As we continue battling COVID-19, Hawaii must do everything to keep our communities healthy and safe — which means building strong public health infrastructure, including protecting funding for comprehensive tobacco control efforts. People deserve to live healthy tobacco-free lives after the pandemic ends.

Comprehensive, adequately funded tobacco prevention programs reduce tobacco use by preventing youth from starting this lifetime addiction and helping adults quit. However, Hawaii’s tobacco prevention efforts are at risk.

More than 20 years ago, Hawaii established the Tobacco Prevention and Control Trust Fund with payments from the 1998 Master Settlement Agreement (MSA) — where Hawaii and 45 other states sued the tobacco companies and won, resulting in states receiving payments to cover current and future costs of tobacco-related diseases. Many states that didn’t create a trust fund see these payments squandered or not used for tobacco prevention, but Hawaii ensured they were protected and used as intended to fight tobacco use.

This program has been extremely successful. Over the past two decades, high school smoking rates decreased roughly 80%; adult smoking decreased 26% since 2011. Additionally, this trust fund has saved Hawaii more than $1 billion in health care costs.

Now, lawmakers want to eliminate this program’s stable funding, especially alarming amid an increase in overall youth tobacco use, including e-cigarettes. After years of decline, in 2018 youth tobacco use increased nationwide. In Hawaii, nearly 31% of high schoolers use e-cigarettes, some of the nation’s highest rates.

Progress on previously declining youth use of other tobacco products, including cigarettes and cigars, has also stalled. As the tobacco industry evolves, the need for strong tobacco control programs has never been greater.

Hawaii’s current investment of $7.9 million yearly on tobacco prevention is about 58% of the amount recommended by the Centers for Disease Control and Prevention. Meanwhile, the tobacco industry spends about $26 million annually to market cigarettes and smokeless tobacco in Hawaii, not including its other deadly, addictive products.

A well-funded, evidence-based program will help counter Big Tobacco’s targeting of youth, Native Hawaiians and Pacific Islanders, LGBTQ individuals and people of lower incomes that have led to disparities in tobacco use.

Smoking remains the leading cause of preventable death, killing 1,400 residents and costing the state $526 million in health care costs annually. Eliminating the already underfunded program would be devastating. The Campaign for Tobacco-Free Kids projects that youth smoking rates would increase almost 9% and 600 more kids will die prematurely from smoking. It’s also estimated to cost the state nearly $40 million in additional future health care costs.

If Hawaii wants to continue reducing tobacco use and its devastating toll on our communities, keiki and ohana, we must preserve this current funding. Relying on the general fund and the appropriations process every year will not provide reliable, consistent funding that allows for continuity of the program and strong leadership staff — critical elements for success. It won’t keep away the powerful tobacco lobby that seeks to protect its bottom line.

Research shows the more states spend on comprehensive tobacco control programs, the greater the reductions in smoking. At this critical moment with lung health at the forefront, we must invest in proven tobacco control efforts.

This issue is vital to the health of Hawaii’s people, and the program needs support from elected officials, not interference. Hawaii must maintain a strong tobacco prevention trust fund that saves lives and health care dollars.

Cynthia Au is the Hawaii government relations director for the American Cancer Society Cancer Action Network; Don Weisman is the Hawaii government relations and communications director for the American Heart Association.