Smokers left out
The more than $200 million Colorado has received in the tobacco lawsuit settlement is teaching children to read, mothers to raise healthy babies and teens the dangers of smoking.
About $11.5 million is aimed at preventing smoking-related illness by reducing secondhand smoke and encouraging people to quit smoking or never start. Colorado hopes to cut the number of smokers from 23 percent to 12 percent by 2010, said Karen DeLeeuw, who runs the grant program for the Colorado Department of Public Health and Environment.
Another $6.1 million will soon be handed out for research into tobacco's lure and effects.
But not a dime of the tobacco settlement is going to help the people whose suffering spawned the lawsuit -- victims of emphysema, lung cancer and other smoking-related illnesses.
Nurse Mary White, who treats such patients as a supervisor of cardiopulmonary rehabilitation at Montrose Memorial Hospital, said some of the money should be helping them.
Instead of suffering through their last years tied to home and an oxygen concentrator, more patients should be able to obtain the education, drugs and portable liquid oxygen that would allow them to live active lives, White said.
For example, 78-year-old Edith Dunn straps a small bottle of liquid oxygen on her back, hops on her ATV and skims the mountain ridges above Silverton at the height of every summer. When her swamp cooler needs work, this emphysema victim and former smoker climbs on the roof of her Montrose home to fix it herself. Until two years ago, she was still rappelling down mountains thanks to the oxygen flowing from her backpack to a tiny hole in her throat.
"My theory is, as long as I have to drag my hose, I'm handicapped," Dunn said. "But when I can put my backpack on, I'm not handicapped."
The key to Dunn's mobility is an expensive little bottle of liquid oxygen. The cheaper and common form of supplemental oxygen involves a concentrator that must be plugged into a power outlet, which means staying home, she said.
"I feel so sorry for these people I see that just quit," she said, "because it's not necessary with a little education."
Medicare doesn't help. Doctors must understand how to write a prescription insisting that portable oxygen is needed in the home. Medicare won't pay for portable oxygen if it is to allow someone to go shopping -- or mountain climbing.
The American Lung Association would like to see more tobacco funds go to people suffering from tobacco-related illness but not at the expense of smoking prevention, said Bob Doyle, director of tobacco programs for the Colorado branch.
The war over recruiting new smokers continues unabated, he said. Tobacco companies, far from reeling under the costs of the tobacco settlement, boosted their advertising 22 percent in 1999 to a record $8.4 billion, according to a Federal Trade Commission report.
Colorado is spending its share of the tobacco settlement on anything but ailing smokers because legislators fought hard for pieces of the windfall for their special interests. Some lawmakers mentioned programs for smokers during the two-year legislative battle, but those proposals died quickly, recalls Karen Reinertson, now head of Health Care Policy and Financing for the state.
The tobacco settlement stated the money was to be used to promote public health, provide money to the states and reduce youth smoking.
Although every program that made the final cut is a good cause, most have little to do with tobacco.
Schools were thrilled to receive grants designed to ensure that Colorado's children learn to read.
The state veterans program is planning to hand out grants with its first $250,000-$300,000 starting in July. Possible projects include transporting veterans to clinics and improving the state's four veterans nursing homes, said Dick Ceresko, director of veterans' affairs.
Clinics are providing basic health care for the poor.
One large chunk of the funds helped provide health insurance to another 10,000 low-income children, and it will add dental coverage for children on that plan in about October, said Barbara Ladon, director of Child Health Plan Plus.
None of these programs has anything to do with smoking.
Millions more dollars fund nurses' visits to poor pregnant women and new mothers to help them deliver and rear healthy babies, in a program that has dramatically improved the children's physical and social health as they grow up. In this program, there is one connection to tobacco: If the nurses can persuade mothers-to-be to quit smoking, they boost the health of both mother and baby.
Two of the seven programs do tackle tobacco head-on.
The smoking education and prevention program has handed out grants to youth groups for their own anti-smoking campaigns, said DeLeeuw. Other grants are expanding the anti-smoking efforts of local health departments, and of law enforcement agencies trying to halt the sale of tobacco to minors, she said.
The most visible effort will be a new statewide hot line offering instant counseling for smokers trying to kick the habit. An advertising campaign in July or August will announce the startup of the quit line, she said.
Finally, the first $6 million in research grants will be chosen in the coming weeks by a governor's advisory board, said Erwin P. Bettinghaus, interim director of the Colorado Tobacco Research Program at the University of Colorado. Among the 68 proposals are studies of the effect of the media on tobacco use, the effect of tobacco on the molecular biology of a cancer gene, and tests of a drug to determine if it reduces the effect of tobacco smoke.
The research program also is surveying schoolchildren and 12,000 households in hopes of finding pockets of population where smoking is especially common, Bettinghaus said. Then the state Health Department can target its anti-smoking efforts among these groups, he said.
More money comes into the tobacco settlement fund every year to continue these programs. But if the state succeeds in cutting smoking, the windfall will drop accordingly, Deputy State Treasurer Ben Stein said.
Arizona this week reported that the number of smokers dropped from 23 percent in 1996 to 18 percent in 1999. It credited an anti-smoking campaign financed with a 40-cents-per-pack tax increase.
Colorado's anti-smoking campaign offers further information on tobacco, including advice on quitting smoking and encouraging children not to start, at www.cdphe.state.co.us/pp/tobacco.
For more information on the health insurance program for low-income children, see www.cchp.org or call (800) 359-1991.
Colorado allocations to date:
Reading programs $15.3 million
Tobacco education and prevention $11.5 million
Children's health insurance $10 million
Tobacco research $6.1 million
Nurse home visitor programs $2.2 million
Low income health care $4.6 million
Veterans' trust fund $767,000
Trust fund for future $72 million
Cash* $80 million
*Will be transferred to trust fund
Source: Colorado treasurer's office