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As NM funding for nicotine prevention falters, those most at risk lose out

Cigarettes in an ashtray
Gerd Altmann

In May, the New Mexico Department of Health’s Nicotine Use Prevention and Control Program gave some bad news to providers who work with Black, Indigenous, Hispanic and LGBTQ communities: immediately stop the prevention work. Two months before their contracts were up, NUPAC said they were out of money and couldn’t keep paying them.

The state’s prevention and outreach efforts were cut off and the Quitline then went down at the end of June after state funding fell short. While 1-800-QUIT-NOW is up and running again, community groups serving some of the people most at risk still are not able to help.

“People who lose out on these services have the least to begin with,” said Alex Ross-Reed, executive director of Health Equity Alliance for LGBTQ+ New Mexicans (HEAL+ NM). She said the most vulnerable New Mexicans are being hit the hardest.

They’re being targeted by tobacco companies, they’re the most impacted by inflation, they’re the most harmed by racism,” she said. “And these people have the least voice in government and are being the most harmed by this cut.”

Health advocates and the CDC say tobacco company advertising has long targeted LGBTQ and Black communities. Andresearch shows those communities are also more likely to use nicotine to cope with discrimination.

Queer and trans people use the products at 40% higher rates than heterosexual and cisgender people, according to the LGBT Cancer Network.

The Food and Drug Administration reports Indigenous people have had the highest rates of commercial tobacco use. Meanwhile, Black people are more likely to die of smoking-related diseases than their white peers, according to the CDC.

In an email, NUPAC Program Manager Esther Hoang apologized to the group of minority-serving providers for what she called, “the sudden issue that was bestowed upon us by DOH,” which she described as a 23% funding reduction for the remainder of the fiscal year due to tobacco settlement revenue coming up short.

She wrote that this was “both great and bad news.” The good news is that the providers’ efforts are having an impact and commercial tobacco sales are down. The bad news is that NUPAC is funded by those sales through the Tobacco Settlement Permanent Fund, and so had less money to help people quit. The state health department said the program had to reduce their spending by about $741,000.

The providers, which subcontract through Constellation Consulting LLC, still don’t have NUPAC funding and are not sure if they will again.

They are not guaranteed to be asked to contract with the vendor NUPAC selects for this next four-year funding cycle.

If tapped, Ross-Reed said she is not sure she will accept the funds her organization has relied on for 20 years.

“I hold a window of possibility if there were some accountability, an apology, and a plan to move forward centering equity,” she said.

She said, in addition to not having access to the last two months of her $65,000 contract, she spent nearly $5,000 on materials right before reading the notice that NUPAC was out of money and was denied reimbursement.

NUPAC funding makes up about 60% of her budget. So, declining a new contract would be a big hit, one Ross-Reed has already had a taste of since May’s stoppage.

“I’ve had to put everything else on hold because if we don’t have money coming in the door, we’re not open,” she said. “So, now I’m fundraising to keep our organization afloat and get new funding streams to continue this health equity work.”

She said the organization will soon launch a campaign to raise $50,000 to sustain itself for the rest of the fiscal year and is awaiting word from foundations.

The Department of Health said in a statement, “The Nicotine Use Prevention and Control Program understands hesitancy by any subcontractors regarding the recent funding shortfall but hopes to maintain their longtime relationships with their partners.”

Kenneth Winfrey’s outpatient clinic Umoja Behavioral Health P.C. runs the New Mexico African American Tobacco Prevention Network. He said the sudden loss of funding damaged relationships with the people they’re trying to help.

”It’s embarrassing, because no matter how much we explain to our communities, they project that feeling of betrayal onto us,” he said. “And we’re the ones trying to do the work.”

He said they have had to turn down opportunities, limiting community exposure to nicotine prevention resources. He said it is not the first time the funding has run dry.

“NUPAC doesn’t seem to issue these contacts with a promise for their duration. It just makes a promise for their spirit and intention,” he said. “As an intensive outpatient agency, this money helps us — but for organizations that really rely on that money as a chief part of how they function, it’s very difficult.”

He said he is hesitant to accept NUPAC funding again if it is offered.

“I would rather promise them whatever extra money the clinic can find to do what the clinic knows it can do,” he said.

He said he doesn't want to risk letting his community members down again.

Updated: August 9, 2023 at 12:20 PM MDT
Following the publication of this story, Kenneth Winfrey with Umoja Behavioral Health P.C. reached out to KUNM to add to his initial comments. He emphasized his hesitancy in accepting NUPAC funding in the future is not without openness to the state repairing its relationship with the organization. Regardless of whether the organization accepts NUPAC funding again, he said Umoja would like to see the state take responsibility for the stoppage’s impact on the Black community and ensure it provides reliable funding for the work in the future.

Nash Jones (they/them) is a general assignment reporter in the KUNM newsroom and the local host of NPR's All Things Considered (weekdays on KUNM, 5-7 p.m. MT). You can reach them at nashjones@kunm.org or on Twitter @nashjonesradio.
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