Subcommittee weighs cuts to tobacco cessation funding as health department and cancer centers urge restoration

The Maryland General Assembly's Appropriation Subcommittee on Health and Social Services heard a Department of Legislative Services analysis on Feb. 5 that recommended trimming $5,700,000 in general funds from the Maryland Department of Health (MDH) fiscal 2026 allowance for tobacco cessation and prevention programs.

The DLS analyst, Naomi Camaro, told the subcommittee that the fiscal 2026 Prevention and Health Promotion Administration (FIPA) budget totals $531,500,000, an increase of about $7 million from fiscal 2025, and that DLS recommends reducing the fiscal 2026 allowance so tobacco cessation programs would be funded at the statutory minimum level. Camaro said the governor’s allowance included $24,000,000 for tobacco cessation and that state law requires at least $18,250,000 be included annually in the budget.

MDH leaders pushed back. Secretary Laura Herrera Scott said the department “respectfully disagrees with this recommendation to reduce the budget for tobacco cessation programs,” arguing the reduction would compromise local health department work and the state’s ability to sustain declines in adult smoking. Deputy Secretary Nilesh Kalyanaraman told the panel the majority of the $5.7 million targeted by DLS “goes to funding the LHDs to do tobacco cessation work,” and characterized the proposed reduction as a risk to ongoing prevention efforts.

Why it matters: DLS presented data showing adult cigarette use has fallen in Maryland over more than a decade but that youth use patterns are mixed. Camaro said FIPA data show decreases in individual products but modest increases between 2021 and 2022 for any tobacco product among high school students; the subcommittee heard that newer products marketed to youth (described in testimony as “other tobacco products” such as a product called ZEN) are a continuing concern for public-health advocates.

Cancer research and cigarette restitution fund: advocates warn of downstream losses

Separately, the subcommittee heard concerns about a proposed $13,000,000 reduction from the Cigarette Restitution Fund (CRF) that would remove special-fund support to Maryland’s two National Cancer Institute-designated comprehensive cancer centers (Johns Hopkins Sidney Kimmel and University of Maryland Greenebaum). MDH officials said the FY26 allowance includes a special fund reduction of $13,000,000 for statewide academic health center cancer research grants, contingent on provisions in the Budget Reconciliation and Financing Act (BRFAA).

Leaders from both centers and patient advocates urged the subcommittee to restore the money. Bill Nelson, director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, described the CRF investment as “a seed investment” that helps attract federal and private dollars and supports translational research, screening and clinical trials. John Groupman of Johns Hopkins and Taufik Owenekoko of the Greenebaum Cancer Center described long-term gains in cancer mortality and the centers’ ability to bring federal research funding into the state. A patient who testified, Philip Aetto, said access to clinical trials in-state had been crucial to his treatment.

MDH said prevention programs often lack alternative funding streams and that research funding can come from other sources, a point MDH asked the subcommittee to consider when weighing competing budget priorities.

Other FIPA issues discussed

- Cannabis public health fund: Camaro said Chapter 26 of 2022 established a cannabis public health fund. FIPA reported $5,300,000 expended through January 2025 and the FY26 allowance includes $6,200,000 in special fund expenditures from that fund for prevention and education programs. DLS noted poison-control calls for unintentional cannabis exposure — especially among children ages 0 to 9 — rose between 2021 and 2022.

- HIV/AIDS (MATAP) funding: DLS and MDH described declining MATAP special-fund rebate revenue and its effect on awards. Camaro said closing balances hit zero in FY24 and asked MDH which services would be reduced as rebate spending falls. MDH staff described several reasons for the decline in rebate revenue, including increased insurance coverage and drugs going generic, and said core services supported by federal Ryan White funding continue.

- Prenatal and infant grant program: the FY26 allowance includes $3,300,000 for the prenatal and infant care grant program. DLS recommended release of $100,000 that had been restricted in FY25, noting FIPA had allocated its full annual appropriation each year and that some multiyear grantees will receive set-aside funding.

- Staffing and vacancies: Camaro reported FIPA includes 569 positions and a December 31, 2024 vacancy rate of about 18.68%. MDH later told the panel that as of Jan. 1 it had 91 vacancies in FIPA and that many were newly created positions or in active recruitment; MDH said it is converting some contractual (SPP) roles to merit (pin) positions and realigning others to meet program needs.

What the subcommittee will do next: No formal vote occurred during this hearing. Members pressed MDH on formulas for allocating local tobacco-prevention dollars by jurisdiction and on the timeline for appointing members to the Pediatric Cancer Research Commission, which MDH said must be seated before research grants from that fund can be administered.

Provenance: FIPA analysis (DLS presentation and MDH responses) and public testimony on CRF and tobacco occurred during the Feb. 5 hearing. The DLS presentation began with Naomi Camaro’s remarks on the FIPA fiscal 2026 allowance and the MDH response and subsequent advocate testimony followed in the same panel.

Ending: The subcommittee did not adopt any motions or votes at the hearing. Members and MDH staff said they will continue discussions in follow-up briefings and that DLS will transmit letters and clarifications based on outstanding questions about vacancies, MATAP reductions and the timing of Pediatric Cancer Research Commission appointments.