Maximizing Public Benefit From Opioid Settlement Resources

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The historic tobacco Master Settlement Agreement (MSA) between 46 State Attorneys General and the tobacco industry in 1999 had a range of consequences. It resulted in the closure of tobacco industry policy groups that undermined public health, sharply reduced tobacco marketing using cartoon characters (eg, Joe Camel) and paid product placement in television, film and other media, and created a new nonprofit foundation whose primary goal was to educate youth and prevent them from initiating tobacco use. It also resulted in more than $206 billion in resources being allocated to states, subject to appropriation by state legislators and governors. This enabled states to recoup the cost of medical and other treatment expenditures for tobacco‐related illness.1 However, by 2018, only 2.6% of the $206 billion in settlement and tobacco state taxes had been used for tobacco‐related harm mitigation or prevention.