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A Budget Beyond Belief
At a time when most agency discretionary budgets are disappearing, one operating component within an agency has no such problem. Instead, the organization's major challenge is going to be how to spend their enormous increases in funding.

The Center for Tobacco Products (CTP) is one of eight Centers within FDA and is primarily responsible for overseeing implementation of a single law, the Family Smoking Prevention and Tobacco Control Act. CTP's work is in addition to the tobacco-related responsibilities of other agencies within the Department of Health and Human Services including the Office of the Surgeon General, NIH, and SAMSHA.

Unlike other agencies and HHS operating components, CTP relies on a dedicated stream of funds generated by user fees paid by manufacturers and importers of tobacco products. The amount of those funds is soaring.

According to an Associated Press story, FDA collected $260 million in user fees in FY 2009 and FY 2010 combined. This year, collections (and spending) are expected to reach $450 million. By 2019, the annual user fees (and spending) are expected to climb to $710 million.

Is this money going to be well spent? Who knows? What is missing are metrics for: 1) assessing the marginal public health impact from increases in CTP spending; and 2) comparing the benefits from additional CTP spending with the marginal benefits that would accrue from additional spending on other public health and human needs programs.

Over 20% of American children now live in poverty. According to USDA, in 2010 over 16 million children lived in food insecure (low food security and very low food security) households. At a time when millions of kids don't even have enough food to eat, does it make sense for the government to be increasing spending by hundreds of millions of dollars funding yet more studies that find that smoking is unhealthy and yet more "messages" telling people not to smoke?

Cigarettes and poverty are both bad for kid's health. Poverty, however, is on the increase. It's time for Congress to mandate that some the abundant resources for the former be shared to help alleviate the later.


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