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Objective. To analyze how the tobacco industry influenced tobacco control policymaking in Costa Rica. Materials and Methods. Review of tobacco industry documents, tobacco control legislation, newspaper articles, and interviewing of key informants. Results. During the mid-to-late 1980s, Health Ministry issued several advanced (for their time) smoking restriction decrees causing British American Tobacco (BAT) and Philip Morris International (PMI) to strengthen their political presence there, resulting in passage of a weak 1995 law, which, as of August 2011, remained in effect. Since 1995 the industry has used Costa Rica as a pilot site for Latin American programs and has dominated policymaking by influencing the Health Ministry, including direct private negotiations with the tobacco industry which violate Article 5.3's implementing guidelines of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). Conclusions. The Costa Rica experience demonstrates the importance of vigorous implementation of FCTC Article 5.3 which insulates public health policymaking from industry interference. ; Objetivo. Analizar cómo la industria tabacalera influyó en la formulación de las políticas de control del tabaco en Costa Rica. Materiales y métodos. Revisión de documentos de la industria tabacalera, de la legislación costarricense de control del tabaco y de periódicos y entrevistas con informantes clave. Resultados. Durante los años ochenta, el Ministerio de Salud aprobó varios decretos para restringir el consumo de tabaco, lo que causó que British American Tobacco y Philip Morris International fortalecieran su presencia política, cuyo resultado fue la promulgación de una ley débil en 1995 todavía vigente. Desde 1995 la industria tabacalera ha utilizado a Costa Rica como piloto para los programas latinoamericanos y ha dominado la formulación de políticas influenciando al Ministerio de Salud, incluyendo negociaciones privadas con la industria tabacalera en violación de las directrices del Artículo 5.3 del ...

BackgroundComprehensive smoke-free legislation covering all enclosed public places and workplaces was implemented in England on 1 July 2007. This study examines the impact of this legislation on smoking prevalence, number of cigarettes smoked and location of smoking, controlling for secular trends through the end of 2008.Method and findingsRepeat cross sectional survey using nationally representative data from the Health Survey for England (HSE). In total there are 54,333 respondents from 2003-2008. Logit and linear regression models were used to examine the effect of the legislation on smoking prevalence and the number of cigarettes smoked daily among continuing smokers which took the underlying trend into account. Our finding suggest that smoking prevalence (current smoker) decreased from 25% in 2003 to 21% in 2008 (AOR = 0.96 per year, 95% CI = 0.95-0.98, P<0.01) and the mean number of cigarettes consumed daily by smokers decreased from 14.1 in 2003 to 13.1 in 2008 (coefficient for time trend = -0.28±0.06 SE cig/day per year, P<0.01). After adjusting for these trends the introduction of smoke-free legislation was not associated with additional reductions in smoking prevalence (AOR = 1.02, 95% CI = 0.94-1.11, P = 0.596) or daily cigarette use in smokers (0.42±0.28 SE; P = 0.142). The percentage of respondents reporting smoking 'at work' and 'inside pubs or bars' decreased significantly from 14% to 2% (p<0.001) and from 34% to 2% (p<0.001), respectively, after the legislation. The percentage reporting smoking 'inside restaurants, cafes, or canteens' decreased significantly from 9% to 1% (p<0.001) and 'inside their home' decreased significantly from 65% to 55% (p<0.01).ConclusionThere is widespread compliance with the smoke-free legislation in England, which has led to large drops in indoor smoking in all venues, including at home. Declines in smoking prevalence and consumption continued along existing trends; they did not accelerate during the 18 months immediately following implementation.

Objetivo. Describir las políticas de etiquetado de cigarrillos vigentes en América Latina y el Caribe en agosto de 2010. Material y métodos. Revisión de la legislación para el control del tabaco en vigencia en los 33 países de la región; análisis de reportes sociales corporativos del grupo BAT; análisis de información de paquetes de cigarrillos recolectados en 27 países. Resultados. En 2002, Brasil se convirtió en el primer país de la región en implementar etiquetas de advertencias sanitarias pictoriales en los paquetes de cigarrillos. Desde entonces, otros seis países adoptaron advertencias pictoriales. El contenido del mensaje y el estilo de la fotografía varía entre los países. Trece países prohibieron descriptores de marca y nueve requieren una advertencia cualitativa con información de constituyentes y emisiones. Las compañías tabacaleras están utilizando estrategias comúnmente usadas alrededor del mundo para bloquear la implementación efectiva del Artículo 11 del Convenio Marco para el Control del Tabaco (CMCT) de la OMS. Conclusiones. Desde 2002, se ha alcanzado un importante progreso en la región. Sin embargo, los países que han ratificado el CMCT aún no han implementado todas las recomendaciones de las directrices del Artículo 11.

