The state plans to spend $6.1 million this year in tobacco prevention efforts, according to a report released last week by a coalition of health organizations, but that number falls short of the $10.4 million recommended by the U.S. Centers for Disease Control and Prevention. Vermont's tobacco prevention spending is closer to the recommended levels than 43 other states, but advocacy organizations and health professionals stressed this week that the state needs to begin placing More resources toward preventing smoking. "One of our disappointments with Vermont is that the state is within striking distance of reaching that CDC number," said Kevin O'Flaherty, the Northeast director of advocacy for the Campaign for Tobacco-Free Kids, one of the groups that sponsoRed the new report. "Reaching that funding level would mean a huge difference over time and drive future smoking rates in the state down." The report, labeled "A Decade of Broken Promises," tracks how states have funded tobacco prevention programs in the 10 years following the landmark civil settlement with the tobacco industry, which supplied the states with annual payments from the companies in perpetuity. In the last decade, the states have received $203.5 billion in payments from the tobacco industry, a combination of $79.2 billion from the settlement and $124.3 billion from taxes on tobacco products, according to the study. In total, only $6.5 billion has been spent on tobacco prevention or cessation programs. Vermont is expected to receive about $101 million this year from the settlement and tobacco taxes, with about 6 percent of that money going toward prevention and cessation programs. State funding for these programs remained level between 2008 and this year's state budget, although it will spend about $400,000 less due to a drop in federal funding for such programs, according to the report. The Lawsuit Attorney General William Sorrell was four weeks into his job in 1997 when he joined dozens of other states in suing the industry to recover costs from tobacco-related health costs. By November of that year, the industry decided to settle with the states in what still is the country's largest civil suit. Sorrell said he joined the lawsuit because it was clear that tobacco-related health problems were costing Vermont. At the time, there were about $15 million in annual tobacco-related health problem costs via the state's Medicaid program, Sorrell said, although he knew that was a "lowball" number compaRed to the real costs. "It was never about the money," Sorrell said, when asked about the settlement that resulted from the case. "Our goal was to hold these companies accountable for their products and try to change the culture of smoking in the country." It's clear that cigarette smoking costs Vermont a lot: This week's report pegs annual health care costs in the state associated with tobacco to be $233 million, which translates to a tax burden of about $623 per Vermont family. The settlement — its formal title is the Master Settlement Agreement — did far More than just set up payments from the tobacco industry to the states, it also led to the industry voluntarily changing the landscape in how it markets its products. Bill Phelps, a spokesperson for Altria Group, the parent company of Philip Morris USA, the company that makes Cigarettes such as Marlboro and Virginia Slim, said that after the settlement, the tobacco companies pulled away from their traditional venues of advertisements. "You won't see us advertise anyMore on billboards, buses, taxis, t-shirts, baseball caps or backpacks," said Phelps, citing a few of the places the companies no longer advertisement tobacco products. "And in 2004 we stopped advertising in major newspapers and magazines." The target market for Philip Morris USA now is adults who already smoke Cigarettes, Phelps explained, and the marketing now occurs mostly in stores where the company's products are sold (the company sometimes pays stores to display promotional items with their logo on it) and via direct mail to consumers. He said the company goes to great lengths to ensure that its products are not marketed or sold to children. "Our goal is to get the adult smoker to ask for our brand," Phelps said. "If they are smoking something else, we want them to switch to our products." The decade-old settlement also resulted in states obtaining access to once-secret documents and studies held by the tobacco industry, according to Sorrell. These documents detailed a campaign to attract new, youthful smokers and to hide the true health consequences of the products, he said. "We saw one study that showed nicotine was just as addictive as opiates," he said.