Hawaiʻi ranks 13th nationwide in funding programs that prevent kids from using tobacco and help smokers quit. That according to a report released today by leading public health groups including the Campaign for Tobacco-Free Kids and the American Heart and Lung Associations.

According to the report, Hawaiʻi is spending $4.5 million this year on tobacco prevention and cessation programs, which is 32.9% of the $13.7 million recommended by the Centers for Disease Control and Prevention.

In Hawaiʻi, 8.1% of high school students smoke cigarettes, while 25.5% use e-cigarettes, one of the highest rates in the nation. Tobacco use claims 1,400 Hawaiʻi lives and costs the state $526 million in health care bills annually.

Other key findings include:

Hawaiʻi will collect $160.3 million in revenue this year from the 1998 tobacco settlement and tobacco taxes, but will spend only 2.8 percent of the money on tobacco prevention programs.

Tobacco companies spend $26.2 million each year to market their deadly and addictive products in Hawaiʻi – more than 5 times what the state spends on tobacco prevention. Nationwide, tobacco companies spend $9.5 billion a year on marketing – that’s over $1 million every hour.

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The report – “Broken Promises to Our Children: A State-by-State Look at the 1998 Tobacco Settlement 20 Years Later” – was released by the Campaign for Tobacco-Free Kids, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, the Robert Wood Johnson Foundation, Americans for Nonsmokers’ Rights and Truth Initiative. This year marks the 20 th anniversary of the landmark 1998 legal settlement between the states and the tobacco companies, which required the companies to pay more than $200 billion over time as compensation for tobacco-related health care costs.

Hawaiʻi has been a leader in fighting tobacco use with a high cigarette tax ($3.20 per pack), a comprehensive smoke-free law, the first statewide law raising the tobacco sale age to 21 and a strong tobacco prevention program. However, Hawaiʻi in recently years has steadily cut funding for tobacco prevention, with a 32 percent cut in the past year.

“Hawaiʻi has made significant progress, but the state is putting kids’ health at risk and burdening taxpayers with higher tobacco-related health care costs by cutting tobacco prevention programs,” said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. “We’ve made great strides in reducing smoking rates, but Hawaiʻi’s leaders cannot let their guard down as tobacco is still the No. 1 cause of preventable death and e-cigarettes threaten to addict another generation. To win this fight, Hawaiʻi needs to do its part to make the next generation tobacco-free.”

Nationwide, the U.S. has reduced smoking to record lows – 14 percent among adults and 7.6 percent among high school students. But tobacco use still kills more than 480,000 Americans and costs the nation about $170 billion in health care expenses each year. Today’s report highlights the need to address large disparities in who still smokes, with smoking rates highest among people with lower income and less education, residents of the Midwest and South, American Indians/Alaska Natives, LGBT Americans, those who are uninsured or on Medicaid, and those with mental illness.

The report also highlights the youth e-cigarette epidemic. Driven by the popularity of Juul, a sleek, easy-to-hide e-cigarette that is sold in sweet flavors and delivers a powerful dose of nicotine, e-cigarette use among U.S. high school students skyrocketed by 78 percent this year to 20.8 percent. In 2018, more than 3.6 million middle and high school students were current e-cigarette users – an alarming increase of 1.5 million in just one year.

By funding tobacco prevention and cessation programs at the CDC’s recommended levels, states can reduce tobacco use among all Americans. But most states are falling far short:

The states will collect $27.3 billion this year from the tobacco settlement and tobacco taxes but will spend only 2.4 percent of it ($655 million) on tobacco prevention programs.

The $655 million that the states have budgeted for tobacco prevention is a small fraction of the $3.3 billion the CDC recommends. Not a single state funds tobacco prevention programs at CDC-recommended levels, and only two states – Alaska and California – provide even 70 percent of the recommended funding.

States with well-funded, sustained tobacco prevention programs have seen remarkable progress.

Florida, with one of the longest-running programs, has reduced its high school smoking rate to 3.6 percent, one of the lowest rates ever reported by any state.

The report and state-specific information can be found at tfk.org/statereport.