Updated

Half of New York's counties are not spending any of their money from tobacco companies on anti-smoking programs, the American Lung Association said Thursday.

Cash-strapped counties have instead been using their windfall from the 1998 settlement of a multistate lawsuit against the tobacco industry to fill gaps in local budgets.

"A lot of counties are using it for other uses, building jails, road improvement projects, dump trucks, even golf course irrigation programs," said Tim Nichols, director of government affairs for the Lung Association.

New York state and its counties will split roughly $25 billion from tobacco makers over 25 years. Although the state and counties are not legally obligated to spend any money on smoking prevention, anti-smoking groups say governments have a moral obligation to do so.

Thirty of the state's 62 counties are not spending anything to fight smoking or did not report their investment to the Lung Association, according to the report. That's down from 43 counties last year, when the association issued its first such report.

The New York State Association of Counties said the report unfairly characterized counties' spending by ignoring their health and Medicaid expenses.

"I think it's important to recognize that the revenues that flow from the master settlement are a reimbursement and not a windfall for county expenditures," said legislative director Stephen Acquario.

But Nichols said counties are blowing their only opportunity to address health problems caused by smoking.

"As part of the settlement, no public entity can ever sue tobacco makers again," he said. "If counties don't do something to stem the cost tobacco use imposes on local taxpayers, they can't go back to tobacco makers to sue them."

Suffolk County spent $4.02 per capita on tobacco control, becoming the only county to reach the $4 level that the National Association of County and City Health Officials recommends as a mimumum investment for local governments.

County Director of Public Health Lori Benincasa said Suffolk has spent most of the money on education, countermarketing and programs to help smokers quit.

"We are barely able to keep up with the people who want to join cessation programs," she said.

At a news conference in Westchester County, which spent $2.84 per capita for No. 3 in the state, County Executive Andrew Spano announced two new programs. One targets teen-age girls with advertising, events and a Web site. Another aims at pregnant woman while they're in the hospital, to keep them from smoking again if they quit during their pregnancies.

Other leading counties are Rockland ($3.12 per capita), Dutchess ($1.78) and Delaware ($1.77). The state spends $1.65 per capita on smoking cessation, Nichols said.

Counties are sharing the funds because New York and California are the only states that require counties to pay a portion of local Medicaid costs. The settlement was designed to compensate governments for public health costs taxpayers incurred because of smoking.

Westchester County is among about two dozen counties, including New York City, Erie, Monroe, Nassau counties, that sold their rights to collect payments to investors. Those local governments received one lump sum worth 40 percent of the projected settlement funds.

In most cases, much of that sum has been used for debt relief or major projects, making it more difficult to invest in anti-smoking programs, Nichols said.

"We know how to save lives," Nichols said. "What we need is the political will to invest this money into programs that save lives."