Latin American countries are experiencing an increasing burden of tobacco-related diseases. Smoke free policies are cost-effective interventions to control both exposure of nonsmokers to the toxic chemicals in secondhand tobacco smoke and to reduce the prevalence of smoking and its consequent morbidity and mortality. The World Health Organization Framework Convention on Tobacco Control has created momentum in Latin America to implement meaningful tobacco control policies. As of August 2007, Uruguay, two provinces and three cities in Argentina, and one state in Venezuela, had passed, regulated, and enforced 100% smokefree legislation. The tobacco industry, working through local subsidiaries, has been the strongest obstacle in achieving this goal and has prevented progress elsewhere in the region. During the 1990s, transnational tobacco companies Philip Morris International and British American Tobacco developed voluntary initiatives ("Courtesy of Choice" and "Environmental Tobacco Smoke Consultancy" programs) to prevent effective smokefree policies. Another important barrier in the region has often been a weak and fragmented local civil society. Opportunities in the region that should be taken into account are a high public support for smokefree environments and increasing capacity building available from international collaboration on tobacco control. Policymakers and tobacco control advocates should prioritize the implementation of smokefree policies in Latin America to protect nonsmokers, reduce smoking prevalence with its economic and disease burden in the region.

Between 1999 and 2001, British American Tobacco, Philip Morris, and Japan Tobacco International executed Project Cerberus to develop a global voluntary regulatory regime as an alternative to the Framework Convention on Tobacco Control (FCTC). They aimed to develop a global voluntary regulatory code to be overseen by an independent audit body and to focus attention on youth smoking prevention. The International Tobacco Products Marketing Standards announced in September 2001, however, did not have the independent audit body. Although the companies did not stop the FCTC, they continue to promote the International Tobacco Products Marketing Standards youth smoking prevention as an alternative to the FCTC. Public health civil society groups should help policymakers and governments understand the importance of not working with the tobacco industry.

BackgroundIn 1976, the U.S. Sugar Association (SA), a globally networked trade organization representing the cane and beet sugar industry, won the Public Relations Society of America's (PRSA) Silver Anvil Award for a crisis communication campaign. Their campaign successfully limited the diffusion of sugar restriction policies to control obesity, heart disease, diabetes, and dental caries, and marked the beginning of the modern-day SA. The sugar industry continues to resist measures to reduce sugar consumption, therefore understanding and addressing industry opposition is crucial to achieving global targets to reduce non-communicable disease.MethodsWe critically analyze common crisis management rhetorical strategies used by SA to defend itself from perceived wrongdoing, and sugar from perceptions of harm using a thematic content analysis based on Hearit's Corporate Apologia theory. Data sources were internal SA documents related to the 1976 Silver Anvil Award in 1) PRSA records, 2) Great Western Sugar Company records, and 3) William Jefferson Darby Papers.ResultsSA, using prototypical apologia stances (counterattack, differentiation, apology, and corrective action) and rhetorical dissociation strategies (appearance/reality, opinion/knowledge, and act/essence) constructed a persuasive narrative to successfully defend sugar from a product safety crisis, and the sugar industry from a social legitimacy crisis. SA's overarching narrative was that restricting sugar, which it claimed was a valuable food that makes healthy foods more palatable, would cause harm and that claims to the contrary were made by opportunists, pseudoscientists, food-faddists, lay nutritionists or those who had been misled by them. SA's apologia does not meet criteria for truthfulness or sincerity.ConclusionCorporate apologia theory provides an accessible way of understanding sugar industry crisis communication strategies. It enables public health actors to recognize and predict industry corporate apologia in response to ongoing product safety and social legitimacy challenges. Industry counterarguments can be examined for truthfulness and sincerity (or the lack thereof), and explained to policymakers considering sugar restriction policies, and to the public, thereby decreasing the effectiveness of illegitimate industry communication efforts to oppose regulation and legislation.

