ATLANTA - When it comes to spending as much as health officials recommend on tobacco prevention and stop-smoking programs, only three states in the country are making the grade.
Most are significantly under funding or putting no money at all into such programs despite the millions of dollars they get each year from tobacco settlement funds.
The states that have dedicated money to prevention in recent years have seen benefits in the form of fewer teens smoking and more adult smokers weaning themselves from tobacco.
The U.S. Centers for Disease Control and Prevention has outlined what states should be doing to have a comprehensive tobacco control program, which includes education in schools and ways to help adults quit.
The CDC has estimated what each state should be spending to implement the programs, but during this budget year, only Delaware, Maine and Mississippi are meeting the minimum funding requirements suggested to them.
The CDC recommends that the states should be spending a combined total of $1.6 billion. Yet, this year, they put in only a third of that amount - and that's an increase after several years of funding cuts.
"That's one of the myths that people have, that tobacco's been taken care of as far as having enough funding to support comprehensive programs that work," said Brick Lancaster, the chief of the Office on Smoking and Health's program services branch at the CDC.
He said even states that had been at the forefront of addressing tobacco prevention, such as Massachusetts, have seen cutbacks in recent years.
"The amount of money that the states are now spending on tobacco control has dropped 28 percent in the last two years," he said. "So there's been significant reductions in tobacco-based funding."
Maine, which this year led the states in meeting its spending suggestion from the CDC, once had one of the highest youth smoking rates in the country and now has one of the lowest, according to joint report from the Campaign for Tobacco-Free Kids, the American Cancer Society, the American Heart Association and the American Lung Association.
Smoking rates for middle school pupils in Maine dropped by 59 percent between 1997 and 2003. During the same period, smoking among high school students dropped 48 percent.
The state puts $14.2 million a year into tobacco prevention - more than the minimum the CDC has recommended for Maine.
"We really set this up by the book by what the CDC was recommending," said Edward Miller, the CEO of the American Lung Association of Maine. "We're still funding prevention programs at a much higher and much more consistent level than other states."
The money pays for dozens of community-based prevention programs across the state and certified tobacco treatment counselors. The state pays for medication smokers sometimes use when trying to quit and "counter marketing" advertisements to extol the dangers of smoking.
With more than 400,000 Americans dying prematurely every year from smoking, according to the CDC, and states spending $75.5 billion in excess medical costs because of the habit, anti-tobacco advocates say it's well worth the money for states to help their residents stop.
Atlanta resident Pam Tucker has tried to quit on her own but knows how hard it can be.
She said she's aware of the health effects when she pulls a drag from her cigarette.
When she was 18, she started smoking after sneaking cigarettes from her parents' stash. She's tried to quit five or six times.
She never smoked while pregnant, but for the past 31 years, she's been unable to quit for good.
"I want to fulfill my life to the fullest, and I know I'm cutting it down," Ms. Tucker said. "It's not an easy thing to do."
When states dedicate the money and resources to help smokers quit or prevent others from starting, officials say, they see savings return in the form of lower health costs.