Determinants of state tobacco-control expenditures

While Centers for Disease Control and Prevention believe that most state governments under-fund tobacco-control programs, little is known about why large variation in spending exists between state governments. This study explores reasons for spending variation through an econometric model of per capita spending on tobacco-control programs that explores the effects of smoking prevalence while holding constant tobacco settlement funds, state budget deficits, and other factors that might also be expected to influence spending variation. Empirical evidence indicates no support for the hypothesis that states with high smoking prevalence spend more on tobacco-control than other states. This finding may be quite surprising to those working in areas of public health and clearly leads to many important policy questions regarding why the data indicate that funding does not appear to bear any relation to perceived public health problems as would be predicted if policymakers were following a 'rational needs' approach to funding.