Press Release

National Center for Tobacco-Free Older Persons

The Center for Social Gerontology, 2307 Shelby Avenue, Ann Arbor, MI 48103

For Immediate Release -- December 9, 1999

For more info: Contact Jim Bergman 734 665-1126 or jbergman@tcsg.org

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Older Persons' Programs Fared Well in Initial Tobacco Settlement Allocations, But News Not All Good

"As the first tobacco settlement payments are about to arrive in most of the states which were parties to the Master Settlement Agreement (MSA), it is fair to quote Dickens in saying 'it is the best of times and the worst of times' for funding of programs for older persons with tobacco settlement dollars," said Jim Bergman, head of the newly formed National Center for Tobacco-Free Older Persons (NCTFOP) and Co-Director of The Center for Social Gerontology.

"Older persons are the primary victims of the disease and death caused by smoking and secondhand smoke in the U.S., with over 94% of the annual tobacco-related deaths occurring to persons aged 50 and over, and 70% to persons aged 65 and over. Yet, when discussions began about how the settlement funds should be used, virtually nothing was said about utilizing a portion of these funds for health-related programs for older persons; older persons were the unseen victims and about to be ignored," said Bergman. "Now, as the first year of legislative activity in allocating the settlement funds draws to a close, it is clear that the voices of these older victims of tobacco have been heard all across this nation, and governors and legislators have begun to respond."

Action by the States -- About $200 Million each for Aging & Tobacco Control

"About 29 states have taken some form of action on the tobacco settlement funds, but about 10 of these states did not actually appropriate funds that can be spent yet, instead deferring the spending decisions until 2000 or 2001 or until voters act on ballot initiatives. Of the approximately 19 states that actually made appropriations that can be spent in FY'2000, 11 of those states (or almost 60%) appropriated funds for PROGRAMS FOR OLDER PERSONS.

"Together, these 11 states have allocated about $160 MILLION for FY'2000 for programs for older persons. In addition, in 4 states, programs for older persons received a total of about $20 to $40 million in new appropriations from general revenues, due to the initial push for settlement funds for these purposes. And, a number of other states increased their Medicaid program appropriations using settlement funds, with much of the Medicaid funding going for in-home or nursing home care for older persons," stated Bergman. "Thus, it is the best of times for older persons because, in less than a year, they have gone from being unseen and unthought-of victims of tobacco-caused diseases and death to being the beneficiaries of a share of the settlement funds."

Of the $160 million of settlement funds allocated for programs for older persons, most has gone for PRESCRIPTION DRUG PROGRAMS for low-income elders or for IN-HOME CARE to enable older persons to stay in their own homes instead of having to go into nursing homes. Significantly, the vast majority of these funds have been targeted to services for the most needy older persons and those with health problems most related to smoking and secondhand smoke. Also, while most of these allocations are just for one fiscal year, these programs constitute long-term commitments by the states of multi-billions of settlement dollars over the coming years.

"Importantly, the settlement funds are being used by a number of states to remedy the PRESCRIPTION DRUG CRISIS facing older persons -- a crisis which Congress has identified but been unable to address thus far," Bergman said.

"The use of settlement funds for such programs for older persons is only right, since most of the medical costs under the Medicaid programs that the states sued to recover were costs incurred by older persons. In this sense, justice is being served since the tobacco industry caused the crisis in health care for older persons, and now they are having to pay for it," said Bergman.

"However, it is also the worst of times in two ways: first, such a small percentage of the total settlement funds are being allocated for health-related services for older and younger persons; and, second, such a small amount of these funds are being allocated for tobacco prevention and cessation programs for older and younger persons," stated Bergman.

According to calculations by the NCTFOP of The Center for Social Gerontology, thus far only about $208 million have been appropriated for FY'2000 for TOBACCO PREVENTION AND CESSATION PROGRAMS by 16 states out of the 19 states which have actually appropriated funds which can be spent in FY'2000. This amount includes funds from Minnesota, Florida, Texas and Mississippi which entered into their own settlements, but does not include allocations made in Washington state which has reserved $100 million for this purpose but for an unspecified period of years and which has not yet set an amount for FY'2000. This figure also does not include any amounts for states such as Virginia, North Dakota, North Carolina or Wyoming which have said they will allocate funds for tobacco control programs, but have, so far, not actually appropriated set dollar amounts for this purpose. Therefore, the actual amounts appropriated so far constitute just a small percentage of the total funds allocated for all purposes thus far by the states.

According to Bergman, "tobacco prevention and cessation programs are crucial to halting the epidemic of tobacco-related disease and death in this nation. Older persons are among the first to say that they believe programs are needed to encourage children -- their grandchildren -- not to start smoking, because they know directly and personally the suffering and grief that results from smoking. Further, smoking cessation programs are vitally needed for older persons in this country, among whom are 13 million smokers aged 50 and over, 4 million of whom are aged 65 and over. Research is conclusive in showing that quitting at any age is beneficial to health, and the improvement in health begins almost immediately, even in older persons."

