| 2/22/2010 3:00:00 PM | Email this article • Print this article | Smoke clears: Tobacco
prevention, cessation agency
survives committee review
Pat Whitney
Courier Staff Writer
Senate Bill 298, which threatens to abolish the Indiana Tobacco Use Prevention and Cessation Agency, essentially died in the House Ways and Means Committee on Thursday with no action taken. The day before, at least 40 advocates supporting the agency testified before legislators for 2 1/2 hours, but no one from the public at-large spoke on the merits of the bill.
The non-vote was little cause for the bill's critics to celebrate.
"I am hearing there may never be one (a vote), one way to let it die in committee," said Dr. Richard Feldman, the former state health commissioner. "That would be good news for now, but it will certainly be inserted in another bill or be decided upon at the end of the session in conference committee."
If that happens, the measure could still eliminate the agency's program with its volunteer executive board and shift the agency's nearly $11 million budget to the Department of Health, where it could be more easily controlled by the governor's office.
An independent agency with expertise in community-based anti-tobacco programs, the agency has educated youth on the dangers of using tobacco while helping adults quit smoking for the past 10 years, funded with $150 million in tobacco-settlement monies.
Indiana will receive an estimated $622 million in fiscal year 2010 from tobacco revenues and the landmark 1998 settlement between the tobacco industry and the U.S. government.
SB298 was filed for greater efficiency, according to Republican Sen. Luke Kenley of Noblesville, urged by Gov. Mitch Daniels to draft a bill that would eliminate what the governor and some legislators feel is a duplication of efforts within programs.
Considering the changing economic climate, legislators will ultimately have to decide which is more important - the programs or education, he said.
"With all the problems with the budget, people need to realize that we are trying to save teachers' jobs and keep schools open. The money to do that will have to come from somewhere. With this bill, administrative costs will go down. Most states run those programs through their health departments. ITPC (Indiana Tobacco Use Prevention and Cessation Agency) has 14 employees which can easily be duplicated."
But Feldman, who headed the state health agency from 1999 to 2003, disagreed.
"It's absolutely not feasible for the Department of Health to duplicate ITPC's programs," he said. "The Department of Health does not have designated persons with the type of expertise needed to continue the programs. There's a lack of essential capacity to work with local communities, coalitions and nonprofits, and write grants."
Kenley also said the governor was looking at a 2000 Centers for Disease Control and Prevention study on smoking adults when the agency started and Indiana ranked 49th.
"It still ranks 49th in smoking adults," he said.
Statistics show that agency programs might not have made the same impact on adults as youth. Youth smoking rates dropped by 42 percent among high school students and by 58 percent among middle school students.
The agency is credited for the increase in smoke-free homes among smokers - up from 29 percent in 2002 to 55 percent in 2008. During the past two years, there's been a 600 percent increase in the number of calls to the Indiana Tobacco Quitline, with 21,000 callers. Available around the clock, the Quitline receives hundreds of calls each week from Hoosiers interested in quitting smoking. Trained quit coaches are available to provide tips and free counseling on strategies for quitting.
Indiana is one of the nation's biggest cigarette consumers. In 2008, 26.1 percent of adult Hoosiers were smokers, the nation's second highest rate, according to data from the Centers for Disease Control and Prevention. Last year, Indiana reported 9,800 tobacco-related deaths.
Tobacco costs Hoosiers more than $2 billion a year in health care costs.
If SB298 is slipped into another bill late in the session, another loss would be counter-marketing against tobacco companies, currently solely maintained by the agency. At the meeting Wednesday, Rep. Bill Crawford said that other groups might provide education but do not actively campaign against and raise awareness of specific products that are marketed toward children like the agency does.
"In tough economic times, it may seem that the tobacco settlement money is an easy target to go after to fill in short-term budget gaps, but that would be very short-sighted," said Tim Filler, chairman of the Campaign for a Tobacco-Free Indiana. "Until recently, in states such as Mississippi and Ohio, great things were happening with tobacco control. Then those independent agencies were eliminated and virtually all of the progress that had been made with regard to getting people to quit has stopped.
For Feldman, who served as State Health Commissioner from 1997 to 2001, the potential of losing Indiana Tobacco Prevention and Cessation funding is personal.
"My proudest moment as state health commissioner was sitting beside Gov. Frank O'Bannon in March 2000 as he signed Indiana's historic tobacco settlement legislation and handed me the pen," he said. "This legislation, the state's greatest public health achievement, created the ITPC with funding adequate to meet guidelines recommended by the CDC. I believed it was essential to create an independent institution, separate from politics and the tobacco industry, separate from the governor.
"In 1999 Indiana was in the national spotlight, the only state using all the money for health and meeting the CDC minimum for tobacco control funding," he said. "Governors in other states have raided that fund over and over. The action will be a pivotal point in the future of health in Indiana and determine the health for our children forever."
Dawn Shelton, student specialist in the CARSS program at the Eggleston building in Madison, fears the outcome of the bill and the effect on her students who abuse tobacco. This year, 234 students are enrolled in CARSS, a high-school alternative. Her students with tobacco addictions receive help from Indiana Tobacco Prevention and Cessation programs.
"Fifty-six of them were sent here this year due to smoking," she said. "It's illegal but teens think they can smoke. And parents are helping kids buy the tobacco. The kids become addicted, which causes disruptive behavior in the classroom. I spoke with Sen. Jim Lewis and Rep. Dave Cheatham, who both said they were voting the language out of the bill that would eliminate ITPC funding."
Lewis, D-Charlestown, sees the non-vote Thursday as a tug-of-war between Gov. Daniels and the speaker of the House.
"Could it be resurrected at the eleventh hour in conference committee late in the session? Possibly. But, in my opinion, it's a long shot. The House leadership does not want this bill to pass."
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