Since the states settled their lawsuits against the tobacco companies in November 1998, the American Heart Association and other health organizations have issued an annual report assessing whether the states are keeping their promise to use a significant portion of their settlement funds and tobacco taxes to attack the enormous public health problems posed by tobacco use in the United States. This year, the report finds that states continue to spend only a miniscule portion of their tobacco revenues to fight tobacco use. The states have also failed to reverse deep cuts to tobacco prevention and cessation programs that have undermined the nation’s efforts to reduce tobacco use. Massachusetts launched its program in 1993 with funding from a voter-approved cigarette tax of 25 cents a pack. In December 1999, the legislature voted to supplement the Massachusetts Tobacco Control Program (MTCP) cigarette tax funding with tobacco settlement money. By 2002-2003, fiscal emergencies and other factors led to funding cuts that nearly eliminated the program. Since then, the legislature has increased funding, most notably in FY2008, when funding was increased from $8.25 million to $12.75 million. However, in FY2010, funding for the program was cut to $4.5 million. In total, the MTCP has been cut by more than 65 percent since FY2008. Unfortunately spending from tobacco companies are only going up, marketing in state is $123.7 million making the ratio of tobacco company marketing to total spending on tobacco prevention 29.8 to 1 Today Tobacco takes a toll in Massachusetts, 18% of adults smoke, 14% of high school student’s smoke and 9,000 deaths are caused by smoking each year. It is costing us #3.5 billion a year on annual health care costs directly caused by smoking and residents' state & federal tax burden from smoking caused government expenditures is $717 per household. The states’ failure to use more of their tobacco money to fight the tobacco problem is especially troubling in light of recent national surveys indicating that smoking declines in the U.S. have slowed. The nation’s progress against tobacco use – the number one cause of preventable death – is at risk unless states increase funding for tobacco prevention and cessation programs. Given such a strong return on investment, states are being truly penny-wise and pound-foolish in shortchanging tobacco prevention and cessation programs. Even in these difficult budget times, tobacco prevention is one of the smartest and most fiscally responsible investments that states can make.