Quit-smoking programs work. Just ask the crew at Rigid Hitch in Burnsville, where a quarter of the office smokers quit with the help of counseling and financial incentives.

"It gave them the support they needed and kind of made them accountable," said Betsy Kauffman, a human resources manager for the business of 40 workers, half of whom smoked before the program.

The problem isn't the effectiveness of such efforts, according to a report released Friday, it's that states aren't investing enough in them to offset the damage that tobacco use can cause.

Minnesota is spending $19.6 million on tobacco control this year, according to the annual report of the Campaign for Tobacco-Free Kids, a national advocacy group. While that is 12th highest in the nation, it is short of the $58.4 million recommended by federal health officials and only a fraction of the $535 million that Minnesota collects from tobacco taxes and lawsuit settlement revenues.

The lack of spending ends up hurting Minnesota in the long run because of the high cost of treating tobacco-related diseases, said Danny McGoldrick of Tobacco-Free Kids, based in Washington D.C.

"We're not saying you need to spend all of this money,'' he said. "But it's really a missed opportunity for Minnesota."

State Health Commissioner Ed Ehlinger said Minnesota must re-examine its "underinvestment" in tobacco control and consider higher fees on cigarettes to raise revenues and discourage teens from buying them. Bringing Minnesota up to the cigarette tax levels in Wisconsin, he said, would generate an extra $340 million per biennium, some of which could cover tobacco control.

"Certainly the issue of tobacco control and prevention and how to fund that is part of the discussion we're having right now," he said.

Tobacco funds waylaid

Like many states, Minnesota used much of its revenue from a 1998 legal settlement with tobacco companies to close general budget deficits. Former Gov. Tim Pawlenty and the Legislature exhausted a $1 billion tobacco trust fund, which had been used to finance health and child welfare programs, to plug budget gaps in 2004.

Pawlenty and Dayton have used additional annual payments from tobacco companies to finance bond sales that help cover the state's deficits.

Minnesota did seal away some money at the time of the settlement, which now funds a nonprofit called ClearWay Minnesota and its quit-smoking programs. That protected money is why the state looks better than most, McGoldrick said. "It was set aside before it ever got to the Legislature to abscond with."

ClearWay's existence guarantees that every Minnesotan has access to quit-smoking counseling, said spokesman Mike Sheldon. However, he believes other state budget cuts have hurt campaigns designed to prevent teens from smoking in the first place.

Despite the hand-wringing over prevention spending, Minnesota Student Surveys have shown a decline in smoking since 1998. Only one-fifth of high school seniors in the latest survey, for 2010, said they had smoked in the prior month.

Ehlinger said the progress has slowed, though. And advocates worry about renewed interest in tobacco, because prevention spending is at its lowest level nationally since the tobacco settlement.

Following past economic downturns, anti-tobacco spending rebounded, but there's no guarantee that will happen again, McGoldrick said. "We're getting farther and farther away from the settlement. We're finding some state legislators who don't know what the settlement is or was."

In Minnesota, some prevention activities are now funded by the Statewide Health Improvement Program, which awards grants to combat a variety of chronic health problems -- and which underwrote the program at Rigid Hitch.

Betsy Kauffman can't say whether the company's smoking campaign cut health costs, though annual claims have declined since it took place in 2010.

One employee was astonished when she no longer suffered bronchitis flareups in the winter. The woman declined to give her name because, she said, her husband never knew she smoked at work and would be mad if he found out.

She admits to an occasional cigarette when out with friends, but said support from co-workers has eliminated her craving to smoke at work.

"I think that's where so many of us get our stress level, and that's not going to go away," she said. "So if you have someone you can talk to, if you're having a bad day, then that can help you out."

Jeremy Olson • 612-673-7744