Bill would boost tobacco control efforts

By JILL SCHRAMM, Staff Writer jschramm@minotdailynews.com
If North Dakota is to lower its rate of tobacco use, voters will have to take the initiative, according to Heidi Heitkamp, former state tax commissioner and attorney general.


The initiative that she refers to is a ballot measure that would redirect new money that the state is receiving from a 10-year-old tobacco settlement agreement into a trust fund for tobacco control programs.


The measure would enable the state to provide $9.3 million a year to implement tobacco control efforts recommended as best practices by the U.S. Centers for Disease Control and Prevention.


Heitkamp spoke to the Safe Communities Coalition and Exchange Club in Minot Wednesday to promote the measure, whose sponsors include former governor George Sinner and several physicians. The initiative has the backing of the North Dakota Pharmacists Association and Minot’s tobacco control group, the STAMP Coalition.


The sponsoring committee hopes to collect 16,000 signatures by the end of June. The Secretary of State needs to verify about 13,000 signatures to put the measure on the November ballot.


By failing to adequately fund tobacco prevention and control, North Dakota isn’t doing what it said it would do, Heitkamp said.


At the time of the tobacco settlement, North Dakota lobbied for a larger share of the money than proposed in a distribution formula weighted in favor of more heavily populated states. The state’s argument was it needed more money to adequately fund the best practices recommended the CDC, Heitkamp said.


Despite winning the argument, North Dakota has never adopted the CDC recommendations, she said.


Following the recommendations would require North Dakota to spend more in areas such as public health education, subsidies to reduce the cost of smoking cessation classes, community coalitions and evaluation of programs.


The $9.3 million needed for a CDC-based program is just a portion of the money received by the state from the tobacco settlement each year, Heitkamp said. The state projects to receive $36.7 million this year.


“We are not asking to take all this money for tobacco control. We are just saying, let’s take what we actually need,” Heitkamp said.


The 1999 Legislature approved a formula for the settlement money that gives 45 percent each to water development and education. Public health receives 10 percent, of which 80 percent goes to tobacco control and prevention.


Under the initiated measure, water development, education and existing public health and tobacco control programs would continue to receive money from the tobacco settlement at the same level as in the past.


However, the state began receiving additional money this year from the tobacco settlement as part of the agreement’s strategic contribution fund. North Dakota is scheduled to receive about $14 million a year for 10 years from that fund.


The strategic contribution fund compensates North Dakota and other states that were directly involved in negotiating the tobacco settlement. Heitkamp took part in the negotiations and credits one of her staff attorneys, Minot native Laurie Loveland, with playing a key role in developing the final agreement.


The initiated measure separates the strategic contribution fund payment from other settlement money by placing it in a new trust fund for tobacco control. A committee of medical and public health professionals along with a representative of each the public and youth would develop and implement a tobacco control program.


The measure also states that if the money in the tobacco control fund runs out, the state can take dollars from the tobacco settlement money in the water development trust fund.


Heitkamp will be addressing the North Dakota Water Users Coalition in June to explain the measure. The water coalition hasn’t taken a position on the measure at this time.


Heitkamp said the measure doesn’t touch the education dollars because education will be important in tobacco prevention efforts.


The decision to initiate the measure came about because public health advocates haven’t been able to persuade legislators to spend more money on tobacco control, Heitkamp said.


“The universal consensus was the Legislature will never fund this program. There’s just not the political will to do this. If we want to get it done, let’s ask the people to do it. There’s no better time than now in North Dakota to actually ask the people, given our financial situation,” she said.


Heitkamp said the state’s collections from the oil extraction tax are far exceeding projections at the current level of oil activity. Water development and schools receive a share of the tax.


Meanwhile, initial success in reducing tobacco use in the state has leveled off, Heitkamp said. Use remains high among American Indians and is higher than the national average for pregnant women.


“We have been very successful in getting the low-hanging fruit. These are really people who could be persuaded. Now we are going into the hard-core tobacco users,” she said.


Tobacco companies also have increased the nicotine in their products and doubled their marketing efforts, she said.


To combat tobacco marketing and make inroads with hard-to-reach populations will require a program like the one recommended by CDC, Heitkamp said.


“It is evidence based. It’s been tried and true,” she said. “This is the most proven, researched program in public health today.”


A Web site with information about the Support Tobacco Prevention initiative is in development and should be active soon. The address is (www.stpnd.com). People can also call the coalition at 839-3321.