STATE UNPREPARED FOR TOBACCO MONEY

MONEY from a tobacco settlement or court victory will help the people of
Washington much more if the state government soon can figure out why the
money is coming, where it's going and who should get it there. Even during
jury selection and heated negotiations, these basic questions remain
unanswered. Without a focused strategy, the state is likely to squander its
citizens' potential fortune as unwittingly as a careless heir.

The state's lawsuit against the tobacco industry has two parts: $3 billion
for Medicaid reimbursements, and $2.7 billion in punitive damages for
conspiring to defraud consumers. Typically, when victims of consumer fraud
can't be compensated individually, the money is used to benefit society in
a directly related way. Since the state can't write checks to all smokers
and their families, it has a moral and legal obligation to do the next best
thing - funnel all of the money to improve public health and reduce smoking.

All of the money.

Not a humble chunk of it, like many health advocates suggest. State
Attorney General Christine Gregoire appointed a group of at least 30 health
advocates from the state and health community to find ways to reduce
smoking. These dedicated individuals should be striding forward and
claiming ownership of the money on behalf of the people whose health they
are paid to cherish. They are not. They've watched legislators lick their
chops at the thought of tobacco money, a veritable Fountain of Pork. An
inevitable feeding frenzy is just one of several reasons for the health
advocates' timidity. Others include:

Leadership woes. The windfall from a settlement could be as much as $143
million a year. The health department spends less than $2 million a year
right now on tobacco-prevention programs. It's show time, and the
understudies are scrambling.

The head of the health department left in June, and four other key
positions remain vacant. The state has no secretary of health, no chief
health officer, no epidemiologist, no director of health policy and no
assistant secretary for health quality assurance. A few seasoned veterans
are minding the fort until Gov. Gary Locke appoints a permanent secretary -
which will take time, since Locke is conducting a national search.

Health officials say everything is fine, but secretly worry about a lack of
vision and leadership at a crucial time in the budget cycle and the tobacco
talks.

No role models. Health advocates speak eloquently about saving children's
lives through tobacco prevention, but many get tongue-tied when asked for
specifics. That isn't surprising. Effective prevention programs are hard to
find, and some of the most common anti-smoking campaigns may actually
encourage smoking.

Gregoire's group is studying states with major anti-smoking efforts, such
as California. But despite long-term assaults with millions spent every
year on billboards and other prevention efforts, teen smoking is on the
rise and at its highest nationwide since 1980. Some say the tobacco
industry's anti-teen-smoking advertisements cleverly encourage tobacco use
by reinforcing smoking as an "adults-only" pastime.

Health advocates know the research is slim. "It's real dicey as to what
would work," one said. "Hopefully some ideas will come through."

The specter of 601. State Initiative 601 puts a lid on spending from the
general fund. That means if the tobacco money goes to the general fund, the
legislators will be unable to spend most of it.

State budget gurus warned the legislature about the 601 problem, urging
them to create a just-in-case dedicated fund solely for tobacco money. They
didn't - partly because Gregoire didn't want them to muddle her settlement
negotiations. Today, there is no special place for the money to go.

The lawsuit creates an unprecedented challenge and opportunity for the
state, and the allies of public health and social justice are making great
strides. To meet the challenge, the state must reach several philosophical
and practical goals:

- -- Create a dedicated fund for tobacco money, with a firewall to protect it
from special interests and budget crises.

- -- Keep public health as the money's first and primary benefactor.

- -- Agree to link spending on prevention to solid research, even if it means
investing the money until better research is available.

- -- Make smoking-cessation programs available to every smoker in the state
through the Basic Health Plan and other insurance plans.

The state has a history of using tobacco money - cigarette taxes - for
purposes that have nothing to do with public health. If Gregoire wins or
settles this case, the state has an obligation to its citizens to reverse
that history.

Checked-by: Pat Dolan