T H E M A RY L A N D C I G A R E T T E R E S T I T U T I O N F U N D S AT J O H N S H O P K I N S
The Cigarette Restitution Fund:
What is it? WHAT IS IT? HOW MUCH MONEY DOES incidence and mortality rates in Maryland. The types of IT PROVIDE, AND WHERE DOES IT GO? cancers funded included breast cancer, cervical cancer, THE BASIC FACTS
In the late 1990s, attorneys from nearly every state in the U.S. brought suit against America’s cigarette manufacturers. They sought reimbursement for the huge costs to states incurred due to smoking-related diseases like cancer. Months of testimony, including evidence that the manufacturers had known for many decades the deadly and addictive nature of their product, were presented. In the end, the court ruled in favor of the states, slapping the nation’s major cigarette manufacturers with $53 billion in penalties. The award, known as the Master Settlement Agreement, was split between 46 states, including Maryland, five territories, and Washington, D.C. In 1999, Maryland’s Governor Parris N. Glendening and the General Assembly were among the first of their lawsuit counterparts to use their award establishing the multi-million dollar Cigarette Restitution Fund (CRF). State leaders have continued to allocate funds throughout our state for smoking-cessation programs and education, crop conversion assistance for tobacco farmers, cancer research, prevention, education, screening, and treatment, and other smoking and cancer-related initiatives. “There was certainly no shortage of possibilities on how to use these funds,” said State Delegate Sandy Rosenberg. “We decided to establish the CRF because we felt it was important to use this settlement to affect some of the disturbing effects cigarette-smoking and cancer have had on the citizens of our state,” he said. SETTING THE BOUNDARIES
State leaders recognized one of the surest ways to impact cancer in our state was to look to Maryland’s two academic health centers—Johns Hopkins and the University of Maryland. In 2000, legislation was passed providing these institutions with grants for public health initiatives and cancer research. Cancer Research Grant funds were restricted to seven cancers named in the law because of their high
colon cancer, lung cancer, melanoma skin cancer, oral cancer, and prostate cancer. The CRF legislation required Hopkins to recruit and retain faculty and to assemble clinicians and researchers to conduct translational research of these cancers. PUBLIC HEALTH GRANT
The CRF also provided Johns Hopkins a public health grant for the development of community-based cancer prevention, education and screening programs. Hopkins clinicians collaborate with colleagues at University of Maryland, Sinai Hospital, the Baltimore City Health Department, and the Department of Health and Mental Hygiene. In 2009, Johns Hopkins, Sinai Hospital, and the Baltimore City Health Department added a colon cancer component. The first Johns Hopkins project was a prostate-screening initiative launched in March 2001. The grant provided for prostate specific antigen (PSA) testing and digital rectal exams performed at designated community sites by Johns Hopkins physicians and nurses as well as any necessary follow-up care or treatment. Funds were projected for subsequent years for public health programs addressing prostate and other targeted cancers. THE CHALLENGE
With Maryland among the states leading the nation in cancer mortality, opportunities to make a difference through research and community screening abound. By the same token, it is the sheer complexity which make these endeavors onerous tasks. “Impacting the high cancer rates in Maryland is a great challenge,” said J O H N G R O O P M A N , P H . D. , chairman of environmental health sciences at the Johns Hopkins Bloomberg School of Public Health. He adds, “We have worked to find ways to reach out to our communities that have been suffering disproportionately from cancer. And, through research studies, we have begun to ferret out the biological, environmental, and behavioral factors that commingle to result in cancer.”