Academic journal article Health and Social Work

Post-Tobacco Master Settlement Agreement: Policy and Practice Implications for Social Workers

Academic journal article Health and Social Work

Post-Tobacco Master Settlement Agreement: Policy and Practice Implications for Social Workers

Article excerpt

Tobacco use has long been recognized as the leading cause of preventable deaths in the United States, and the severe health and social consequences of tobacco use have been well documented. Cigarette smoking accounts for an estimated 443,000 deaths annually--nearly one of five--in the United States (Centers for Disease Control and Prevention [CDC], 2008).Each year, the number of deaths caused by tobacco use exceeds the total deaths resulting from HIV, alcohol use, illegal drug use, motor vehicle accidents, homicides, and suicides. In addition, tobacco smoking is the recognized cause in 90 percent of deaths from chronic obstructive lung disease, 90 percent of lung cancer deaths in men, and 80 percent of lung cancer deaths in women (U.S. Department of Health & Human Services, 2004). The World Health Organization (WHO) has projected that by 2030, 10 million people will die annually because of tobacco use. This figure includes the deaths of 7 million people in developing countries, making tobacco use the worlds leading cause of preventable death (Mackay & Eriksen, 2002).

THE TOBACCO MASTER SETTLEMENT AGREEMENT (MSA) OF 1998

As evidence of the negative health consequences of tobacco use grew, nearly every state government filed suit against tobacco manufacturers seeking to recoup tobacco-related health care costs and to force the companies to alter their marketing practices, particularly youth-oriented marketing. The states asserted that the tobacco manufacturers violated consumer protection laws, misinformed the public about the health risks of smoking, and changed nicotine levels to keep smokers addicted. In response to the growing number of cases, the tobacco manufacturers sought a multistate settlement. The MSA of 1998 involved an agreement among seven major tobacco manufacturers and the attorneys general of 46 states, several U.S. territories, and the District of Columbia. Under the MSA, the tobacco manufacturers agreed to substantially change the way they marketed tobacco products and to pay the states $206 billion through 2025. The tobacco companies also agreed to finance a 1.5 billion antismoking campaign. The MSA settlement, which was the largest settlement sum in any civil litigation in U.S. history (Cutler et al., 2002), also entailed the states agreeing to abandon their separate lawsuits against the tobacco companies. These provisions were similar to those established in earlier settlements reached separately with Florida, Minnesota, Mississippi, and Texas. The primary purpose of the MSA was to fund antismoking campaigns to encourage current smokers to quit and to prevent new generations of smokers, particularly among youths. In addition, the settlement funds were intended to compensate states for health expenses incurred in the treatment of tobacco-related illnesses.

Despite implementation of the MSA, a decade later in 2008, nearly 71 million Americans 12 years of age and older were current users (that is, within the past month) of a form of tobacco, representing 28.4 percent of the population in that age range (Substance Abuse and Mental Health Services Administration [SAMHSA], 2009). In addition, 59.8 million people (23.9 percent of the U.S. population) were current cigarette smokers, 13.1 million (5.3 percent) smoked cigars, 8.7 million (3.5 percent) used smokeless tobacco, and 1.9 million (0.8 percent) smoked tobacco in pipes (SAMHSA, 2009). These numbers include people who used more than one type of tobacco product. Although the use of cigars, smokeless tobacco, and pipe tobacco changed very little between 2002 and 2008, the rates of cigarette and other tobacco product use among young adults (ages 18 to 25 years) declined from 45.3 percent in 2002 to 40.8 percent in 2008, which was a statistically significant reduction (SAMHSA, 2009). Similarly, rates of current cigarette use among youths ages 12 to 17 years declined from 13.0 percent in 2002 to 9.1 percent in 2008, and this decline was statistically significant at the . …

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