Although it has many supporters (also known as nicotine addicts), the tobacco industry has few friends. That’s not only because it markets a lethal product, but because of its inability to cop to its health-corroding properties and its history of lying. According to the Centers for Disease Control and Prevention (CDC), tobacco use kills more than 400,000 people every year in the U.S.

Under the Master Settlement Agreement in 1998, as described by the California Department of Justice, seven tobacco companies agreed to change the way their products are marketed and pay the states an estimated $206 billion. They agreed to finance a $1.5 billion anti-smoking campaign, open previously secret industry documents and disband industry trade groups that state attorneys general said conspired to conceal damaging research from the public.

Fourteen years after the settlement, the annual study sponsored by the Campaign for Tobacco Free Kids reports that “states continue to spend only a minuscule portion of their tobacco revenues to fight tobacco use. The states have also failed to reverse deep cuts to tobacco prevention and cessation programs that have undermined the nation’s efforts to reduce tobacco use.” This is so even though in this budget year the states will collect a record $25.7 billion in revenue from the tobacco settlement and tobacco taxes.

The study concluded that states:

• will spend only 1.8 percent of the $25.7 billion ($459. 5 million) on programs to prevent kids from smoking and help smokers quit—that’s less than two cents of every dollar in tobacco revenue spent to fight its use.
• have failed to reverse deep cuts that reduced tobacco prevention funding by 36 percent from fiscal year 2008 to fiscal year 2012. The $459.5 million the states have allocated this year is the second lowest amount they have spent on tobacco prevention programs since 1999, when they first received settlement funds.
• are falling woefully short of recommended funding levels for tobacco prevention
  programs set by the CDC—only 12.4 percent of the $3.7 billion the CDC
  recommends for all the states combined.

As the New York Times reported earlier this month, the settlement gave states total freedom about how to spend the money. Many use the dough to fund programs unrelated to tobacco, and to plug budget holes. Public health observers decry the fact that there’s no guarantee any money is earmarked for tobacco prevention and cessation programs.

In the last four fiscal years, federal funds for smoking prevention amounted to about $522 million. As The Times notes, tobacco companies spend $8 billion a year promoting their product.

Public health officials strongly believe that anti-smoking programs work. California’s smoking rate was above the national average 20 years ago; today it’s the second-lowest in the country. Officials attribute that decline to, as The Times puts it, “modest but consistent spending on programs that help people quit and prevent children from starting.”

According to the report, Washington State saved $5 in tobacco-related hospitalization costs for every $1 it spent during the first 10 years of its program.

But thanks to budget cuts, some states have as much as abandoned their efforts to curb smoking. State financing for North Carolina’s program has been eliminated, Ohio has not allocated any funds for its once-successful program and for three successive years Washington State has cut its program by about 90 percent.

Another threat to what has been a promising national effort to reduce smoking and its ill effects came in a court ruling earlier this month. An appeals court in Washington, D.C., reaffirmed a decision that forcing tobacco companies to put graphic warnings on cigarette packages violates their free-speech rights (see our post from August).

You might recall the shock value of the labels at issue—they included images of sewn-up cadavers and diseased lungs and gums. The images were approved by the FDA in 2011 and were to appear in September.

According to the Winston-Salem Journal, the court denied the FDA’s request to reconsider affirming the earlier ruling to block the images with a two-sentence order. “[T]he government has failed to carry both its burden of demonstrating a compelling interest and its burden of demonstrating that the rule is narrowly tailored to achieve a constitutionally permissible form of compelled commercial speech.”

“The graphic images are neither factual nor accurate.”

The FDA has 90 days to appeal, and if it does, the case goes to the U.S. Supreme Court.

In what some people might call an only-in-America episode, an Ohio federal appeals court in March upheld use of the graphic labels. Tobacco manufacturers, of course, have petitioned the U.S. Supreme Court to review the Ohio decision. The feds have until Dec. 26 to file a response, and it could be February at the earliest before the justices decide whether to take the case.

'Tis the season, apparently, for adjudicating tobacco cases. In November, a federal judge ruled that tobacco companies must spend their own money on an advertising campaign telling people that they lied about the dangers of smoking cigarettes. As described in a story by Reuters, this might be the harshest sanction arising from the 1999 Justice Department case accusing tobacco companies of racketeering.

The campaign will appear in various media for as long as two years. If that seems extreme, consider that the court referred to “past deception” by cigarette makers dating to at least 1964.

The judge ordered the advertising campaign in 2006, and six years later the companies are still arguing about the wording. And the tobacco companies could always appeal this decision, too. So it will be a while before any public act of contrition occurs. But here, according to Reuters, are a couple of the potential apologies:

• "A federal court has ruled that the defendant tobacco companies deliberately deceived the American public by falsely selling and advertising low tar and light cigarettes as less harmful than regular cigarettes."
• "Smoking kills, on average, 1,200 Americans. Every day."

As a spokesman for Tobacco-Free Kids told Reuters, "Requiring the tobacco companies to finally tell the truth is a small price to pay for the devastating consequences of their wrongdoing."

If anyone still doubts that tobacco and tobacco smoke are harmful, consider a story recently published on ScienceDaily.com. “It is a known fact that active maternal smoking during pregnancy has negative effects on child health, such as attention deficit and hyperactivity disorder (ADHD),” it said, and “new research suggests that second-hand smoke, or environmental tobacco smoke (ETS), may be just as harmful.”

The study by researchers at the University of Pennsylvania School of Nursing examined data from 646 mother-child pairs in China, where more than 7 in 10 men smoke. One in 4 children whose mothers were exposed to smoke exhibited behavior problems compared to 16 in 100 children of unexposed mothers. The children whose mothers were exposed to passive smoke performed worse on speech, language skills and intelligence tests. They also showed more conduct disorders.

As the study’s lead author said, "The key message for pregnant women is to protect their growing fetus from exposure to second-hand smoke."

Stay tuned—although there is no doubt tobacco is a deadly product, the powerful forces that turn it into consumer goods have lots of money to indulge their irresponsible and venal instincts.