The head of the state’s tobacco prevention agency expressed disappointment as she characterized the end of BreatheND as overturning the will of the people. Jeanne Prom, the executive director of BreatheND, says she will be watching to see if the state will follow through with its professed ability to do more with less.

It was a duplication of services that moved many lawmakers to put an end to the agency.

“More duplicative than anything,” Al Carlson, R-Fargo, said of the work of BreatheND. “The money should flow to one place.”

He said there also could be better ways to allocate dollars for tobacco prevention.

“Maybe do more in schools rather than TV sets,” Carlson said.

The Republican-led Legislature defunded the North Dakota Center for Tobacco Prevention and Control Policy this past session and rolled tobacco settlement money into the North Dakota Department of Health budget, effective July 1.

This session’s move was the first opportunity lawmakers had to eliminate the agency, which was created by a ballot measure in 2008.

“They had their run, and now the baton is being passed,” Sen. Ray Holmberg, R-Grand Forks, said.

Holmberg, who chairs the Senate Appropriations Committee, said it was felt that, after looking at the administrative costs of operating the tobacco prevention programs, it would be better situated within the health department.

Prom said the change could undo several years of work that marked a rapid decrease in youth and adult smoking rates in North Dakota.

“We are proving our outcomes, and that didn’t seem to matter,” said Prom, adding lawmakers in support of the agency considered it to be one of the more effective state agencies.

BreatheND was created and funded using a percentage of the state’s tobacco settlement fund, part of a 1998 agreement reached by states with the major tobacco companies. The agency has used about 20 percent of the dollars for its comprehensive tobacco prevention program.

In Senate Bill 2004, the North Dakota Department of Health budget, about $13.6 million was made available for tobacco prevention and cessation programs for 2017-19. For 2015-17, the tobacco advisory committee had a $16.5 million budget and a staff of eight.

State Health Officer Mylynn Tufte said the health department has been working with local public health units to ensure programs remain intact albeit with reduced funding. A transition plan is being developed.

“We know that, for the Department of Health to be successful, we’ll need the help of the local public health units,” said Tufte, adding the agency will continue to track smoking rates and quit rates among adults and youths.

She said there also is a study to see whether people are moving from traditional tobacco products to e-cigarettes, or vaping.

By July 1, files from the existing Comprehensive Tobacco Control Advisory Committee must be turned over to the health department; then a new statewide tobacco prevention and control plan must be completed by July 31.

The funding changes will primarily be noticeable through a reduction in outreach and advertising efforts, according to Arvy Smith, a deputy state health officer, who said the ND Quits hotline won’t be impacted.

“We’re hopeful that we’re able to deliver,” Tufte said. “We have been given a challenge.”

Prom, who led the tobacco prevention program in the health department from 1992 to 2001, countered that a smaller, issue-oriented agency, such as BreatheND, can attack smoking cessation better than a larger agency. 

The importance of tobacco cessation is enough to warrant a separate agency, according to Prom, who equated its importance to the action taken this session to create a new Department of Environmental Quality.

A key item to consider in the long term is the innovation of the tobacco industry, with various new products, flavors for tobacco, e-cigarettes and digital advertising, according to Prom.

“This is not a marketing tool to hook adults,” Prom said. “The tobacco fights only get tougher.”

Rep. Jon Nelson, R-Rugby, said he was not initially a strong supporter of BreatheND.

“The results that were being produced by BreatheND were very impressive. I thought they had proven themselves," said Nelson, adding that the group provided serious bang for the buck. “We’ll just see what happens. (But) I think the BreatheND staff should be commended for their work.”

Lawmakers who supported the change argued during the session that tobacco usage has declined in North Dakota for about 20 years and the agency can’t take full credit for the decline.

(Reach Nick Smith at 701-250-8255 or 701-223-8482 or at nick.smith@bismarcktribune.com.)

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