In 2000, Oklahomans approved a constitutional amendment directing that the state’s annual payments from tobacco companies, reached as part of a 1998 Master Settlement Agreem

ent, be deposited into a trust from which investment earnings would be spent on smoking cessation and other health-related measures.

The plan was hailed as a triumph of long-range thinking over short-term political desire. But a new independent review shows Oklahoma has reaped relatively little benefit from the trust’s spending and smoking prevalence is higher in Oklahoma than in a state that dedicated no settlement money to smoking cessation.

In its latest report presented to lawmakers, the Legislative Office of Fiscal Transparency (LOFT) evaluated the outcomes generated by the Tobacco Settlement Endowment Trust (TSET) spending over the past two decades.

The conclusions were blunt.

“Oklahoma’s ranking for tobacco use remains one of the worst despite high levels of spending and continued protection of the settlement fund,” said Shannon Rios, senior program manager of process improvement at LOFT.

The state’s tobacco settlement fund today holds $1.7 billion, which generates between $50 million and $60 million per year in annual earnings, and TSET’s most recent budget was $54.95 million.

But Rios told lawmakers serving on the Oversight Committee for the Legislative Office of Fiscal Transparency that LOFT’s review of TSET found “a lack of evidence demonstrating correlation between state spending on tobacco cessation and prevention and smoking prevalence.”

Oklahoma ranks eighth-best nationally for spending on anti-tobacco efforts, but still ranks 40th worst for smoking with one of the nation’s highest prevalence rates among adults, and ranks 44th for youth smoking, according to the report.

“Connecticut, which does not dedicate any state funding to tobacco prevention, ranks fourth in adult-smoking prevalence, further demonstrating a disconnect between spending and outcomes,” Rios said.

“Connecticut currently appropriates no funds towards tobacco cessation either from their general funds or from the Master Settlement Agreement,” said Frank Magness, financial analyst at LOFT.

Similarly, the state of Washington spends just 3.4 percent of the amount recommended by the federal Centers for Disease Control and Prevention (CDC) for anti-tobacco efforts, yet Washington has the sixth-lowest rate of adult smoking. Rhode Island spends just 3.1 percent of the CDC-recommended level and has the 10th-lowest adult smoking rate.

Nationally, states spend less than 20 percent of the amount recommended by the CDC on anti-smoking efforts. Oklahoma spends more than 50 percent of the recommended amount, but the LOFT report indicated Oklahoma is spending more for less.

“Oklahoma’s smoking rates remain among the highest in the nation,” Rios said. “While there’s been progress over the past 20 years, the state’s improvements lag behind the progress achieved in other states.”

In 2018, data showed 19.7 percent of Oklahoma adults smoked tobacco, compared to a national average of 16.1 percent, while 9 percent of Oklahoma high-school students smoked tobacco cigarettes compared to 6 percent nationally.

According to the LOFT report, over the past decade the annual healthcare-related and economic costs of tobacco use in Oklahoma have increased from $3.1 billion to more than $4 billion.

Some health measures have even declined amidst the backdrop of TSET spending.

“With cardiovascular-disease deaths, Oklahoma has worsened its ranking, now having the highest heart-disease mortality rate in the nation,” said Zach Sumner, senior project manager of financial operations and change management at LOFT. “Cigarette smoking is responsible for approximately 20 percent of these deaths.”