Progress in Reducing Tobacco Use Across Nebraska

Abstract

Tobacco use is the leading cause of preventable death in the United States, causing over 400,000 deaths annually. In Nebraska each year, 2,400 adults die prematurely because of cigarette smoking. It is estimated that 45,000 Nebraskans now under the age of 18 will eventually die prematurely from cigarette smoking. Cigarette smoking is responsible for 419millionofNebraska2˘7sannualhealthcarecosts(representingapproximately7percentofthestate2˘7sannualhealthcarecosts,including12percentofNebraska2˘7sannualMedicaidexpenditures),andsmokingrelatedmortalityresultsinover419 million of Nebraska\u27s annual health care costs (representing approximately 7 percent of the state\u27s annual health care costs, including 12 percent of Nebraska\u27s annual Medicaid expenditures), and smoking-related mortality results in over 400 million in forgone future earnings in the state per year. In 2000, the Nebraska State Legislature took an important step towards addressing the state\u27s most significant public health problem by enacting Legislative Bill 1436, which appropriated 21millionfromtheTobaccoSettlementTrustFundtosupportstatewidetobaccopreventionandcessationefforts.ThisadditionalfundingenabledtheNebraskaHealthandHumanServicesSystem2˘7s(NHHSS)existingtobaccoprogram,TobaccoFreeNebraska(TFN),togreatlyexpanditseffortsbyestablishingacomprehensivestatewidetobaccoprogram.ThefundingmarkedaturningpointforTFN,resultingintheCentersforDiseaseControlandPreventioncitingtheprogramasoneofthemodeltobaccopreventionandcessationprogramsinthenation.In2002,theStateLegislaturetookanotherimportantsteptowardseliminatingtobaccouseinNebraskabypassinga30centincreaseinthestate2˘7scigarettetax.TFNsachievementsasamodelprogramhavebeenpreviouslydocumentedinthe2001and2002StateSnapshotsandthroughavarietyofotherreportsdevelopedbyanindependentevaluationteam.Thesereports,includingthisStateSnapshot,provideinformationonstatewideprogressintobaccocontroleffortstoNHHSS,national,state,andlocalpolicymakers,andotherinterestedparties.Theyear2003markedanotherturningpointforTFN.InJune,theNebraskaStateLegislaturemadeanappropriationof21 million from the Tobacco Settlement Trust Fund to support statewide tobacco prevention and cessation efforts. This additional funding enabled the Nebraska Health and Human Services System\u27s (NHHSS) existing tobacco program, Tobacco Free Nebraska (TFN), to greatly expand its efforts by establishing a comprehensive statewide tobacco program. The funding marked a turning point for TFN, resulting in the Centers for Disease Control and Prevention citing the program as one of the model tobacco prevention and cessation programs in the nation. In 2002, the State Legislature took another important step towards eliminating tobacco use in Nebraska by passing a 30-cent increase in the state\u27s cigarette tax. TFN’s achievements as a model program have been previously documented in the 2001 and 2002 State Snapshots and through a variety of other reports developed by an independent evaluation team. These reports, including this State Snapshot, provide information on statewide progress in tobacco control efforts to NHHSS, national, state, and local policymakers, and other interested parties. The year 2003 marked another turning point for TFN. In June, the Nebraska State Legislature made an appropriation of 405,000 annually to TFN through Legislative Bill 285A rather than renewing the program\u27s funding at its previous level of 7million.Thenewappropriationrepresentsa94percentcutintheannualprogramfundingoriginallyprovidedbyLB1436.Becauseofthisrecentbudgetcut,manycomponentsofNebraska2˘7scomprehensivetobaccopreventionandcessationprogramhavebeenscaleddownorwillsoonbeeliminated(seebelow).ThisplacesthefutureofTFN2˘7sstrongcommunitybasedfoundationinjeopardysincetheprogram2˘7slevelofsupportiswellbelowtheannual7 million. The new appropriation represents a 94 percent cut in the annual program funding originally provided by LB 1436. Because of this recent budget cut, many components of Nebraska\u27s comprehensive tobacco prevention and cessation program have been scaled down or will soon be eliminated (see below). This places the future of TFN\u27s strong community-based foundation in jeopardy since the program\u27s level of support is well below the annual 13.3 million in funding recommended by the CDC to implement statewide best practices in tobacco control

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