From golf courses to harbor improvements to college grant funds -- or simply dumping the money into the general budget -- tobacco settlement money has been spent on many things other than preventing smoking, the number one preventable cause of death in the United States. Most often, settlement funds are used to plug budget holes.

Though the 1998 tobacco settlement did not specify how the resulting $206 billion in payment to states was to be spent, many public officials touted the healthcare benefits that would be realized. "I thought that was what the settlement was about anyway, to help people stop smoking," said Jamal Al-Asadi, an Atlanta smoker.

Now, despite the large sums distributed each year, most states fall below the Centers for Disease Control's recommended spending levels of smoking prevention programs; some have even cut existing programs to make way for initiatives in other areas and to address budget needs.

For the 12 states that took lump sum payments instead of an annual dole, most of the settlement money is gone, hindering the possibility of better anti-tobacco programs in the future.