"Funding is needed for the prevention of smoking in public places, as well as for other tobacco prevention and cessation programs, inasmuch as secondhand smoke causes over 50,000 deaths annually in this county, with older persons the primary victims. Older persons and young children are among the primary victims of the health problems caused by secondhand smoke, and settlement funds are needed to address this very serious health issue," said Bergman.

Bergman concluded, "there is a clear message that needs to be sent to governors and legislators as they decide in the coming year how to spend the billions of tobacco settlement funds: TOBACCO MONEY FOR TOBACCO-RELATED HEALTH PROBLEMS."

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The National Center for Tobacco-Free Older Persons (NCTFOP) was founded by The Center for Social Gerontology (TCSG) of Ann Arbor, Michigan and is dedicated to redressing and mitigating the physical and emotional harm to older persons caused by the actions of the tobacco industry. The NCTFOP serves as a national advocate and source of information on tobacco and older persons issues, as well as a center for conducting research, education, and training to increase public awareness of the effects of tobacco on older persons and to reduce smoking and exposure to secondhand smoke by older persons. TCSG, founded in 1972, is a non-profit research, training and social policy organization whose mission is to promote the individual autonomy of older persons and advance their well-being in society.

FOR THE MOST COMPREHENSIVE SOURCE OF INFORMATION ON THE USE OF TOBACCO SETTLEMENT FUNDS for older persons and tobacco prevention and cessation programs, go to TCSG's web site at www.tcsg.org/tobacco/settlement/updates.htm.

Attachments:

1.) Fact sheet on tobacco and older persons.

2.) Listings by state of settlement funds allocated to aging and tobacco control programs.

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STATES IN WHICH TOBACCO SETTLEMENT FUNDS HAVE BEEN ALLOCATED FOR AGING PROGRAMS

Alabama: $2 million in FY'2000 and annually for at least the next 25 years for a trust fund for elderly services; also, $40 million allotted for FY'2000 to the Medicaid program.

Delaware: A new prescription drug program for elders was enacted to be paid out of settlement funds; estimated cost in FY'2000 is $2.7 million and $5.1 million in FY'2001.

Florida: $1.7 billion over the next four years will go into the newly-created Lawton Chiles Endowment for Children and Elders; in FY'2000, $17.3 million will be allocated to community-based care for elders to wipe out an existing waiting list to enable elders to avoid going into nursing homes.

Maine: $5 million in FY'2000 to expand the prescription drug program for elders; this represents 27% of the settlement funds which were allocated for FY'2000.

Massachusetts: $42 million in FY'2000, with $22 million for expansion of the existing prescription drug program for elders, and $20 million for a new program to cover catastrophic drug costs of elders.

Michigan: $53 million in FY'2000, allocated as follows: $30 million for a prescription drug program for elders; $5 million to match $5 million of federal funds so as to double the nursing home resident personal needs allowance to $60/month; $5 million for respite care for elders through the Area Agencies on Aging; $3 million for a new Long-Term Care Advisor program in the state Office of Services to the Aging; and $10 million for a one-time allocation for long-term care innovation grants.

Minnesota: No settlement funds went to aging programs, but aging received $12 million of new general funds for expansion of the prescription drug program for elders; this was simply a last-minute decision of the legislature about what funds to use for this purpose, general funds or tobacco settlement funds, after aging and tobacco control groups had made a very strong push for settlement funds for this purpose.

Nebraska: $0.5 million per year for respite care for the elderly and disabled.

Nevada: 30% of the total settlement payments annually (in perpetuity) for aging programs, equals about $360 million over 25 years, or an average of about $14.4 million per year; the funds are to be split equally between a prescription drug program for elders and services to enable elders to remain in the community.

New Jersey: $19.2 million in FY'2000, with $8.7 million for expansion of the prescription drug program for the elderly and disabled, and $10.5 million for community-based long-term care alternatives for elders; the $19.2 million is about 20% of the state's total settlement allocation for FY'2000.

Oregon: No settlement funds were allocated because the legislature voted to send the issue of deciding how to use the funds to a ballot initiative in November, 2000; however, the Aging Network had made such a strong push for settlement funds for transportation services for elders that the legislature appropriated $4 million of new general funds for this purpose.

Rhode Island: $3.4 million in FY'2000 for community-based care to enable elders to remain in their homes.

Vermont: $325,000 in FY'2000 for community-based services for the elderly; aging services also received a large general funds increase which resulted in part from the strong effort to obtain tobacco settlement funds.

Wisconsin: No settlement funds were allocated for aging, although this is somewhat difficult to discern since the state lumps settlement funds into the general revenues; however, in-home services for elders did receive an increase which is undoubtedly due in part to the availability of settlement funds in the general fund.

