this deadly addiction. Sadly, less than 3% of these monies were used to fund tobacco prevention and cessation. As a result no state is offering services they feel are needed to adequately address the treatment needs of smokers, but rather they are offering the services they can based on the inadequate funding they receive. It is a rather sad commentary on how Federal and State governments have addressed the leading cause of preventable death in the US.

This problem has been further exacerbated by the fact that no revenue from the recent $0.62 federal excise tax increase went to fund help for smokers wants to quit. Together these failures to fund treatment and prevention have resulted in less reduction in smoking than was hoped.

Certainly these are tough times. We are in the middle of a severe financial downturn with the feds and states all struggling to keep their heads above water. Nevertheless, many of us in the tobacco-dependence treatment field strongly feel that it is unethical – that it is even a human rights issue – that smokers are taxed on their addiction but none of that revenue is then used to help them become smoke free. We further run the risk of government becoming “addicted” to this source of revenue and, as a result, become less incented to reduce smoking prevalence.

The Tobacco Control field at the federal, state, private, and volunteer levels is full of individuals who are passionate and fully committed to reducing the death and disease caused by smoking. However, to be successful in this critical work funding is necessary to provide services to help smokers of all ages to quit. In the CDC’s most recent Mortality and Morbidity Weekly Report (Vol 58/No 44) you find the following statement: “Offering and providing effective cessation counseling and treatment are integral to reducing the smoking epidemic….”

One can only hope that this report results in those who hold the purse strings to take another hard look at funding for programs to help smokers quit.