Tobacco Settlement Endowment Trust

Summary of Policy Considerations and Agency Recommendations

The Oklahoma State Legislature and TSET may consider the following:

Policy Considerations

• Adopt a coordinated funding plan across all state agencies supporting tobacco cessation, prevention, and related health outcomes.
• Empower one of the State’s health agencies to determine state- specific spending priorities and identify measurable, observable outcome data for tracking and reporting progress for key health metrics, including tobacco use.
• Define within statutes specific areas of spending on health programs consistent with TSET’s mission and the original purpose of the Master Settlement Agreement, such as Medicaid.
• Amend statutes to provide clarity for the constitutional broadness of TSET’s mission.
• Amend O.S. Title 62, Section 2306 to provide clearer guidance to the Board of Directors for TSET regarding the type of allowable expenditures related to executing its duties.
• Reorganize TSET within an existing state agency focused on health outcomes aligned with TSET’s constitutional duties. Options include the Department of Health, the Health Care Authority, and the Department of Mental Health and Substance Abuse Services.
• Expand the definition of smoking in statutes to include e-cigarettes and emerging technologies for ingesting nicotine and tobacco-related products.
• Create or repurpose an existing governmental body with the authority to create and execute a statewide strategy for improving the health and wellness of Oklahomans, including reducing tobacco use to below the national average. One option could be to build on the existing Advancement of Wellness Advisory Council, which is led by the Commissioner of Health.
• Require the production of an annual report about tobacco products and trends in the region, including taxation, use, sales, illegal sales and emerging products, including e-cigarettes. The current State Plan produced by the State Department of Health could be adapted.
• Require licensure for the distribution and sale of e-cigarettes. Options for the enforcement agency could include the ABLE Commission or the Attorney General’s Office.
• Require an annual forecast for MSA payments be provided to the Legislature. For example, Colorado’s Department of Public Health and Environment currently provides this to the public.

Agency Recommendations

• TSET should reorient its logic models to measure for behavioral change. These models should be publicly available and include data-collection plans that measure statewide impact success metrics at every level; short-term, intermediate, and long-term.
• TSET should partner with the State Department of Health to conduct more rigorous statistical analysis to better understand relationships between variables that impact smoking prevalence.
• TSET should begin collecting data to understand e-cigarette use across the state, as well as other tobacco products and emerging trends.
• TSET should report data related to health outcomes directly attributable to TSET programs and spending.
• TSET should measure outcome data, both intermediate and long- term, to determine the statewide efficacy of media campaigns.
• TSET should prioritize tobacco prevention and control programs based on Oklahoma-specific outcomes and needs.
• TSET should examine the operational cost effectiveness of its Helpline, looking to other states for examples of cost-saving measures.