What Has Changed Since The Tobacco Settlement?

Over the course of this week, NPR's Debbie Elliot will look at what has and hasn't changed since the Tobacco Master Settlement Agreement in 1998, as well as what lies ahead for the tobacco industry.

Ten years ago this week, the states reached a $246 billion settlement with tobacco companies. The settlement was the beginning of an era that saw landmark changes for smoking nationwide.

A Long-Shot Lawsuit Catches On

Former Mississippi Attorney General Mike Moore recalls how the idea of challenging the tobacco companies started. A lawyer friend of his, Mike Lewis, had a secretary whose mother was dying of heart disease caused by smoking. Lewis didn't have the resources to sue the industry on the woman's behalf, so he came to Moore.

"He came up with an idea that maybe since the state was paying for her medical care through the Medicaid program — she had spent all her money and now was on Medicaid — that maybe the state could file a lawsuit and recover its losses," Moore says.

At the time, big tobacco had won every smoker lawsuit that was ever filed against the industry, saying smokers knew what the dangers were. The concept for this lawsuit took the smoker out of the equation — states didn't choose to smoke, yet had to pay to treat sick smokers.

The idea was considered a long shot, but slowly caught on. More and more states' attorneys general filed similar cases. As the cases and what they uncovered got more and more media attention, the tobacco industry came to the attorneys general looking to get out from the under the huge financial threat that the cases posed — not to mention the public relations nightmare it had become.

The tobacco companies agreed to a $246 billion settlement to be paid to the states over 25 years. They also agreed to change the way the industry did business, most notably doing away with advertising icons Joe Camel and the Marlboro Man.

A Cultural Shift

Cigarette makers now do much more target advertising, using elaborate databases, direct mail and point-of-sale at convenience stores and adult-only venues like bars.

Smoking rates are down across the board, too. For youths, the number has dropped from 36 percent to 20 percent. For adults, it's down from 25 percent to less than 20 percent. And states have increasingly restricted where people may smoke.

Even though smoking rates have fallen in the past 10 years, smoking is still the No. 1 preventable cause of death in the U.S.

And what happened to the money? States have spent less than 5 percent of their settlement proceeds on tobacco control. Many have used the money to help balance budgets, build schools and pave roads. The few that have invested more heavily in antismoking programs have lowered their smoking rates.

While most of the attorneys general who helped negotiate the deal are disappointed that states haven't done more with their cash, Moore says the money wasn't as important as what has happened culturally.

"Most of all we've changed the way people look at tobacco," he says. "There's no question anymore in anybody's mind that it's harmful and it will kill you."

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