At a small table in a hallway bustling with anti-tobacco activists and policymakers, Ed Martello hawked his wares. The Rockville-based Deus Technology engineer had designed a computerized machine to more accurately examine X-rays for lung cancer, and he h

"Why not use some of this tobacco money to fund a way to detect lung cancer in the early stages?" Martello said this week. "The county could do a screening program for high-risk smokers and ex-smokers." Two-and-a-half years ago, Maryland joined a national settlement agreement with the tobacco industry, winning $4.2 billion over 25 years. Now, as the state has begun to disburse some of the proceeds to counties including Montgomery, local officials must decide how best to spend it. Hospitals, nonprofit groups and health care product manufacturers have all lobbied for a piece of the settlement. In Montgomery, however, officials hope forums like Tuesday's tobacco summit help build a consensus to prevent policymakers from throwing money at what Montgomery's Health and Human Service Director Charles Short calls "hobbyhorse" programs of the week. More than 100 people attended the forum. "Our focus has been to build a shared vision," Short said. "We didn't want all of our advocacy groups fighting among themselves." Last fall, counties received their first tobacco money disbursement from the state. Montgomery received $1.8 million for cancer prevention and treatment and expects the same amount next year. Last week, the state handed out the first disbursement of money aimed at fighting tobacco use. Montgomery received $404,000 and expects over $1 million next year. Still, counties did not receive as much as they would have liked. Gov. Parris N. Glendening (D) withheld some of the money because of an ongoing dispute over the fees owed to the private lawyer who led the state's fight against tobacco companies. Guided by principles adopted by state lawmakers, most counties are spending their money in much the same way as Montgomery, said Carlessia Hussein, director of the state's Cigarette Restitution Fund Program. The county plans to give the bulk of its money to community groups, with an emphasis on those that help prevent tobacco use in minority communities. School-based programs will get the next-largest portion, and the county will beef up its underage tobacco sales enforcement as well as programs that help people quit smoking. In cancer treatment and prevention, the county plans to focus primarily on colon cancer screening and treatment because it is "one of the most common and preventable" cancers, said Carol W. Garvey, the county's chief health officer. The county also will provide funding to the Primary Care Coalition, a group of health care providers that serves low-income residents. Montgomery and Prince George's counties will get an added boost: Each is eligible for up to $1 million in state funds thanks to a bill sponsored this legislative session by state Sen. Christopher Van Hollen Jr. (D-Montgomery). The money will go to area hospitals to provide cancer screening and treatment, treat uninsured patients and better share information about up-to-date treatment protocols and clinical trials.

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