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It has been nearly 10 years since the Attorneys General joined forces in a concerted legal attempt to recover the costs of caring for smokers with cigarette-related illnesses. To avoid a possible bankruptcy, tobacco companies have accepted a legal agreement known as the Master Settlement Agreement (MSA). With the MSA, states received a 25-year payment of hundreds of billions of dollars from «Big Tobacco.» In addition, the tobacco industry has been forced to make new concessions on how advertising for cigarettes and other products is aimed at youth in order to reduce smoking across the country. In return, the 46 states that were parties to the MSA agreed to abandon their ongoing individual and collective actions against the tobacco industry. The impact of the scheme is the subject of much discussion. Here we return to the MSA as it was implemented, its potential effects and the lesson it teaches physicians about the realities of public health in the United States. The MSA provides for a massive financial transfer of cigarette manufacturers to the United States for the cost of treating smoking-related diseases and funding for educational programs to reduce underage smoking (see Table 1 for The Diet`s Strengths). In addition to WMA funds, four states, 4 The MSA has also established a national non-profit foundation (the American Legacy Foundation) to support research into effective tobacco programs ($250 million over 10 years) and fund an anti-smoking campaign for a total of $1.45 billion over five years. , a National Tobacco Grower Settlement Trust would provide $5.15 billion over a 12-year period to compensate tobacco quota holders and farmers for expected financial losses due to an expected decline in MSA cigarette consumption. In recent years, Massachusetts received $257 million in 2016, $254 million in 2017 and $243 million in 2018 from the agreement, according to the district attorney`s office.

The issue of the tobacco industry`s responsibility for the health problems of the population and the compensation for their treatment have been increasing since the 1960s. In 1999, the Attorney General jointly launched the largest class action in U.S. history and sued the tobacco industry to recover the costs of caring for smokers. In the Master Settlement Agreement (MSA), states were rewarded with billions of dollars and won concessions on how to promote cigarettes and address minors. Ten years after this agreement, much is known about how MSA funds were distributed and how states used the money. There is some understanding of the amount of money spent on tobacco-related health care costs and whether funds have been allocated to efforts to reduce smoking in a given state. However, little data is available on the impact of MSA on tobacco control at the local and national levels. This commentary examines these issues as well as the evolution of the tobacco industry to compensate for the losses incurred by the comparison. Finally, an analysis of the complexity of the current tobacco policy will be put in place to enable physicians and other health stakeholders to better understand the current political dynamics and to make tobacco control policy more effective in the future. In November 1998, the Attorneys General of 51 U.S. states and territories reached a pioneering agreement as a result of this litigation. Among many others, and subject to a few exceptions, the Master Settlement Agreement: In 2001-2006, an increasing number of reports and anecdotal accounts suggest that a high percentage of ASM funding has been dissolved in areas far removed from the original intentions of the agreement.