Michigan ranks near the bottom nationally in how much it spends on smoking prevention and cessation and is missing a key opportunity to cut smoking rates and improve its citizens' health.

That's according to a report released Thursday by the U.S. Centers for Disease Control and Prevention that ranked Michigan 40th in spending on efforts to curb tobacco use in fiscal year 2001. The CDC also ranked Michigan higher than the national norm in 1999 in the percentage of adults and teenagers who smoke. "What we see are the states that are spending more are seeing significant drops in their adult and youth smoking rates," said Terry Pechacek, associate director for science at the CDC's office on smoking and health in Atlanta. "All the states that are making adequate investment are seeing 20-, 40-, 50-percent drops in youth smoking." The CDC said it hopes its new report, "Investment in Tobacco Control: State Highlights 2001," will be used by state officials as motivation to invest in research-proven prevention efforts. The CDC recommends Michigan spend at least $54.8 million a year on tobacco programs. The state currently spends $6.6 million annually, the report says, and is one of a handful of states that put none of their tobacco settlement dollars directly into tobacco-control programs. Much of Michigan's settlement money goes into college scholarships for students who do well on the MEAP test and to medical research on cancer and cardiovascular disease, said Susan Shafer, Gov. John Engler's spokeswoman. "The more educated children are, the less likely they are to smoke, so we thought that was a good investment in our future," Shafer said of the scholarships. The 1998 settlement reached among several tobacco companies and 46 states provides about $279 million to $365 million a year to Michigan. Engler earned the ire of health officials recently when his new budget proposed that the state continue to use none of the settlement money for prevention. "It is a disgrace that we've spent so little of the tobacco settlement money on addressing the tobacco problem," said Dr. Ron Davis, director of health promotion and disease prevention at the Henry Ford Health System and the former director of the federal office on smoking and health, on Thursday. "The whole point of the lawsuit ...was to make the tobacco companies pay for the damages they've caused and to prevent that from happening again." Scott Walker, director of health promotions for the Michigan Department of Community Health, said the state has a comprehensive approach that includes using media, schools and quit-smoking kits. He said a 75-cent-per-pack tax Michigan implemented in 1994 reduced tobacco use by about 20 percent, even though the per capita smoking rate has remained the same. The CDC report did not include all of Michigan's annual tobacco spending, Walker said. For instance, the state gave $6 million to the Council of Michigan Foundations, some of which will likely go to groups that fight tobacco use. And he said the state invests $1.1 million in a school health curriculum that's used in most districts and has a tobacco-education component. Walker said he is not convinced more money would reduce smoking rates in Michigan, which the CDC report says are at 34 percent for 9th through 12th graders and 25 percent for adults. "I think the jury is out," Walker said. On that point the CDC and many public health officials disagree. The CDC report shows that Florida, which invested heavily in prevention in recent years, saw smoking rates among middle school students drop by 40 percent between 1998 and 2000. Rates among pregnant women in Massachusetts, also considered a national leader in prevention, dropped by half. California, which started aggressive programs more than 10 years ago, now has the second-lowest adult smoking rate in the country at 18.7 percent. Recent research has shown that lung cancer and heart disease are dropping in California. As he waited at a bus stop on Grand River in Detroit, Eubiquiti Johnson, 19, a sophomore at Wayne State University, said he believes antismoking ads can be effective but not just any ad will work. "If you have an ad and you say 'Don't smoke, it's bad for you' -- they'll laugh at you. But if you have ads showing blackened lungs and things like that, it'll have an impact," said Johnson, who started smoking at 13. On Belle Isle, Linda Vasquez, 36, finished a cigarette as she watched Canada geese. Vasquez, who started smoking at age 14, said she has been trying to stop and is down from 2 1/2 packs a day to a half-pack. "It's not going to help anybody to tell people not to smoke," she said. "I don't care if they raise the price to $50 -- if people want to smoke, they're going to smoke."

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