Estimated to total more than $246 billion over 25 years, the 1998 Master Settlement Agreement (MSA) between the tobacco industry and the 50 states, as well as recent increases in state tobacco excise taxes, has created an unprecedented opportunity to fund vital public health-related expenses. In fiscal year 2003, the states received more than $20 billion in tobacco-generated revenue, including $8.7 billion in tobacco settlement payments and $11.6 billion in tobacco taxes. Unfortunately, the states are spending only a combined $683 million, or less than 3.5%, of their tobacco-generated revenue on tobacco control efforts.