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F I S C A L I M P A C T R E P O R T

SPONSOR:	Altamirano		DATE TYPED:	2/22/03		HB
SHORT TITLE:		Smart Moves Youth Smoking Cessation Program				SB	765
					ANALYST:		Dunbar

APPROPRIATION

Appropriation Contained		Estimated Additional Impact		Recurring or Non-Rec	Fund Affected
FY03	FY04	FY03	FY04
	$1,000.0			Recurring	Tobacco Program Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

Relates to: HB144, HB137, SB133, SB228, SB534, SB707, SB730, SJR17

Relates to: General Appropriation Act

SOURCES OF INFORMATION

Responses Received From

Department of Health (DOH)

Health Policy Commission (HPC)

SUMMARY

Synopsis of Bill

Senate Bill 765 appropriates $1,000,000 from the Tobacco Settlement Program Fund to the Department of Health to continue the statewide “SMART Moves” youth smoking cessation program for expenditure in FY 2004.

Significant Issues

Youth smoking is a serious problem in New Mexico. Data collected by the Behavioral Health Services Division (BHSD) indicate that youth between the ages of twelve and seventeen use tobacco at a rate 3.6% higher than the national average; currently 16.6% of the youth in New Mexico report smoking cigarettes. Research from the federal Center for Substance Abuse Prevention has indicated that mandating attendance and completion of a smoking prevention or cessation program is an effective means of deterring the onset of use or thirty-day use. In 2001, about 27% of high school students in NM reported smoking cigarettes in the past 30 days, many of whom will continue smoking into adulthood.

FISCAL IMPLICATIONS

The appropriation of $1,000.0 contained in this bill is a recurring expense to the Tobacco Settlement Program fund. Any unexpended or unencumbered balance remaining at the end of FY 04 shall revert to the Tobacco Settlement Fund. However, the bill stipulates that if the Tobacco Settlement Fund is abolished or depleted, the appropriation would be from the State General Fund.

SMART Moves cessation /prevention received $900.0 in non-recurring Tobacco Settlement Program Funds in FY 03. Smart Moves program was implemented in FY 2003 through the Behavioral Health Services Division (BHSD).

The proposed appropriation from the Tobacco Fund would be of a recurring nature. In FY 03, the Department of Health received $5,000.0 in Tobacco Settlement Recurring Funds. In FY 04, the DOH will receive an additional $1,000.0 ($6,000.0) in recurring Tobacco Funds.

ADMINISTRATIVE IMPLICATIONS

Current staff could administer this appropriation. If the appropriation in SB 765 was allocated to BHSD, it is the Division’s standard practice to set aside ten percent of the amount for rigorous evaluation of the interventions.

CONFLICT, RELATIONSHIP

Conflicts with SB 298 and HB 244, both of which propose abolishing the tobacco settlement permanent and program funds.

SB 765 relates to:

· HB 144, SB 133 and SB 534, which propose tobacco program fund appropriations for SFY04.

· HB 137, which outlines procedural requirements for non-MSA tobacco manufacturer payments to New Mexico via the Tobacco Escrow Fund Act (6-4-13 NMSA 1978). SB 228, which proposes to use 10% of Master Settlement Agreement (MSA) funds to create the Next Generation Trust Fund, and SB 707, which would mandate cessation programs for young people who possess tobacco.

TECHNICAL ISSUES

DOH proposes that the title of the appropriation should be changed to “Youth Smoking Cessation and Alcohol, Tobacco, and Other Drug Abuse (ATODA) Prevention Programming.” The inclusion of the SMART Moves curricula in the title precludes many potential offerors, according to DOH, because the Boys and Girls Club organizations are the only ones utilizing the SMART Moves curricula. The exclusion, DOH says, of other offerors would not provide a fair and competitive request for proposal process. See “Substantive Issues” below for outcomes realized through the SMART Moves program and for information on the “Not on Tobacco program.

