Report critical of tobacco trust spending, outcomes

The Legislative Office of Fiscal Transparency on Monday released its report on the Tobacco Settlement Endowment Trust.

Voters in 2000 approved constitutional protections for how the state would spend millions from the 1998 Master Settlement Agreement with tobacco companies.

TSET spends the earnings from the $1.6 billion trust fund for health programs, including tobacco cessation. Earnings are between $50 million and $60 million a year.

For years, lawmakers have eyed the funds for a variety of purposes, such as Medicaid expansion.

Most recently, voters rejected a legislative proposal to reduce the amount of dollars going to TSET from the MSA.

The report noted that Oklahoma is the only state that constitutionally protects the funds received from the MSA.

“Approximately 40 percent of TSET’s spending is dedicated to tobacco cessation and prevention,” the report said. “However, LOFT observed a lack of evidence demonstrating correlation between state spending on tobacco cessation and prevention and smoking prevalence.”

The state ranks 8th in spending, but 40th in adult smoking prevalence and 44th in youth smoking prevalence, according to the report.

In its response, TSET said the state’s tobacco use ranking is high, but it would be higher without TSET programs.

The report found that TSET tracks short term outcomes of its marketing and communication campaigns, but does not track the data necessary to determine the effectiveness of them across the state.

TSET’s response indicated that its public education campaigns change attitudes and behavior.

For example, exposure to the “Tobacco Stops with Me” campaign doubled quit attempts among tobacco users and increased awareness about the harms of secondhand smoke.

The LOFT report found that TSET’s resources are not aligned with the state’s greatest needs.

“In an analysis of smoking prevalence rates at a county level, compared to county-level programmatic spending by TSET, LOFT observed no apparent alignment of TSET resources with the areas of the state with the highest rates of smoking prevalence,” the report said.

A signature program, the Oklahoma Tobacco Helpline, spends five times more for cessation services than the national average, the report said.

Oklahoma spends $11.52 compared to a national average of $2.21 and a regional average of $2.55, the report said.

“While the Helpline reports positive outcomes, it reaches just 3 percent of Oklahoma smokers,” the report said. “Of those callers, approximately a third reportedly quit smoking.

TSET disagreed with the finding, saying LOFT’s research provides incomplete information and understanding of TSET budget priorities.

Spending on the Oklahoma Tobacco Helpline, which has served more than 450,000 Oklahomans, is higher because more people are using and receiving services, TSET said.

The report said most of TSET programs cannot be tied directly to measurable outcomes.

Julie Bisbee, TSET executive director, said the conversation about TSET is healthy, adding that the agency welcomes opportunities to work with lawmakers to improve health.

She said lawmakers have a great deal of power in influencing policy.

“One-hundred percent clean indoor air would really be a wonderful thing to see in our state,” she said. “We have talked about it for many years, but not quite made it there yet.”

One of TSET’s marketing campaigns seeks to ban smoking in all work places. It depicts a waitress serving beverages to customers who are smoking.

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