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Lambeth touts tobacco-prevention bill Lambeth takes turn trying to expand tobacco-prevention funding in N.C. Legislation would restore funding for prevention programs

Winston-Salem Journal - 3/8/2017

The N.C. Youth Tobacco Survey for 2015 determined that 9.3 percent of high-school students and 2.3 percent of middle-school students were current smokers. Those rates are down from 13.5 percent and 2.5 percent, respectively.

The survey found that 16.8 percent of high-schoolers had used an e-cig and vaporizer, 3.5 percent a hookah product and 3.1 percent a little cigar.

For each category, the survey defines product use as at least once over a 30-day period.

Nationwide, traditional cigarette smoking dropped to a record low of 10.8 percent, compared with 12.7 percent in 2013, according to the Centers for Disease Control and Prevention's biannual National Youth Tobacco Survey.

Smoking of e-cigs, vaporizers, hookahs and e-cigars jumped from 4.5 percent to 24 percent. The 2015 survey was the first to put e-cigs in a separate category and not in the smokeless-tobacco category.

Anti-smoking advocates have explained the increase in young adults consuming e-cigs as experimentation typical of the young, and e-cigs as a better alternative to traditional cigarettes.

N.C. Rep. Donny Lambeth will be the latest legislator to attempt what has become a quixotic challenge - restoring state funding for tobacco-prevention programs.

Lambeth will hold a press conference at 10 a.m. today to unveil House Bill 276, bipartisan legislation that would commit $17 million each of the next two budget years toward youth initiatives. A co-sponsor is Rep. Sam Watford, R-Davidson.

Lambeth wants tobacco-use prevention and educational programs to return to every county, with a particular focus on electronic cigarettes and other innovative products.

"Tobacco use is a pay-now or pay-later situation," said Lambeth, who served as president of N.C. Baptist Hospital and Davie and Lexington medical centers.

"With this $17 million a year investment, we can prevent young people from ever picking up tobacco.

"Or, if we fail to invest now, we can pay $3.81 billion in smoking-related health care costs and $4.24 billion in productivity losses each year."

In 2011, the Republican-controlled General Assembly abolished the N.C. Health and Wellness Fund after 10 years as part of an attempt at resolving the state's budget gap at that time. The average annual spending on tobacco-prevention programs had been $17.3 million.

Money for that program, as well as annual funding for the economic-development program Golden Leaf Foundation, had come from North Carolina's annual share of Master Settlement Agreement (MSA) funds, which has been about $140 million in recent years.

The landmark MSA agreement was reached in November 1998 between the top U.S. tobacco manufacturers and 46 state attorneys general. The manufacturers agreed to pay $206 billion over 20 years to those states to help pay for health-care expenses related to smoking. In some instances, the MSA payments are to be paid in perpetuity.

Most of the states, including North Carolina, have siphoned much, if not all, of the MSA payments toward their general funds.

For example, since 2012, the only annual dedicated state funding toward tobacco-prevention programs has been $1.1 million for the QuitlineNC program.

The 2017-19 budgets for Gov. Roy Cooper, introduced March 1, includes $1 million per year in funding for the QuitlineNC and You Quit Two Quit pregnancy programs.

By comparison, the federal Centers for Disease Control and Prevention recommends the legislature dedicate $99.3 million. Only seven states and Washington D.C. are spending less on direct funding than North Carolina.

"We should once again invest a portion of these funds into tobacco use prevention programs that we know work," Lambeth said.

For the past four years, a coalition of public-health advocacy groups has taken North Carolina's elected leaders to task for cutting the funding.

Lambeth's challenge with his proposed bill is that the Republican-controlled legislature has shown no interest in restoring the Health and Wellness Fund, even when bills are introduced by Republican colleagues.

For example, former Sen. Stan Bingham, R-Davidson, led two bipartisan efforts to get the legislature to provide tobacco-prevention funding in the 2015-16 sessions.

His first effort in 2015 was for $7 million. His second effort in 2016 was for $250,000.

Neither bill emerged from a committee.

Lambeth said he is aware of the long odds of getting support for his bill.

"But as a health committee chair, I have a responsibility to point out and work towards a healthier Carolina," Lambeth said. "This is one of those opportunities.

"It certainly has a long way to go. We will make our best efforts to help our fellow legislators understand the benefits.

"If it does not get much support, I will work with other budget chairs to get some additional funding in the budget in several of these focused areas."

Dr. John Spangler, a professor of family and community medicine at Wake Forest Baptist Medical Center, said Lambeth's bill would help contribute to a minimum of 80 fewer tobacco-related deaths in Forsyth County each year and 2,280 fewer deaths statewide.

"This figure looks only at heart disease, cancer and diabetes, and not at death from other diseases like chronic obstructive pulmonary disease, so, it is definitely an underestimate," Spangler said.

rcraver@wsjournal.com (336) 727-7376 @rcraverWSJ