• 11/21/2004
  • Andrew Schotz
  • Herald-Mail Online

A lower rate of smoking in Maryland has cut the amount of money available for health officials to curtail smoking. It’s an interesting dilemma, but Earl Stoner, the director of health services for the Washington County Department of Health, isn’t complaining.

“If anything, you’d want to work yourself out of a job,” he said.

It’s been six years since major tobacco manufacturers agreed to pay $206 billion to 46 states, Washington, D.C., and U.S. territories to settle a lawsuit. Four other states previously had negotiated their own $40 billion deal, according to a summary of the agreement posted at the National Conference of State Legislatures’ Web site.

Maryland’s share is $4.4 billion, to be paid over 25 years, according to Carlessia Hussein, the director of the cigarette restitution fund program for the Maryland Department of Health & Mental Hygiene

In the current fiscal year, Washington County is getting $277,122 for cancer prevention programs and $232,852 for tobacco-use prevention programs, Hussein said. The sum of the two amounts has dropped two straight years.

The Washington County Health Department’s funding was cut 13 percent from 2003 to 2004, then another 13 percent in 2005, said Kimberly Rasch, the program manager for the department’s cancer surveillance and control program.

The funding cuts forced the department to scale back its media campaign on colorectal cancer – a local focus – and left no money for prostate cancer ads, said William Christoffel, the county’s health officer.

Hussein said Maryland’s overall smoking rate dropped 50 percent from 1985 to 2003, and funding cuts were similar in other counties. Cancer and tobacco prevention money was shifted to a Medicaid fund on the rationale that it also is a health- and tobacco-related expense.

“It always has a huge appetite,” Hussein said.

According to the Campaign for Tobacco-Free Kids, Maryland spent $30 million on tobacco prevention in fiscal year 2003, or 99 percent of what the Centers for Disease Control and Prevention recommended as a minimum.

The next year, the state spent $14.8 million, or 49 percent of the recommended minimum. Maryland’s rank in tobacco prevention spending dropped from fourth to 13th.

Washington County put much of its cancer prevention money into colorectal cancer awareness because “it is a cancer that can be detected and cured,” Christoffel said.

In 2001, the health department launched a public awareness campaign that included door-to-door contacts, TV commercials and newspaper ads.

Through focus groups, the health department found that people didn’t get colonoscopies – tests to detect colon or rectal cancer – and didn’t know much about them, Rasch said.

Christoffel said he personally can attest that the preparation for the test – drinking large volumes of liquid the day before – is worse than the test.

The media campaign stopped last year, but the education part is continuing. Health officials say their message seems to have reached its audience.

County statistics show that the number of colonoscopies rose in Washington County from about 3,300 in 2001 to about 6,400 in 2002. There were more nearly 7,000 in the county last year.

Meanwhile, the rate of colorectal cancer in 2003 was less than half what it was the previous year and about one-third of the 1997 rate, according to county statistics. Christoffel called that “an outstanding success.”

The health department also has spent cancer prevention money on prostate and oral cancer programs. Each year, the health department holds an oral cancer conference for doctors, dentists and related health professionals. Stoner said about 200 people attended the last one; others were turned away.

The health department uses tobacco-use prevention money on school programs, smoking cessation classes, grants for community organizations, an anti-smoking campaign with the Hagerstown Suns, and store compliance checks, to see if minors illegally can buy tobacco, Stoner said.