DEFENDING TSET

Talking Points

High-level Talking Points

• Oklahoma can invest in health long-term because of a voter-created and affirmed endowment, the only one of its kind in the nation.
• TSET’s focus is the prevention of chronic disease, as well as medical research and access to health care. In focusing on prevention, TSET saves money in the long run because prevention of chronic disease is less expensive than treatment of chronic disease.
• TSET invests in prevention – supporting Oklahomans in making healthy choices – reducing the need for costly health care for chronic diseases – by partnering with communities and organizations across the state to create safe places for physical activity and improving access to healthy, whole foods and empowering Oklahomans to make healthier choices.
• Long-term investments have helped lower Oklahoma’s smoking rate.
• TSET grants help get cancer care to Oklahomans close to home.
• TSET funding supports healthcare access and getting doctors to rural areas.
• Today’s Oklahomans are reaping the benefits of the structure and protections that were created 25 years ago.

Structure and History

• Today’s investments in health wouldn’t be possible today without the protections approved by the citizens of Oklahoma.
• TSET’s structure purposely gives the Board of Directors independence from the legislature and other appointing authorities. This enables the board to commit to long range planning and investment and rise above the politics of the day.
• TSET was created through a constitutional amendment in 2000. In 2020, the people of Oklahoma rejected by almost 60% an amendment to divert Tobacco Settlement monies away from the TSET endowment.
• TSET is a fiscally conservative idea, saving and investing money then spending only the earnings on programs to improve health. As the largest funder of prevention work in Oklahoma, TSET saves tax dollars.

Budget and Impact

• Today, TSET’s budget is around $82 million a year. In November of 2025, TSET awarded $150 million in TSET Legacy Grants (over and above the annual budget) that will transform health and health care access in Oklahoma.
• Historic investments from TSET Legacy grants that help build a pipeline for healthcare providers like doctors and nurses.
• TSET has invested close to $1 billion in Oklahoma to improve health. The approval of Legacy Grant awards marked $1 billion in investment to address pressing health issues in Oklahoma.

Tobacco Control and Helpline

• TSET is the primary funder of the Oklahoma Tobacco Helpline. It has served more than 630,000 Oklahomans since its creation in 2003. It is the number one quitline in the country in several metrics, including satisfaction and quit rate.
• The Helpline is one of the highest-rated quit lines in the nation with survey respondents reporting a 96% satisfaction rate.
• The Oklahoma Helpline quit rate is 45.4%, greatly exceeding the national benchmark quit rate of 30%.
• From FY17-21 a little over $15 million in Medicaid costs was saved by Oklahomans who quit smoking using the Helpline.
• For every $1 spent on the Helpline, our state saves about $3.20 in health care costs each year.
• Stephenson Cancer Center
• TSET support has allowed Stephenson to expand its nationally recognized clinical trials program, which provides patients with access to the newest cancer treatment.
• Since 2012, SCC has recruited 81 new researchers and support from SCC’s clinical trials programs have led to six new FDA-approved cancer drugs.
• A mobile lung cancer screening initiative, funded with $1.7 million from TSET, is providing access to life-saving screenings in rural areas.

Research Funding

• TSET supports cutting-edge research that makes Oklahoma a destination for world-class researchers. TSET’s investment in OU’s TSET Health Promotion Research Center (HPRC) has helped to treat 10,000 Oklahomans and hundreds of studies. For every dollar of TSET funding, HPRC leveraged a return on investment of $2.56. HPRC allocates 54% of grants and dollars to tobacco control, physical activity and nutrition research.
• TSET has provided research funding to the Oklahoma Center for Adult Stem Cell Research (OCASCR). A partnership between OMRF, OU Health and OSU. Since 2010, OCASCR has leveraged $40 million in funding into over $471 million in private and federal grants.
• Health Care Workforce Training Commission
• TSET provides 40% of the total funding for each TSET sponsored physician, making it one of the largest contributors to this public/private collaborative partnership. TSET funds are matched by both public and private entities to ensure that physicians are placed in communities with the most need.
• TSET has helped repay student loans for physicians in rural and underserved areas. There are currently 37 participants receiving TSET repayment, with 89 past participants. Resulting in over 665,000 patient visits since 2013.

Grants

• The TSET Healthy Living Program has partnered with 27 agencies in 28 counties since 2012, working to prevent cancer and cardiovascular disease by preventing and reducing tobacco use and obesity on a local level.
• Since 2012, almost $10 million has been awarded to schools and communities to improve health through TSET Healthy Incentive Grants.
• TSET Built Environment Grants fund community infrastructure improvements and programs that promote health.
• Example: TSET awarded Cushing district schools $975,512 for a Tiger Trail in Payne County, a 1.6-mile concrete trail to connect all Cushing district schools with pedestrian and bicycle access for students, staff and residents.
• TSET Targeted Achievement Grants support evidence-based strategies that help communities increase access to physical activity, improve healthy food options and prevent youth tobacco use.
• TSET Discovery Grants fund local or statewide non-infrastructure projects with immediate impact to 501(c)(3) nonprofits, public entities, and educational institutions. Projects must address tobacco prevention, improve Oklahomans’ health, enhance health care services (especially for children), or support the well-being of senior adults.
• Example: TSET awarded a TSET Discovery Grant to LIFE Senior Services in Tulsa, which used the funds to open the Roma Berry Center for Seniors.
• The one-time TSET Legacy Grants of $150 million were awarded in November, and funding began in January 2026. They are designed to address Oklahoma’s leading causes of death -cancer and cardiovascular disease. More information.
• Example: TSET awarded the Board of Regents of the University of Oklahoma Health Sciences, Access to Clinical Trials $25 million to help build a Stephenson Cancer Center facility in Tulsa, increasing access to clinical trials in Tulsa and northeast Oklahoma.

Health Communication

• Health communication is one of the most effective strategies for reducing tobacco use and promoting healthy behaviors in a population. The goal of TSET health communication interventions is to reduce the leading causes of death in our state by preventing and reducing the two main risk factors: obesity and tobacco use.
• Big Tobacco spends $1 million per hour on marketing in the U.S. with nearly $150 million targeted toward Oklahomans annually.
• Research shows that health communication interventions provide an excellent return on investment by increasing healthy behaviors that prevent cancer, cardiovascular disease and other costly health conditions. These efforts save lives and improve the quality of life for Oklahomans. They also reduce health care costs for businesses, lessen the burden on the state’s health care system and decrease Oklahomans' medical costs.
• Example: The TSET Healthy Youth Initiative uses statewide public health education messaging, youth-led advocacy programs and character-building to affect positive behavior change. Including funding “My Life My Quit” because it offers cessation support to teens 13-17 that use tobacco products.