$1 billion tobacco fund untapped in cancer fight

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The $1 billion paid to the state by tobacco firms is a mountain of money that could be used for early detection, research, treatment and education. Instead, the money spent thus far has paid for other programs, squandering an opportunity critics of state government say other states have seized to create powerful financial war chests to battle breast and other forms of cancer.

The money is a potential key to saving the lives of South Carolinians.

Georgia has committed $400 million of its tobacco settlement money to fight cancer and has already used some of the money to hire top cancer scientists, buy mammography machines and pay for education campaigns.

Smoking increases the risk of both forms of cancer, according to the American Cancer Society.

Linda Sanders, a Spartanburg breast cancer survivor of nine years, said she doesn't understand why lawmakers haven't used the state's tobacco settlement money to fund early detection while so many women in South Carolina are dying of breast cancer and other forms of cancer each year.

''There are too many women dying,'' Sanders said. ''Women are falling through the cracks because this money is not being made available, not only for breast cancer but for other types of cancer.''

Glenda Sims, who operates a free breast cancer screening program in Spartanburg County that tests 100 women a year, said that ''women of limited resources just struggle.''

''What increases our mortality rate is a lack of resources for early detection,'' she said. ''We cannot prevent some people from getting the disease. But being able to detect it early and get people the proper treatment early is the thing that's going to save lives. And that's where we are missing the boat.''

Spending the tobacco settlement

State lawmakers have spent nearly half of the state's $1 billion in tobacco settlement funds received thus far. The money has been used for programs that include car tax reductions, water and sewer projects, compensation for tobacco growers and sexual predator treatment, and on incarcerated juveniles with mental health problems, according to records from the State Budget and Control Board.

Though $336 million has been targeted for health-related issues - about $218 million to fund Medicaid - none has been directed toward cancer, other than indirectly paying for cancer treatment covered under Medicaid, according to Les Boles, director of the state budget office of the Budget and Control Board.

Medical University of South Carolina President Ray Greenberg, a cancer researcher, said South Carolina needs to commit to battling cancer regardless of how it's paid for.

''Whether we use tobacco settlement funds or not, we're still faced with the problem of disproportionate high rates of certain forms of cancer and many people who can't afford even the more basic forms of a cure,'' he said.

''As a state we need to be able to grapple with that issue. I've come to believe it's less important that you track a certain source of funds than you make a policy decision that we care about the health of our people and we're going to invest in this,'' he said.

Legislators were asked by members of groups battling cancer to help provide cancer prevention and early detection money using the tobacco settlement fund but said no, said Nancy Cheney, government relations director for the state's chapter of the American Cancer Society.

Cheney, who said she wasn't certain which lawmakers were approached, said she was among a group that sought funds for smoking cessation and prevention campaigns.

''It mostly fell on deaf ears,'' she said. ''The tobacco settlement money was to go to help treat those with tobacco-related illnesses and for prevention. And it just didn't happen.''

State Rep. Bob Harrell, a Charleston Republican who chairs the House committee responsible for deciding how the state spends money, said he doesn't recall being asked to approve cancer funding. He said lawmakers were interested in funding health care generally rather than specific diseases.

''You could create a list of things that it isn't specifically going to,'' he said. ''It didn't go to colon cancer, specifically, or skin cancer, specifically, or heart disease, specifically, or lung cancer, specifically. We dedicated it to health care, generally.''

The fund paid $1.7 million in 2000 and $1.6 million in 2001 for a youth anti-smoking campaign but no longer funds the program. South Carolina remains one of only six states that does not currently use its tobacco money to run teen anti-smoking efforts, according to the Campaign for Tobacco-Free Kids, a national anti-smoking organization.

Efforts in other states

Other states, notably Georgia, have tapped their tobacco settlement funds to pay for cancer programs.

Former Georgia Gov. Roy Barnes committed the state to a $1 billion cancer battle in 2000 that will use up to $400 million of the state's tobacco settlement fund. The money was used to hire cancer scientists, buy mammography machines for rural hospitals, run cancer prevention and education campaigns, fund research and treatment programs and help train caregivers.

In Colorado, according to the American Cancer Society, tobacco money has been used for breast and cervical cancer treatment and prevention programs. In Idaho, tobacco money has funded indigent care for people with lung cancer and tobacco-related illnesses.

In Maryland, officials have used tobacco settlement funds for cancer research with an emphasis on tobacco-related illnesses. And in Utah, the state's tobacco settlement money this year helped provide funding for the University of Utah Huntsman Cancer Institute.

Greenberg said South Carolina lawmakers have also chosen not to raise the cigarette tax - a major weapon against cancer.

''There is very compelling evidence that increasing the cost of cigarettes cuts down smoking among young people, and that's probably the single most important thing we can do in addressing the cancer problem in the state,'' he said.

The MUSC president said he hopes this year's formation of a health collaborative by MUSC, the University of South Carolina, Greenville Hospital System and Palmetto Health hospital in Columbia can provide some of the same research emphasis in battling cancer that Georgia's coalition has.

South Carolina's cancer spending

State health officials examining the problem of disproportionate rates of cancer suffered by South Carolina minorities earlier this year recommended the state ''invest more funding in prevention and education.''

The state spends nothing on television prevention or education campaigns for breast or cervical cancer, according to officials with the American Cancer Society.

According to the Cancer Society, 610 women are expected to die this year of breast cancer in the state, and another 160 are expected to die of cervical cancer, a highly preventable type of cancer.

Irene Prabhu Das, director of the state Department of Health and Environmental Control's Division of Cancer Prevention and Control, said state officials will spend $600,000 over the next year on ''comprehensive cancer activities'' using the S.C. Cancer Alliance, a recently organized nonprofit coalition of groups that battle cancer.

She said the money will be used to help collect data on cancer, research treatment costs for indigent cancer patients and help fund local health agencies with early detection and screening services for various types of cancer.

South Carolina spends about $3.3 million a year on the Best Chance Network, a prevention program for breast and cervical cancer. The money, which comes from a grant by the U.S. Centers for Disease Control, represents about one-- fourth of

1 percent of the $1.2 billion in state dollars spent each year on Medicaid, state officials say.

The Best Chance Network offers screening services for low-income women between the ages of 47 and 64.

About 60 percent of the grant is used to pay for screenings and outreach efforts, including nine outreach workers. The rest goes for administration, including data collection, case management and evaluation, according to Linda Tvorik, public education coordinator for Best Chance in South Carolina.

While officials are grateful for the program, they point out that it does not reach women outside that age group or who do not qualify for other reasons, such as insurance coverage and income. That concerns some who believe African-American women should be screened earlier than the age of 40, the age generally recommended by the American Cancer Society.

Other breast cancer screening and prevention programs involving state agencies are funded by federal and private grants through MUSC and Clemson University. Hospitals and nonprofit groups, such as the American Cancer Society and the Susan G. Komen Breast Cancer Foundation, also help with screening and awareness programs in the state.

Early detection is a key to surviving breast cancer, health officials say. About 10 percent of those examined in the federally funded breast cancer screenings in the state show abnormal tests, according to DHEC. If detected early, women have a 96 percent survival rate, officials say.

Pat Fluharty, executive director of the Cancer Association of Spartanburg and Cherokee counties, said South Carolina lawmakers have been shortsighted.

''It's like they don't care,'' she said. ''If somebody thought about it, with some preventative measures, the Medicaid costs would eventually go down. You wouldn't have to be treating breast cancer and lung cancer and all those other things if you were doing something with that money now.''

''I understand we need sewer and water lines,'' she said. ''But if you have cancer and you're going to die, you don't need a sewer.''