OTHER SUBSTANTIVE ISSUES

Tobacco use is considered the chief preventable cause of death in the United States with over 20 percent of all deaths attributable to tobacco use. Approximately 52 percent of NM youth who participated in the 1997 Youth Risk and Resiliency Survey reported that they smoked a tobacco product in the past year. The national average is about 50 percent. Harding County has the highest percentage of past-year use at almost 80 percent. Luna County and Los Alamos County have the lowest percentage at about 38 percent.

· Among young people, the short-term health effects of smoking include damage to the respiratory system, addiction to nicotine, and the associated risk of other drug use. Long-term health consequences of youth smoking are reinforced by the fact that most young people who smoke regularly continue to smoke throughout adulthood. (CDC. Preventing tobacco use among young people---A report of the Surgeon General. 1994, p. 15).

· Smoking is associated with poor overall health and a variety of short-term adverse health effects in young people and may also be a marker for underlying mental health problems, such as depression, among adolescents. High school seniors who are regular smokers and began smoking by grade nine are

In FY2002, DOH Behavioral Health Services Division (BHSD) funded four community-based agencies to provide SMART Moves to youth in their communities. Some of the outcomes realized for FY02 include significant improvements in the learning level of students, significant decreases in student hyperactive behaviors, significant reductions in the 30-day use of inhalants, marijuana, drugs, and tobacco, significant increases in non-parent adult support, significant decreases in depression, significant decreases in aggressive behaviors, reductions in alcohol use, significant decreases in impulsive behaviors, significant decreases in conduct and inattention problems, delays in the maturation process to use alcohol, tobacco, and other drugs (ATODs), decreases in favorable attitudes towards ATODs, and significant increases in the perception of harm of ATODs.

In the first half of SFY 2003, BHSD has, through contracts with two statewide agencies, provided tobacco education and cessation services to children, youth, and families across the State of New Mexico. This was possible through an appropriation from the FY02 Legislative Session which provided $900,000 for those services. These services include parenting classes for families, youth tobacco use prevention education classes, and youth tobacco cessation classes, as well as environmental strategies to decrease youth access to alcohol, tobacco, and other drugs. The programs used in FY2003 include the SMART Moves curricula and “Not on Tobacco: A Total Health Approach to Help Teens Stop Smoking.”

The “SMART Moves” program has been recognized by the Substance Abuse and Mental Health Services Administration (SAMHSA) as a proven prevention program. SMART Moves is part of a series of evidence-based substance abuse prevention curricula. As stated on the National Boys’ and Girls’ Clubs of America web-site, “The SMART Moves (Skills Mastery and Resistance Training) prevention/education program addresses the problems of drug and alcohol use and premature sexual activity. According to the Boys and Girls Clubs of America, SMART Moves (Skills Mastery and Resistance Training) program is a community-based prevention/education program addressing the problems of drug and alcohol use and premature sexual activity.

“NOT on Tobacco”: A Total Health Approach to Help Teens Stop Smoking is a curriculum endorsed by the American Lung Association and is a life management skills curriculum, so that teenagers learn how to reduce stress, make decisions, and communicate more effectively with family and friends.

The tobacco use cessation program consists of facilitator-led same-gender groups that help the youth either quit smoking or cut back on smoking. There is information on cessation and a cessation plan. NOT can help solve the smoking problem among teenagers. Teens who smoke are at risk for developing a lifelong addiction that can cause serious health problems and limit their life expectancy. The objectives of NOT include helping teenagers: stop smoking; reduce the number of cigarettes smoked; increase healthy lifestyle behaviors; and, improve life management skills.

This current fiscal year, through the Youth Smoking Cessation and ATODA Prevention Programming contracting process, a total of 2,030 youth and 197 families in New Mexico communities will be impacted.

Annual health care costs in New Mexico directly caused by smoking are $360 million and the portion covered by State Medicaid was $144 million. Residents' state & federal tax burden from smoking-caused government expenditures was $507 per household. (Source: US Centers for Disease Control and Prevention-2001 and 2002 data).

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