However, in 2000, the economy began to sink into recession, with the bursting of the dowry and the rapid fall of stock indexes. On September 11, 2001, following the terrorist attacks in New York and Washington, D.C., the economy was further held back by declining tourism and air traffic. The economy began to pull out of recession in 2003, but countries that had cut taxes a few years earlier found that they did not have enough income to meet the important needs of all programs. A tax increase in response would be politically dangerous for politicians who have been earned or based on the promise of tax cuts. Inevitably, the temptation was irresistible to treat MSA`s revenues as a “cookie-glass” to be bugged to fill budget gaps. In addition, in tobacco-producing countries, tensions between tobacco control objectives and rural economic development have increased, with some arguing that tobacco reduction efforts would harm the tobacco industry and, therefore, employment and rural incomes.13 “14 In a summary survey on congressional and state issues, one analyst found that the MSA “does not address the issue of state authorization to legislate on compensation funds, and it still somehow determines how states spend the funds.” 11 Since the MSA did not require state revenue for certain activities, the way was clear for states to allocate ASS revenues on the basis of their specific political and economic situation15. The reduction in total domestic consumption of cigarettes is a success for MSA.24 domestic cigarette units were down, but the decline was stronger in 1999. While the MSA may have helped to ensure the financial viability of major U.S. tobacco producers by increasing their profitability, thereby reducing cigarette consumption, the increase in the price of cigarettes in itself has significant public health benefits.

Since the MSA did not regulat exports, producers could have moved from domestic consumption to an increased presence in foreign markets due to increased exports26. The key agreement in the comprehensive settlement was a compromise to grant the tobacco industry legal immunity for most of its measures in exchange for money payments and political concessions.3,4 This compromise was controversial, divided the public health community and contributed to the defeat of efforts to transform the comprehensive regulation into legislation.