Despite the notion that the landmark settlement between state governments and tobacco companies a decade ago would be a boon for public health initiatives to curb smoking, few states have made tobacco prevention enough of a priority target for the funding, according to public health advocates.

Only three states — Colorado, Delaware and Maine — are spending tobacco settlement monies in accordance with U.S. Centers for Disease Control and Prevention (CDC) guidelines for funding tobacco prevention, the Richmond Times-Dispatch reported July 20. This has led to a sense of disappointment among public health advocates over missed opportunities, as they see states spending settlement dollars to close budget deficits or shore up public education and infrastructure investment.

Eric Lindblom, policy research director for the Campaign for Tobacco-Free Kids, said that "the most enormous problem is that the states have not been allocating a decent amount of the money to tobacco prevention to reduce smoking-caused diseases and harm."

Virginia is currently spending about 37 percent of the CDC's recommended level of $39 million a year for tobacco prevention efforts in that state. And even the monies that state legislators have earmarked to youth prevention — a total of 10 percent of the state's overall settlement allocation — have been subject to raids to address other priorities, such as a 2003 shift of $15.5 million in funds to help close a budget gap. Those funds were never restored to the tobacco-fighting effort.

Virginia officials say that despite the challenges, they have made progress in using settlement monies to reach young people about the dangers of smoking. Ricky Fulcher, leader of a foundation that oversees the settlement-funded youth prevention effort, said a multimedia campaign on smoking has a recognition rate of close to 80 percent among the state's youth. The foundation also awards grants to community and school groups for healthy lifestyle programs, and supports smoking addiction research at state universities.