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Lawrence Bergner, MD, MPH

Lawrence Bergner is a retired public health physician.

Correspondence: Correspondence should be sent to Lawrence Bergner, MD, MPH, 101 W 12th St, 9G, New York, NY 10011 (e-mail: bergner{at}attglobal.net).

To Ken Warner’s list of "ludicrous" tasks for the "new" tobacco industry,¹ I would add the use of its considerable influence with governors and legislators to get them to spend significant amounts of the billions of dollars of settlement money on prevention programs, as the states promised to do in the terms of the settlement. Most states are spending very little for this purpose relative to the recommendations of the Centers for Disease Control and Prevention (CDC). A few are spending none.

New York State ranks 24th with fiscal year 2002 spending of $40 million (the CDC recommended $96–$269 million). The governor and Mayor Bloomberg (he of the eponymous school of public health) have proposed major increases in cigarette taxes and have been making much proud noise about the likelihood that this will reduce initiation of smoking by young people. But these are simple revenue-raising measures to balance budgets; they make no specific provisions to support measures to reduce smoking.

It has been reported that the proposed budget for the New York City Health Department’s smoking control program will be reduced to $3 million from $13 million the previous year. At the same time the Health and Hospitals Corporation, which attempts to minimize the adverse effects of smoking by helping those already addicted—and the city—to avoid the costs and consequences of smoking, is reported to be losing all of the $6.5 million previously budgeted for 2003 for this purpose.

Those of us who enthusiastically applauded the settlement should have been a little more skeptical. Is it too late to ask the "new" tobacco industry to help us? They know their way around the state capitals better than most of us do.

Reference

1. Warner KE. What’s a cigarette company to do? Am J Public Health. 2002;92:897–900.[Free Full Text]

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