Preventative health cuts: Montana's Tobacco Use Prevention Program under the knife

LAKE COUNTY — At the end of January, the House Appropriations Subcommittee on Health and Human Services voted to eliminate funding to the Montana Tobacco Use Prevention Program (MTUPP). This cut is one piece of House Bill 2, an appropriations bill that is currently working its way through the House and Senate in Helena.

Through a variety of platforms, MTUPP has worked to mitigate tobacco’s harmful effects and to prevent its use; according to the Lake County Health Department, tobacco use is the number one cause of preventable death in Montana.

The subcommittee’s decision to cut funding to MTUPP has left many in Lake County confused and disappointed. Over the last 10 years, the programs that compose MTUPP have helped lower Montana’s youth smoking rate from 27 to 15 percent and its adult smoking rate from 22 to 17 percent.

Emily Colomeda, a registered nurse and Director of Services at Lake County Public Health, acknowledged that the government needs to be more responsible, but disagreed with the decision to eliminate MTUPP.

“We need to show restraint in the economy and work on balancing the budget,” Colomeda said. “But why pull the full funding for a program proven to be effective?”

Her question is particularly insightful considering that funding for MTUPP does not originate from tax-payer revenue. Instead, MTUPP receives money paid out by the United States’ four major tobacco companies, as part of the Master Settlement Agreement (MSA).

According to Diana Schwab, Tobacco Prevention Coordinator at the Lake County Health Department, over 80 percent of Montanans support the continued use of MSA money for its intended purpose: improved health and tobacco use prevention.

MTUPP programs contributing to these goals include youth prevention initiatives and the Montana Tobacco Quit Line, a cessation resource.

Since 2004, the Quit Line has served over 52,000 Montanans, and helped more than 17,500 to quit for good. In January of this year, the Quit Line received 1,868 calls, the largest number of calls received in a single month.

Schwab said the Quit Line is of particular importance in Lake County because personal counseling and cessation classes are not currently available here.

“Our county has a higher number of calls to the quit line than other counties of similar size,” Schwab said.

Another aspect of MTUPP important in Lake County is the youth tobacco prevention program. Youth Advocate for Lake County Public Health, Bev Machacek, counsels high schoolers on tobacco use, and advises students involved in reACT, a peer education program.

ReACT is a program that Machacek believes has been extremely successful in Lake County. It is just one of the programs that would disappear should House Bill 2 become law.

Machacek fears that cutting programs like reACT could result in increased teen tobacco use, particularly of smokeless tobacco.

“What we are seeing with youth today in Lake County is higher use of smokeless tobacco and a lot of misconceptions about the product,” Machacek said. “Many teenagers think smokeless is less harmful than cigarettes, when in fact it can actually be more harmful.”

With the lives of current and future tobacco users on the line, what is the state’s justification for cutting funding to MTUPP?

Sen. Carmine Mowbray emphasized that House Bill 2 is still in its earliest stages. It must be passed by several House committees before it even reaches the Senate, at which point Mowbray will have her say.

She predicts that the bill may go through some significant changes in the upcoming weeks.

“By the time a bill has been heard by the various committees and passed the House, a lot of unpalatable elements have been removed,” Mowbray said.

Colomeda and other employees at the Lake County Health Department feel too strongly about the cuts to MTUPP to just hope for the best.

They have agreed to sign and send to Helena a resolution asking full funding to be restored.