The 1998 Tobacco Master Settlement Agreement (MSA) was developed between states and tobacco manufacturers to settle the states' lawsuits against tobacco manufacturers and recover tobacco health-related costs. States won billions of dollars and concessions regarding how tobacco products could be advertised. The purpose of the MSA was to prevent cigarette smoking and compensate for health expenses incurred in the treatment of tobacco smoking-related illnesses. Twelve years after the settlement, it is clear that MSA monies have been gravely diverted from tobacco prevention and cessation programs to balance budgets. The authors' review indicates that increases in funding for state tobacco prevention and cessation programs reduce tobacco use across all populations. Implications for social policy and social work practice are offered.