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Tobacco use is the leading cause of preventable death in the United States, causing over 400,000 deaths annually. In Nebraska each year, 2,400 adults die prematurely because of cigarette smoking. It is estimated that 45,000 Nebraskans now under the age of 18 will eventually die prematurely from cigarette smoking. Cigarette smoking is responsible for $419 million of Nebraska's annual health care costs (representing approximately 7 percent of the state's annual health care costs, including 12 percent of Nebraska's annual Medicaid expenditures), and smoking-related mortality results in over $400 million in forgone future earnings in the state per year.
In 2000, the Nebraska State Legislature took an important step towards addressing the state's most significant public health problem by enacting Legislative Bill 1436, which appropriated $21 million from the Tobacco Settlement Trust Fund to support statewide tobacco prevention and cessation efforts. This additional funding enabled the Nebraska Health and Human Services System's (NHHSS) existing tobacco program, Tobacco Free Nebraska (TFN), to greatly expand its efforts by establishing a comprehensive statewide tobacco program. The funding marked a turning point for TFN, resulting in the Centers for Disease Control and Prevention citing the program as one of the model tobacco prevention and cessation programs in the nation. In 2002, the State Legislature took another important step towards eliminating tobacco use in Nebraska by passing a 30-cent increase in the state's cigarette tax.
TFN’s achievements as a model program have been previously documented in the 2001 and 2002 State Snapshots and through a variety of other reports developed by an independent evaluation team. These reports, including this State Snapshot, provide information on statewide progress in tobacco control efforts to NHHSS, national, state, and local policymakers, and other interested parties.
The year 2003 marked another turning point for TFN. In June, the Nebraska State Legislature made an appropriation of $405,000 annually to TFN through Legislative Bill 285A rather than renewing the program's funding at its previous level of $7 million. The new appropriation represents a 94 percent cut in the annual program funding originally provided by LB 1436. Because of this recent budget cut, many components of Nebraska's comprehensive tobacco prevention and cessation program have been scaled down or will soon be eliminated (see below). This places the future of TFN's strong community-based foundation in jeopardy since the program's level of support is well below the annual $13.3 million in funding recommended by the CDC to implement statewide best practices in tobacco control.