Restore Comprehensive Funding
Washington Breathes’ members and partners work together to restore Washington State’s commitment to supporting sustainable, well-funded, community-centered programs to reduce commercial tobacco use and nicotine dependence. These programs should provide effective, culturally appropriate services that address inequities and protect our communities against tobacco industry tactics.
- Washington State ranked 45th in the nation in FY 2022 and 33rd in FY 2023 for its state investment in commercial tobacco prevention and cessation treatment. WA fell back to 39th in the nation in FY 2024 because the level of state support decreased again. 1
- From 2012-2022, less than 1% of tobacco-related Washington state revenues were invested in nicotine prevention and cessation.
- $3.26 billion in annual health care expenditures are directly caused by commercial tobacco use.
- $847.6 million in state Medicaid program health expenditures are caused by commercial tobacco use.
Restoring A Comprehensive State Program is Essential for...
- Providing evidence-based and equity-focused prevention, education, and treatment services in all communities.
- Reducing known disparities in populations that are targeted by the tobacco industry and systemically disadvantaged. (Learn more about Addressing Disparities)
- Protecting our children, teens, and young adults from the industry’s pervasive e-cigarette marketing that fuels the vaping epidemic, especially among those who are Native American, Alaskan Native, people of color, and LGBTQ+. (Learn more about Supporting Healthy Youth)
Learn more about current state investments and restoring a comprehensive program.
Share Our Fact Sheet: 'Washington Invests Too Little in Preventing & Treating Nicotine Dependence'
Proven Success of a Comprehensive Approach
Washington was a national leader in reducing smoking and improving health in the early 2000s because of state investments that protected communities and helped people quit nicotine. From 2000 to 2009, about $23.6 million of state funds were invested each year in the Department of Health’s comprehensive prevention and cessation program that supported community-based programs, school-based programs, cessation services, retailer education and compliance to prevent youth access, and public awareness campaigns. As a result:
- from 2001-2005: overall smoking rates fell 22.5% to 17.6% and youth smoking fell 12.5% to 7.8%.2 These results exceeded national declines during the same time.
- From 2000-2009: each $1 spent by the state on tobacco prevention and control saved more than $5 in tobacco-related health care costs.3 Hospitalizations for heart disease, stroke, respiratory disease and cancer caused by tobacco use were reduced during this time.
From 2000-2009, Washington State dedicated portions of tobacco tax revenues and Master Settlement funding into a multi-faceted comprehensive program to prevent use and help people quit nicotine. A seven-year program plan was developed through an inclusive process and is described in “A Tobacco Prevention and Control Plan For Washington State” (September 2000). It is a model strategy that Washington needs to reinvest in.
Components of a Comprehensive State Strategy:
Hard Consequences of Funding Cuts
Lack of sufficient investment has slowed the state’s progress towards reducing smoking and other nicotine use, especially in communities with the highest tobacco use rates that are most impacted by tobacco-related disease and premature death.
State funding for commercial tobacco prevention and cessation was dramatically cut during the Great Recession in 2009, and have not been restored to support the proven comprehensive strategy. Program funding went from an average of $23.6 million per year (2000-2009) to an average of $2.3 million per year (2012-2022). Successful programs were scaled back or shut down, and many experienced staff could not be retained.
Washington receives more than $500 million per year in tobacco tax revenues and Master Settlement Agreement payments, but none of those funds are dedicated to helping people who want to stop using nicotine products, supporting nicotine-free youth, or countering the constant onslaught of enticing new products from the tobacco industry.
From 2012-2022, less than 1% of tobacco-related Washington state revenues were invested in nicotine prevention and cessation.
The pie chart above shows distribution of revenues for FY 2022. Since FY 2020, revenues from the vapor products tax have been allocated 50% to the Andy Hill Cancer Research Endowment and 50% to Foundational Public Health Services (FPHS). FPHS funding supports critical governmental public health infrastructure, but does not directly fund commercial tobacco prevention or cessation programs.
