Smoking rates have fallen steadily and dramatically in the last 20 years, thanks to a multipronged effort that has driven up the price of cigarettes, cut down on the places where they can be smoked, pressed their harmful health effects, and provided support to those who want to quit.

However, new tobacco products backed by millions of dollars in advertising continue to come to market, and high tobacco use persists among certain demographics. As much as smoking has seemed to disappear, the problem is far from over, and Maine cannot afford to rest on the successes of the last two decades.

A proposal in Gov. Paul LePage’s budget plan runs that risk. By using $20 million from the Fund for a Healthy Maine to maintain reimbursement rates for primary care doctors who work with MaineCare patients, the proposal bolsters smoking cessation at the expense of proven and effective prevention efforts when both are necessary to keep smoking rates, and health care costs, from rising.

The Fund for a Healthy Maine was created as a result of the 1998 tobacco settlement to funnel the state’s portion to Healthy Maine Partnerships, groups that organize and coordinate smoking prevention and cessation efforts, as well as other public health initiatives, at the local level.

Maine has done better than most states at making sure at least some of the settlement money is put toward anti-tobacco initiatives, and the state has benefited. In 1997, Maine had the highest youth smoking rate in the country. It is now solidly middle-of-the-pack.

The governor’s plan would gut the Healthy Maine Partnerships and put these gains in peril, while also jeopardizing the work the groups do in reducing obesity, promoting cardiovascular health, and coordinating response to epidemics. In Maine, the partnerships take the place of public health departments, and they could not be replaced easily.

It’s not that LePage’s proposal misuses the money — increasing access to primary care certainly would help MaineCare patients, who smoke at twice the rate of other Mainers. But there’s no reason the state cannot fund the governor’s initiative and keep whole the Healthy Maine Partnerships.

Maine last increased its cigarette tax in 2005, and it is falling behind the rest of the Northeast. An increase would help fund further anti-tobacco initiatives, and serve as a disincentive to smokers as well.

The state also should equalize taxes on other tobacco products, so that loose tobacco and cigars are taxed at the same rate as cigarettes. That alone would raise an estimated $9 million to $11 million.

Smoking has declined not just because of rising prices, increased awareness, stricter rules or better treatment, but because of a steady commitment to all those initiatives. We shouldn’t stop now.

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