Executive Summary Introduction Tobacco use is the leading cause of preventable death in the United States, responsible for over 400,000 deaths annually. In Nebraska each year, 2,400 adults die prematurely because of cigarette smoking.1 It is estimated that 45,000 Nebraskans now under the age of 18 will eventually die prematurely from cigarette smoking. Cigarette smoking is responsible for $419 million of Nebraska's annual health care costs (representing approximately 7 percent of the state's annual health care costs including 12 percent of Nebraska's annual Medicaid expenditures), and smoking-related mortality results in over $400 million in forgone future earnings in the state per year. In 2000, the Nebraska State Legislature took an important step towards addressing the state's most significant public health problem by enacting Legislative Bill 1436, which appropriated $21 million from the Tobacco Settlement Trust Fund to support statewide tobacco prevention and cessation efforts. This funding enabled the Nebraska Health and Human Services System's (NHHSS) existing tobacco program, Tobacco Free Nebraska (TFN), to establish a comprehensive statewide tobacco program and greatly expand its efforts. The funding marked a turning point for the program, resulting in the Centers for Disease Control and Prevention (CDC) citing TFN as one of the model tobacco prevention and cessation programs in the nation. In 2002, the State Legislature took another important step towards eliminating tobacco use in Nebraska by passing a 30-cent increase in the state's cigarette tax. TFN’s achievements as a model program have been previously documented in the 2001 and 2002 State Snapshots and through a variety of other reports developed by an independent evaluation team.2 These reports, including this State Snapshot, provide information on statewide progress in tobacco control efforts to NHHSS, national, state, and local policymakers, and other interested parties.
