My vice is worse than your vice
Health Dollars
Is fat eclipsing tobacco as the public-health scourge of the day? Concern is brewing among antismoking advocates that their biggest private funding source for public-health efforts, the Robert Wood Johnson Foundation, is bored with nicotine addiction and shifting its focus to fast-food consumption. "The annual Tobacco-Free Kids gala was nothing but long faces this year," says Anne Marie O'Keefe, senior manager of policy and media advocacy at the Academy for Educational Development in Washington, D.C. One reason: The event, held in May, honored former RWJF President Steven Schroeder, who resigned last December. "He was the one who put the issue of smoking cessation on the map," says O'Keefe. In fact, over his 12-year tenure, RWJF devoted $408 million to antismoking efforts, including starting the Campaign for Tobacco-Free Kids.
The shift in priorities is not an illusion. A lot of people have quit smoking, and at the same time a lot of people are getting fat, says Michael McGinnis, the director of the health group at RWJF. "These issues are not on the same trajectory," he says. "The toll from tobacco is declining, although it is still substantial." The foundation plans to spend $100 million over the next five years in antitobacco efforts. It could devote up to $175 million to physical-fitness and nutritional campaigns over the same time period. The foundation's new president, Risa Lavizzo-Mourey, says: "The time is right to tackle obesity."
Momentum. Antismoking advocates fear their successes could be eroded if funding dries up. "The tobacco industry will never give up," says Donna Grande, codirector of the SmokeLess States National Tobacco Policy Initiative at the American Medical Association, which receives funding from RWJF. If advocacy resources diminish, there will be a need "not to lose the energy and momentum that's been built on the health side of the issue."
Still, Grande and others agree that obesity is an important public-health concern. "We don't view obesity and tobacco prevention as competing problems," says Joel Spivak, a spokesperson for Tobacco-Free Kids. "Both are serious public-health problems that need to be addressed with the resources commensurate to the toll they take on society." And McGinnis insists the foundation has not lost interest in tobacco issues. He says RWJF will try to encourage others to fund antismoking efforts in the future. -Stacey Schultz
This story appears in the June 16, 2003 print edition of U.S. News & World Report.