Across America, special interest groups are lining up, hoping to get money out of the national tobacco settlement for their pet causes, many of them non–health related. Signed on November 23rd by 46 states, the settlement requires several of the major tobacco companies to pay $206 billion over the next 25 years. Each state will receive a different amount, dependent partially on their number of Medicaid residents. And although there is nothing in the deal outlining how the funds have to be used, cancer centers in at least three states are working on garnering a share—beating out groups that would use the money for new classrooms, roads or housing.

The suits were originally filed by all 50 states to recover costs of caring for Medicaid recipients who contracted tobacco–related illnesses. Under the action, tobacco companies are required to stop billboard advertising, limit sponsorship of sporting events and mount a counter–marketing campaign aimed at children. Four states—Mississippi, Minnesota, Florida and Texas—settled separately with the industry earlier in 1998. But none of the settlements have been finalized. In every state, a Supreme Court judge has to agree to the terms before the state legislature can appropriate the money. That is where the lobbying comes in.

In Texas, the Attorney General, the Governor and the state House and Senate appropriations leaders have agreed that the lion's share of the $15.3 billion payout should go to health–related programs, says Harry Holmes, associate vice president for government relations at the M.D. Anderson Cancer Center. If the legislature, which begins meeting this month, accepts this agreement, M.D. Anderson will get $100 million over over two years beginning in 2000, to go to an endowment for research and education. Cancer centers in Florida also managed to get in some requests to their legislators, and in addition are requesting $100 million from increased tobacco sales tax for a new cancer research tower at the Tampa–based Moffitt Cancer Center. Final decisions are expected in May.

Seven cancer centers in Pennsylvania are lobbying for a 25 percent share of the state's $11.2 billion payout. "These funds have to be set aside in order to deal with the burden of human cancer we're going to face in the next generation," says F. Jay McKay, executive vice president of Fox Chase Cancer Center. The money would be spent on basic science, genetics, addiction research, and new therapies, McKay says. Each institution's share will be determined by the amount of National Cancer Institute funding it receives, a division to which all seven have agreed. "It's a fair amount of money and it will greatly strengthen the institutions in Pennsylvania," says McKay.

But some groups, including the American Lung Association, opposed the settlement. Paul Billings, ALA spokesman, says "there's less money here than people think." ALA is working to overturn the settlement in some states where such action is still possible. In others, ALA aims to steer the funds into education and addiction prevention programs, according to Billings.

The tobacco manufacturers settled primarily to avoid the cost and hassle of fighting 50 separate suits. It is not an admission of negligence. "In a settlement, you don't normally admit guilt," says Mary Aronson, an independent tobacco industry analyst based in Washington DC. "They're viewing [the settlement] as blanket protection from future litigation." The companies still face private suits, however.