Tobacco takes a staggering toll on the health, well being, and finances of states. This report provides an independent evaluation of the performance of Arkansas⁰́₉ seven health-related programs funded by the state⁰́₉s share of the multi-state tobacco Master Settlement Agreement (MSA), includes an historical overview and summary of the activities of the Arkansas Tobacco Settlement Commission (ATSC), and examines changes in health outcomes attributed to the MSA-funded Arkansas programs over the past decade. MSA imposed no restrictions on how states could spend their payments, and states chose to allocate them to a wide variety of activities. In Arkansas, virtually all of the state's share of MSA funds were allocated to health related programs, with approximately one-third dedicated to tobacco prevention and cessation. The authors⁰́₉ findings are drawn from quarterly reports and spending and funding data compiled by the ATSC and the seven funded programs, as well as data provided by the programs to calculate unit costs for key program initiatives. Secondary data sources employed to assess health-related outcomes included national surveys plus state supplements for the Behavioral Risk Factor Surveillance System (BRFSS); U.S. Census data; data summaries from non-profit organizations such as the American Lung Association, Campaign for Tobacco Free Kids, and the United Healthcare Foundation; and statistics from the Arkansas Department of Health. The contents of this report should be of interest to national and state policymakers, health care researchers and providers, and others concerned with the effect of the tobacco settlement funds on the health of Arkansans.