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STATES IN WHICH SETTLEMENT FUNDS HAVE BEEN OR APPEAR LIKELY TO BE ALLOCATED FOR AGING or TOBACCO CONTROL PROGRAMS:

AGING: Alabama - $2 million in FY'2000 for trust fund for elderly services; Arkansas; Delaware - an estimated $2.7 million in FY'2000 and $5.1 million in FY'2001 for a prescription drug program for low-income elders; Florida - $1.7 billion fund for elders & kids with $17.3 million for elders in FY'2000; Maine - $5 million in FY'2000; Massachusetts - $42 million in FY'2000; Michigan - $53 million in FY'2000; Mississippi; Nebraska - $0.5 million; Nevada - 30% of settlement payments annually equals $360 million over 25 years; New Jersey - $19.2 million in FY'2000; New York; Ohio; Oklahoma; Pennsylvania; Rhode Island - $3.4 million in FY'2000; Vermont - $325,000 in FY'2000.

TOBACCO CONTROL: Alaska - $1.4 million for FY'2000; Arkansas; District of Columbia; Florida - $45 million in FY'2000; Hawaii - 25% of settlement total, or about $3.6 million in FY'2000 and about $10-12 million in future years; Maine - $3.5 million in FY'2000; Maryland - $21 million annually; Massachusetts - 1/4 of 30% of funds annually or about $22.8 million in FY'2000; Minnesota - $489 million into endowments for tobacco prevention programs, with $17.7 million for FY'2000; Mississippi - a pilot program for 1999 & 2000 was funded with $62 million ; Montana - $7 million for biennium of FY'2000-01; Nevada - 10% of settlement funds annually or $120 million over 25 years; New Hampshire - $3 million per year; New Jersey - $18.6 million in FY'2000; New York; North Carolina; North Dakota - some portion of 10% of the funds set aside for health programs; Ohio; Pennsylvania; Rhode Island - $1 million for FY'2000; Texas - $200 million into an endowment, with interest of about $10 million anually for tobacco prevention; Vermont - reserved $19.2 million for FY'2000; Virginia - 10% of settlement funds for tobacco control and other health programs (not yet decided how much for what); Washington - $100 million for tobacco control, but not clear how much for FY'2000 or future years out of the $100 million; Wisconsin - $23.5 million for the biennium, with $2.3 million for FY'2000 and $21.2 million for FY'01; Wyoming - all settlement funds in a trust, with some to be allocated in 2000 for tobacco prevention.

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FACT SHEET ON TOBACCO & OLDER PERSONS

Prepared by: The Center for Social Gerontology, Ann Arbor, MI

Of the over 416,000 smoking-related deaths annually in the U.S., over 94% are to persons aged 50 and over; over 70% are to persons aged 65 and over.

One in three smokers die prematurely in the U.S., losing an average of 12 to 15 years of life versus normal life expectancy -- thereby eliminating retirement years for most of these people. We refer to smoker's continuing to smoke in spite of these odds as "Smoker's Russian Roulette."

Nationally about 13% of persons aged 65 and over are smokers -- over 4 million persons. Nationally about 26% of persons aged 50 to 64 are smokers -- about 9 million persons. Thus, nationally over 13 million Americans aged 50 and over are currently smokers. Further, the over 13 million smokers aged 50 and over account for about 27% of all adult smokers in the U.S.

Today's generation of older Americans -- those persons born between 1900 and 1948 who are now aged 50 and over -- had smoking rates among the highest of any U.S. generation. In the mid-1960s, about 54% of adult males smoked and another 21% were former smokers; over 34% of adult females were smokers and another 8% were former smokers. Today's epidemic of smoking-related deaths is the result of these high smoking rates.

Of the approximately 3 million pipe smokers in the U.S., over half are over the age of 46.

All the major causes of death among the elderly are associated with smoking or secondhand smoke -- cancer, heart disease, and stroke. And, each of these diseases generally is associated with months and years of disabling pain and suffering.

Tobacco-related fires claimed almost 1,400 deaths in 1995; of these over 700 occurred to persons aged 50 and over (over 50%) and almost 440 of these deaths were to persons aged 65 and over (over 30%). Smoking is the number one cause of fires that kill older persons.

Of cases of oral and throat cancer in the U.S., 95% occur in persons aged 40 and over; the average age at diagnosis is 60 years. Smoking, particularly when combined with heavy alcohol consumption, is the primary risk factor for approximately 75% of oral cancers in the U.S. In 1998, about 30,000 Americans will be diagnosed with oral and throat cancer; about 8,000 deaths will result, of which 5,200 will be men and 2,800 women.

Recent research has indicated that smoking use is related to a number of other health problems/diseases that are generally associated with aging, including hearing loss, dementia and Alzheimer's.

Research has shown that stopping smoking results in improvement in health status at any age, including in those persons aged 65 and over. Some health benefits are almost immediate, and the longer people refrain from smoking, the more their health improves.

Data in this Fact Sheet has been taken from the following: Centers for Disease Control "Smoking-Attributable Mortality, Morbidity, & Economic Costs" SAMMEC 3.0, August, 1996; Orleans, C.T., & Slade, J., editors, Nicotine Addiction: Principles & Management, 1993; MMWR, p. 2, 8/28/98; MMWR, pp. 588-9, 7/12/96; CDC State Tobacco Control Highlights, 1997; Pipe Tobacco Council data in Wall Street Journal, 12/31/96.

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