Consequences of state cuts to commercial tobacco prevention and cessation:
Reduced ability to address known inequities. Many communities were left behind in the state’s progress to reduce smoking, even as they are the most targeted by tobacco companies and disproportionately suffer from higher use rates, chronic diseases, and premature death. These disparities impact people who are American Indian/Alaska Native, Black/African-American, Hispanic, Latine, Asian, Pacific Islander, LGBTQ+, veterans, lower income, and people with behavioral health concerns.
Reduced ability to pivot with the industry’s e-cigarette push. Resources and staffing for community-based prevention programs are too limited to effectively counter the influx of flavored e-cigarettes and the resulting dramatic increase in nicotine dependence among youth and young adults.
Reduced capacity to sustain effective programs and experienced staffing. Funding limitations and uncertainties dismantled the successful statewide program built from 2000 to 2009. Across the state many committed professionals continue trying to do all they can with limited resources and need ongoing support to rebuild effective programs.
In the early 2000s, Washington State invested in a comprehensive commercial tobacco programs that was a successful model for the nation.
In response to the 2008 recession, Washington State eliminated all general fund support and all funding from the tobacco industry’s annual Master Settlement Agreement payments.
Program funding went from an average of $23.6 million per year (2000-2009) to an average of $2.3 million per year (2012-2022) from state tobacco licenses and fines.
New state investment of $5 million in the FY 2024-2025 biennium budget is a promising sign, but still falls far short of adequate state support.
Washington state received an F grade for Tobacco Prevention and Cessation Funding in the American Lung Association’s annual State of Tobacco Control report in 2023, and for many years before that.
Meanwhile...the industry spends more than $80 million a year in Washington to market its addictive and deadly products.
Did you know?
Funding for Foundational Public Health Services is critical, but it does not directly support commercial tobacco prevention and cessation.
Washington state’s Foundational Public Health Services Account helps fund the critical core services for public health and safety provided by Washington’s governmental public health system (state, local, and Tribal). This provides an essential foundation for healthier communities across the state, but it does not fund every critical public health program.
None of the funds from the Foundational Public Health Services Account are currently allocated to commercial tobacco education, prevention programs or cessation services. Supporting the public health system indirectly benefits commercial tobacco prevention and cessation through health assessments, data systems, improving access to clinical care, and other services that support healthy communities.
Earlier reports to the Legislature recognized commercial tobacco prevention and cessation as key parts of foundational public health services, but this goal has not yet been realized. The 2016 FPHS Report to the Legislature on Public Health Modernization and the 2014 FPHS Final Phase II Technical Workgroup Report, detail recommended models and funding plans to support commercial tobacco prevention & control.
- Campaign for Tobacco-Free Kids: States Ranked by Percent of CDC-Recommended Funding Levels.
FY 2022 State Rankings https://assets.tobaccofreekids.org/content/what_we_do/state_local_issues/settlement/FY2022/1_FY2022_Rankings.pdf
FY2023 State Rankings: https://assets.tobaccofreekids.org/content/what_we_do/state_local_issues/settlement/FY2023/1-FY2023-Rankings-of-Funding-for-State-Tobacco-Prevention-Programs.pdf
FY 2024 State Rankings: https://www.tobaccofreekids.org/what-we-do/us/statereport/washington, accessed January 2024.
- Julia Dilley, et al. “Effective tobacco control in Washington State: a smart investment for healthy futures.” Prev Chronic Dis 2007 Jul;4(3):A65. https://pubmed.ncbi.nlm.nih.gov/17572969/
- Julia A. Dilley, et al. “Program, Policy, and Price Interventions for Tobacco Control: Quantifying the Return on Investment of a State Tobacco Control Program”, American Journal of Public Health 102, no. 2 (February 1, 2012): pp. e22-e28. https://doi.org/10.2105/AJPH.2011.300506