INTRODUCTION: Electronic cigarettes (e-cigarettes) are often promoted to assist with cigarette smoking cessation. In 2016–2017, the relationship between e-cigarette use and having stopped smoking among ever (current and former) smokers was assessed in the European Union and Great Britain by itself. METHODS: Cross-sectional logistic regression of the association between being a former smoker and e-cigarette use was applied to the 2014 Eurobarometer survey of 28 European Union countries controlling for demographics. RESULTS: Among all ever smokers, any regular ever use of nicotine e-cigarettes was associated with lower odds of being a former smoker (unadjusted OR=0.34, 95% CI=0.26, 0.43, AOR=0.43, 95% CI=0.32, 0.58) compared with smokers who had never used e-cigarettes. In unadjusted models, daily use (OR=0.42, 95% CI=0.31, 0.56); occasional use (OR=0.25, 95% CI=0.18, 0.35); and experimentation (OR=0.24, 95% CI=0.19, 0.30) of nicotine e-cigarettes were associated with lower odds of being a former smoker compared with having never used nicotine-containing e-cigarettes. Comparable results were found in adjusted models. Results were similar in Great Britain alone. Among current smokers, daily cigarette consumption was 15.6 cigarettes/day (95% CI=14.5, 16.7) among those who also used e-cigarettes versus 14.4 cigarettes/day (95% CI=13.4, 15.4) for those who did not use them (p<0.05). CONCLUSIONS: These results suggest that e-cigarettes are associated with inhibiting rather than assisting in smoking cessation. On the population level, the net effect of the entry of e-cigarettes into the European Union (and Great Britain) is associated with depressed smoking cessation of conventional cigarettes.

INTRODUCTION:Electronic cigarettes (e-cigarettes) are often promoted to assist with cigarette smoking cessation. In 2016-2017, the relationship between e-cigarette use and having stopped smoking among ever (current and former) smokers was assessed in the European Union and Great Britain by itself. METHODS:Cross-sectional logistic regression of the association between being a former smoker and e-cigarette use was applied to the 2014 Eurobarometer survey of 28 European Union countries controlling for demographics. RESULTS:Among all ever smokers, any regular ever use of nicotine e-cigarettes was associated with lower odds of being a former smoker (unadjusted OR=0.34, 95% CI=0.26, 0.43, AOR=0.43, 95% CI=0.32, 0.58) compared with smokers who had never used e-cigarettes. In unadjusted models, daily use (OR=0.42, 95% CI=0.31, 0.56); occasional use (OR=0.25, 95% CI=0.18, 0.35); and experimentation (OR=0.24, 95% CI=0.19, 0.30) of nicotine e-cigarettes were associated with lower odds of being a former smoker compared with having never used nicotine-containing e-cigarettes. Comparable results were found in adjusted models. Results were similar in Great Britain alone. Among current smokers, daily cigarette consumption was 15.6 cigarettes/day (95% CI=14.5, 16.7) among those who also used e-cigarettes versus 14.4 cigarettes/day (95% CI=13.4, 15.4) for those who did not use them (p<0.05). CONCLUSIONS:These results suggest that e-cigarettes are associated with inhibiting rather than assisting in smoking cessation. On the population level, the net effect of the entry of e-cigarettes into the European Union (and Great Britain) is associated with depressed smoking cessation of conventional cigarettes.

INTRODUCTION:Electronic cigarettes (e-cigarettes) are often promoted to assist with cigarette smoking cessation. In 2016-2017, the relationship between e-cigarette use and having stopped smoking among ever (current and former) smokers was assessed in the European Union and Great Britain by itself. METHODS:Cross-sectional logistic regression of the association between being a former smoker and e-cigarette use was applied to the 2014 Eurobarometer survey of 28 European Union countries controlling for demographics. RESULTS:Among all ever smokers, any regular ever use of nicotine e-cigarettes was associated with lower odds of being a former smoker (unadjusted OR=0.34, 95% CI=0.26, 0.43, AOR=0.43, 95% CI=0.32, 0.58) compared with smokers who had never used e-cigarettes. In unadjusted models, daily use (OR=0.42, 95% CI=0.31, 0.56); occasional use (OR=0.25, 95% CI=0.18, 0.35); and experimentation (OR=0.24, 95% CI=0.19, 0.30) of nicotine e-cigarettes were associated with lower odds of being a former smoker compared with having never used nicotine-containing e-cigarettes. Comparable results were found in adjusted models. Results were similar in Great Britain alone. Among current smokers, daily cigarette consumption was 15.6 cigarettes/day (95% CI=14.5, 16.7) among those who also used e-cigarettes versus 14.4 cigarettes/day (95% CI=13.4, 15.4) for those who did not use them (p<0.05). CONCLUSIONS:These results suggest that e-cigarettes are associated with inhibiting rather than assisting in smoking cessation. On the population level, the net effect of the entry of e-cigarettes into the European Union (and Great Britain) is associated with depressed smoking cessation of conventional cigarettes.

