Abstract
We investigate whether the distributions to the states from the Tobacco Master Settlement Agreement (MSA) in 1998 is associated with stronger tobacco control efforts. We use state level data from 50 states and the District of Columbia from four time periods post MSA (1999, 2002, 2004, and 2006) for the analysis. Using fixed effect regression models, we estimate the relationship between MSA disbursements and a new aggregate measure of strength of state tobacco control known as the Strength of Tobacco Control (SoTC) Index. Results show an increase of $1 in the annual per capita MSA disbursement to a state is associated with a decrease of −0.316 in the SoTC mean value, indicating higher MSA payments were associated with weaker tobacco control measures within states. In order to achieve the initial objectives of the MSA payments, policy makers should focus on utilizing MSA payments strictly on tobacco control activities across states.
Highlights
Tobacco use has been a major public health problem in the United States for many decades
The Strength of Tobacco Control (SoTC) measure included in this analysis may not be a representative of an adequate measure of actual tobacco control policy efforts that have taken place in each state and the results of the paper should be interpreted with caution. This is one of the first studies to investigate the relationship between Master Settlement Agreement (MSA) payments and state tobacco control environments across all states within the U.S
We find that higher MSA payments are associated with weaker tobacco control environments across states
Summary
Tobacco use has been a major public health problem in the United States for many decades. Master Settlement Agreement Spending and Tobacco Control Despite these statistics tobacco manufacturers were not held liable for health care costs associated with tobacco consumption for many years. This changed in 1998 when the four largest tobacco companies in the U.S, as the original participating manufacturers (Brown & Williamson, Lorillard, Philip Morris, and R.J. Reynolds) entered into a settlement agreement with the Attorneys General of 46 states and the District of Columbia to help offset the excess burden on state Medicaid programs from tobacco-related diseases. Prior to the MSA, four other states (Florida, Minnesota, Texas, and Mississippi) entered into separate individual agreements with the tobacco industry whereby those states would receive settlements totaling $40 billion over the same 25-year period [4]
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