Supervisors Approve Anti-Smoking Funds Despite Reservations : Health: Board votes to spend $5.3 million on programs for minorities. Dixon warns the money will be closely monitored.

Despite serious reservations about the effectiveness of programs aimed at persuading minorities in Los Angeles County to stop smoking, the Board of Supervisors on Tuesday approved spending an additional $5.3 million on the effort.

But the county’s top administrator, Richard B. Dixon, issued a stern warning that the 35 agencies funded Tuesday will be closely monitored in the coming months. Dixon also said he anticipates bringing the board suggestions for improved anti-smoking campaigns early next year.

“We are not convinced that the current programs are the right way to go,” Dixon said.

A state fund generated by the 25-cents-a-pack cigarette tax increase approved by voters in 1988 pays for the programs.

Dixon said he became concerned about the use of the money while preparing an analysis of the 16 organizations funded in 1991-92. That study, requested by Supervisor Gloria Molina at the end of April, found that it cost more than $32 on average for a program just to contact a person.

County health officials and representatives of some of the anti-smoking programs had accused Molina, a former smoker, of intentionally holding up funding on behalf of tobacco companies. Campaign contribution statements for 1991 and 1992 indicate she received $3,500 from Philip Morris, the world’s largest tobacco company--more money than any other supervisor.

On Tuesday, however, Molina defended her concerns as based on fiscal prudence--not political posturing.

The range in estimated costs per person reached in the 1992-93 contracts is “frightening,” said Molina, noting that they vary from less than $4 to $120.

“I do worry when it’s going to cost us $120 a person,” she said. “I wonder if maybe we would be better off sending them to a stop-smoking clinic.”

However, an examination of the programs funded Tuesday shows that the cost per person can be misleading. By that yardstick, KCET-TV ran the least expensive program with a $3.74-per-person cost. But the station arrived at that figure by including the 75,000 expected viewers of an anti-smoking television program.

At the other end of the spectrum, Charles Drew University of Science and Medicine in South Los Angeles plans to spend $120 a person. That money would include holding small smoking cessation clinics for 500 people--sessions a spokeswoman described as “similar to Alcoholics Anonymous.”

Dixon said that if attendance at anti-smoking sessions were used as the only gauge of effectiveness, the programs spent $11,380 per person.

But he added that he found that the programs’ effectiveness was hard to determine because administrators had not been required to keep sufficiently detailed data--a problem he said will be addressed this year.

At Molina’s request, the board approved an amendment to the funding approval that requires the county Department of Health Services to set standards for data collection and to require follow-up surveys of effectiveness.

Peggy Toy, western regional director for the National Black Leadership Initiative on Cancer, said such standardization may be misleading, particularly if success is gauged by per-unit costs and the numbers of individuals who actually stop smoking.

Toy said that mainstream stop-smoking programs have not proved effective in minority communities, one reason why the cigarette tax money was set aside to develop new strategies for those populations. Developing such new approaches can be expensive, she said, particularly in the first few years.

“I think that you need to be briefed a little bit more on the strategies that are being tried,” Toy told Molina. “Standard evaluation measures do not apply.”