In addition to passing a statewide clean indoor air law in 2005, from 2004 to 2012, North Dakota tobacco control advocates and program leaders used locally-based approaches to instituting stronger tobacco control programs and policies and secured funding for a comprehensive tobacco control program and a new tobacco control agency that existed outside of the state Department of Health but was subjected to amendment attempts in each Legislative Session. As of 2012, the maturing program – divided between two state agencies and other state partners – was showing signs of success and has the opportunity to continue to reduce tobacco use. · From 1985 to 2012, despite coalition changes due to lack of funding and leadership, tobacco control advocates were committed to maintaining a statewide coalition. · Tobacco Free North Dakota (TFND), the statewide tobacco control coalition created in 1985, varied in its level of activity from 1985 to 2012. · Following the Master Settlement Agreement in 1998, tobacco control advocacy lacked a sustained statewide coalition. TFND fell dormant following the 2001 Legislative Session as a result of a lack of consistent leadership or funding. · The DOH provided a forum for a statewide tobacco control coalition when, in 2002, it created the Healthy North Dakota Tobacco Policy Subcommittee consisting primarily of state voluntary health organizations and local tobacco program leaders as well as a DOH employee; it became the active statewide coalition in 2004 and in 2005, succeeded in getting the Legislature to pass a clean indoor air law that prohibited smoking in most public places and places of employment that contained some exemptions. · In 2008 state and local partners reactivated TFND as the statewide coalition. This decision fit nicely with the desire of the new leadership in the DOH tobacco control program who wanted to relocate policy work outside of the DOH out of concerns that the DOH would be accused of "illegal lobbying," a common tobacco industry strategy for intimidating health departments and preventing them from engaging in effective tobacco control policy advocacy. In 2010, the TPC Executive Committee, created by Measure 3, funded TFND and other state partners such as the American Lung Association with a Special Initiatives Grants which allowed these organizations, which previously lacked funding, to hire staff and increase their statewide presence on tobacco control policy issues.

