Supervisors unanimously approved a plan Tuesday to spend $8 million in tobacco settlement money this year on health care programs, including $1.2 million for tobacco prevention.

Under the plan, Ventura County Medical Center will receive about $2.6 million to buffer the cost of treating a growing number of poor and uninsured patients. Private hospitals will receive $900,000 to divide among them, and another $900,000 will go to doctors who provide emergency care to uninsured patients. The plan is built on joint recommendations from Chief Executive Officer Johnny Johnston and two volunteer committees appointed by supervisors. Each year, the committees will review the plan, evaluate funded programs and suggest any changes. The county expects to receive between $8 million and $10 million a year from the 1998 settlement between 46 state attorneys general and the tobacco industry. While Ventura County is one of the few nationwide to put some of that money into tobacco prevention, many at Tuesday's meeting argued the plan did not put enough. Representatives from local heart and lung associations, youth groups and cancer societies pleaded with supervisors during the public comment to increase the funding to as much as 25 percent, or $2 million. The Centers for Disease Control in Atlanta recommends that counties and states spend 20 percent to 25 percent on education and prevention. "We believe tobacco is the number one health problem facing Ventura County," said Jack Nicholl, of the local chapter of the American Lung Association. "One out of five people in Ventura County who die, die from tobacco use." More than 400,000 Americans die of tobacco-related disease each year. About 90 percent of current smokers took up the habit at or before age 18. But supervisors balked at increasing the allocation. Supervisor Steve Bennett said he is skeptical that prevention and education programs actually work. "After 25 years in education, I have seen many ineffective tobacco education programs," Bennett said. "I will be passionate about this category and watching to see how effectively this money is spent and whether these new programs actually work." Supervisor Judy Mikels said spending 15 percent of this year's $8 million from the multistate tobacco settlement was "very fair." Mikels said the master settlement agreement already put $1.6 billion of the $256 billion settlement into a national tobacco education program. "I think there is a public misunderstanding out there about the tobacco settlement and what is already being spent on tobacco education," Mikels said. "When you balance that need with all the other needs for health care and those of people who don't smoke, I think 15 percent for education is very fair." The $1.6 billion anti-youth-smoking campaign Mikels referred to is produced by the tobacco industry, which also spends about $500 million a year in California on tobacco advertising. Critics of the tobacco industry's education campaign like Dr. Stanton Glantz, a professor of medicine at the University of California, San Francisco, say the campaign is based on strategies that don't work such as emphasizing that parents tell their children not to smoke because it's an "adult" activity.

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