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The painful cost of tobacco use
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My mother passed away last week. She was 70 years old and suffered from chronic obstructive pulmonary disease (COPD) for many years. COPD is an awful disease both for the patient and for those who watch them labor to breath.

For many years my mother was a smoker. Like many of her generation this was quite common and, like many, her medical ailments can be at least partially, if not mostly, attributed to this habit.

In 1998, Georgia was one of 46 states that signed an agreement with the five largest tobacco manufacturers settling all lawsuits against the manufacturers and calling for the states to receive over $206 billion over the next 25 years from the manufacturers.

Using a formula devised by the U.S. Attorney General, the amount each state was to receive was determined. The agreement called for an initial payment in the year 2000 and yearly payments through 2025. Each state was left to determine how the funds were to be spent.

In 2000, then Gov. Roy Barnes (D) committed using Georgia’s tobacco settlement funds for cancer research, economic development and tobacco prevention with the Legislature agreeing for the most part.

During the 2000 legislative session, the OneGeorgia Fund was established to support economic development initiatives and receives a third of the state’s $159 million per year tobacco settlement funds.  Historically, rural areas of our state had been heavily dependent on tobacco as a “cash” crop and this program was intended to help transition those areas as tobacco became less profitable.  

While most of the remaining settlement funds are used for health care costs, including funding for Medicaid and critical access hospital reimbursement, disappointingly, only a portion is used for cancer programs and tobacco prevention.  

Since reaching a high of $24.7 million appropriated in FY02 for tobacco prevention and cessation programs, Georgia’s spending on these programs has decreased dramatically. Currently Georgia allocates only $3.2 million a year for tobacco prevention. The U.S. Centers for Disease Control and Prevention (CDC) ranks Georgia 48th among states in the funding of tobacco prevention programs noting that Georgia spends only 5.3 percent of the CDC’s minimum recommendation. Many Georgians, including myself, feel we can do better in these efforts.   

These figures are especially alarming considering the remarkable progress made in the U.S. in reducing smoking that has now stalled among both youth and adults. It’s been estimated that over 17 percent of high school students smoke in Georgia and that over 13,000 kids under 18 become new daily smokers each year.  

During the last few months of my mother’s life she was under hospice care and she spent her last days in Hospice House. The love and care these professionals gave my Mother and our family was truly remarkable.  

Every legislator remembers the first law they passed and I am especially proud that my first bill called for palliative care to be provided under hospice. Palliative care specializes in the relief of the pain, symptoms and stress of serious illness and incorporates a team approach to therapy.   

The team of doctors, nurses, social workers, chaplains, therapists, volunteers and others at Hospice Savannah was a true blessing to our family and we will forever be thankful for their services.

As is often the case in these situations, my mother’s death has brought our family closer. As my sister literally dropped everything and put her life on hold for the last month to become my parent’s primary caregiver, and as I watched my father say good bye to his wife of 51 years, I have been reminded of the importance of family.   

I have always believed that most, if not all, of the social ills our society faces can be resolved through the family unit. I am even more certain of that now.  

I love you, Mama.