Brown University News Bureau

The Brown University Op-Ed Service
Tracie Sweeney, Editor
Distributed March 1999
Copyright ©1999 by David B. Abrams

Using tobacco settlement funds to save lives in Rhode Island

By David B. Abrams
David B. Abrams is professor and director of the Brown University/Lifespan Center for Behavioral and Preventive Medicine. He has spent more than 20 years doing research on nicotine addiction and helping people quit smoking. In 1996-97, he was appointed by the director of the National Cancer Institute of the NIH to chair a special review panel which issued a report to the nation on how to control cancer in the 21st century and reduce cancer's burden on all Americans

"Nicotine addiction is not just a bad habit smokers bring on themselves. It's a medical disease"

Tobacco use kills 2,000 Rhode Islanders every year. That's like having one fully occupied jet plane crash every single month of every year at Green Airport leaving no survivors.

We should not have to watch another loved one die from tobacco addiction. Our state will receive $40 million to $60 million a year from a legal settlement from the tobacco industry to compensate Rhode Islanders for harm caused them by smoking.

Rhode Island has a unique opportunity to be a national leader by using the settlement money to implement a comprehensive plan to improve health and health care. Key elements of such a program should include advertising campaigns that counter the tobacco industry ads, enforcement of laws that prohibit youngsters' access to cigarettes, establishment of certified smoking cessation programs, and self-help and public health education.

The truth is that nicotine, the addictive drug in cigarettes, snares children in our state, and once addicted many cannot quit even as adults. The tobacco industry's internal documents have proven that it makes money by marketing cigarettes to children, often in poorer communities. The tobacco industry knows full well that cigarettes are addictive - as addictive as cocaine - and treatment of nicotine addiction must be taken seriously. Nicotine addiction is not just a bad habit smokers bring on themselves. It's a medical disease.

Parents who smoke are their children's role models. If we want to prevent kids from getting hooked on nicotine, we need to help adults quit. Smoking during pregnancy causes low birth weight in newborns. Children who live with smokers are twice as likely to die of Sudden Infant Death Syndrome. They have many times more ear and throat infections, which often lead to unnecessary surgery. About 40 percent of all children's asthma would go away if no one smoked around children.

Women's lung cancer is an epidemic now, and has been epidemic in men for decades. What many women smokers don't realize is that their risk of dying from lung cancer is much greater than of either breast cancer or heart disease. By the year 2003, lung cancer will kill double the number of women as does breast cancer, and, unlike breast cancer, lung cancer has no known successful treatment. Anyone's chance of surviving five years after discovery of lung cancer is less than 15 percent; the breast cancer survival rate exceeds 80 percent.

Excellent prevention and cessation treatments exist, but few people can afford them. There are too few clinics and too few special programs with trained professional counselors to help the most heavily addicted smokers.

We must take what we know from research and make it easily available to every Rhode Islander. At least 20 percent of the tobacco settlement funds must be used to reduce tobacco use, with the rest going toward improving health and treating tobacco related diseases such as cancer. This money must go toward preventing children from abusing tobacco and other substances and toward helping adults - especially the uninsured and those with low paying jobs who smoke the most - get the best cessation treatments available. The money must also go toward helping smokers, their families, their health care providers and the health care system deal with the consequences of tobacco addition. Every last cent must be dedicated to improving health and health care.

The tobacco industry has killed 50 million men and 10 million women from 1950 to 2000, far more than the 8 million killed by Nazis in World War II. The tobacco companies finally admitted their guilt and agreed to pay damages. Does it not seem fair, then, that the tobacco money should go to the victims and not to more big government spending programs?

Rhode Island can seize the opportunity to be a leader in the way it uses the settlement money to improve its citizens' lives, but that role can't be assumed by putting settlement money into the general treasury.

Governor Almond must reconsider his statement that the settlement money will be not be dedicated to improving health. He must empower the attorney general's task force that was appointed to oversee the tobacco settlement. This task force is qualified to make sure the money is spent wisely on a comprehensive plan, carefully monitor the results of the plan, and produce an annual "report card" to Rhode Island's citizens on whether they are getting value for their money.