Executive Summary Kentucky, a leading tobacco producing state in the U.S. and home to Brown and Williamson and Commonwealth Brands tobacco companies, has a significant historic, economic, and social heritage tied to tobacco. Until 2004 tobacco was grown in all but one county in the state, mostly on small family farms. The significant tobacco industry presence created a historical resistance to tobacco control efforts. To influence policymakers, between 1994 and 2010 the tobacco industry contributed $311,614 to Kentucky political parties and individual candidates running for state-level offices, focusing contributions around pivotal elections, with candidates for governor and key legislative leadership being the largest recipients. Additionally, between 1993 and 2012, the tobacco industry spent $9.7 million in lobbying expenditures. In 1988, the first statewide tobacco control coalition focused their initial efforts on youth as a noncontroversial strategy to introduce tobacco control issues in the tobacco growing state. Beginning in 1994 state tobacco control advocates worked with state policymakers and tobacco farmers to create the Coalition for Health and Agricultural Development. The coalition set a statewide and national precedent for tobacco control advocates and tobacco farmers working together to address tobacco-related health and economic issues. In 1994, the tobacco industry used efforts by tobacco control advocates to reduce youth smoking by passing a state law prohibiting youth access to tobacco products as an effective medium to lobby for the enactment of a weak youth access law that included state preemption to prohibit community-level activity to limit youth access to tobacco products. The 1994 legislation also included a provision that required designated smoking areas in government buildings where smoking was restricted. Later, this requirement would dissuade local governments from covering workplaces since government workplaces would be exempt or forced to install expensive ventilation equipment. Since 1997, the prevalence of youth tobacco use in Kentucky has declined. In 2011, the youth tobacco use rate was 24.1 percent, a decrease from 26.1 percent in 2009. However, in 2011, the prevalence of youth tobacco use in Kentucky (24.1 percent) was still higher than the national average (19.5 percent) and Kentucky was ranked 1st for the highest youth tobacco use rates. Between 2001 and 2010 there were increases in smokeless tobacco use among youth and adults, and in cigarette smoking rates among low socio-economic status adults. The 1998 Master Settlement Agreement was an important event for tobacco prevention and control in the tobacco growing state. Tobacco farmers in Kentucky had a shift in attitude and were more receptive and willing to work with state tobacco control advocates to use a portion of the state's Master Settlement Agreement monies for tobacco control programming. In 2000, state tobacco control advocates secured 2.5 percent ($5.5 million for the first biennium 2001-2002) of the state's Master Settlement Agreement monies for tobacco prevention and control programming, with most of the funding going to build policymaking capacity at the local level. The local health department tobacco control programs worked to create awareness about tobacco use issues that synergistically worked with state tobacco control advocacy efforts on smoke-free air policies. Between 1971 and 2012, the state tobacco excise tax had only been raised twice from 3-cents to 30-cents in 2005 and from 30 cents to 60 cents in 2009. While state tobacco control advocates wanted to increase the tobacco excise tax to reduce youth tobacco use, the state tobacco excise tax increase was used to mitigate significant state budget shortfalls. Between 2000 and 2012, the state program worked with local health department programs and state agencies, and used contracts with the University of Kentucky and University of Louisville to provide technical assistance in achieving the local program goals and objectives. The state program experienced success in reducing exposure to secondhand smoke through local communities working to achieve smokefree air. In 2004, state tobacco control advocates successfully enacted the first local smoke-free air ordinance in the state in Lexington-Fayette. The tobacco industry unsuccessfully tried to overturn the law through litigation, and by state legislation to preempt local smokefree air policies. State tobacco control advocates used the Smoke-Free Lexington-Fayette campaign as a model to garner public support to protect workers and public health through additional local smoke-free air policies throughout the state. Between 2005 and 2012, state tobacco control advocates, led by the University of Kentucky Center for Smoke-free Policy (KCSP) successfully enacted 35 smokefree policies (22 were comprehensive) to protect 34.1 percent of the state's population. In 2006, state tobacco control advocates successfully pushed for legislation to allow local governments to prohibit smoking in local government buildings without being required to assign designated smoking areas, which allowed state tobacco control advocates to begin strengthening local smoke-free measures to include all workplaces. Local governments had been reluctant to include workplaces in smokefree ordinances since it could not include local government workplaces. In addition, Governor Fletcher issued an Executive Order to prohibit indoor smoking in state government buildings controlled by the Executive Branch. For the first time in the history of the state, smoking was prohibited in most state government buildings. In 2010, state tobacco control advocates implemented the Smoke-Free Kentucky campaign and five-year plan to advocate for a statewide smoke-free air law. In 2012, the smokefree air legislation was voted out of the House Health and Welfare Committee, which represented a significant step forward since previous efforts did not pass in committee. Tobacco control advocates should continue to work to protect, strengthen, and pass local smokefree air policies and other tobacco control policies, advocating for the repeal of preemption of local control for youth access, and for increases in tobacco excise taxes. State tobacco control advocates can further strengthen their efforts by exposing the tobacco manufacturer ties, through campaign contributions and lobbying expenditures, to legislators who propose to threaten the advances that have been made in tobacco control. State tobacco control advocates should continue to seek higher tobacco excise taxes and for increased tobacco control funding for a sustained tobacco prevention media campaign. State tobacco control advocates should build on their successful track record by giving priority to continuing to protect, strengthen, and pass local smokefree air policies and 100% tobacco free schools. Recognizing the politically hostile environment in tobacco growing state legislatures, state tobacco control advocates should take a strong public position that state preemption of local smokefree air policies is a "deal breaker" for any state smokefree law and pledge to work to kill any such law, regardless of the other provisions.

To describe how the tobacco and gaming industries opposed clean indoor air voter initiatives in 2006, we analyzed media records and government and other publicly available documents and conducted interviews with knowledgeable individuals. In an attempt to avoid strict "smoke free" regulations pursued by health groups via voter initiatives in Arizona, Ohio, and Nevada, in 2006, the tobacco and gaming industries sponsored competing voter initiatives for alternative laws.

Around-the-clock tobacco talks, multibillion-dollar lawsuits against the major cigarette companies, and legislative wrangling over how much to tax a pack of cigarettes-these are some of the most recent episodes in the war against the tobacco companies. The Cigarette Papers shows what started it all: revelations that tobacco companies had long known the grave dangers of smoking, and did nothing about it.In May 1994 a box containing 4,000 pages of internal tobacco industry documents arrived at the office of Professor Stanton Glantz at the University of California, San Francisco. The anonymous source of these "cigarette papers" was identified only as "Mr. Butts." These documents provide a shocking inside account of the activities of one tobacco company, Brown & Williamson, over more than thirty years. Quoting extensively from the documents themselves and analyzing what they reveal, The Cigarette Papers shows what the tobacco companies have known and galvanizes us to take action

EXECUTIVE SUMMARY - Iowa was a tobacco control leader in the 19th Century. In 1897 the General Assembly completely prohibited the use, sale, and possession of tobacco products in the state. When the law was repealed in 1921, the General Assembly enacted strong measures to prevent tobacco use by minors. In 1921 Iowa passed the first state cigarette excise tax (2 cents). - Tobacco control reemerged in the 1970s, however a coalition of health groups were consistently outmaneuvered by tobacco industry lobbyists. - In 1990 health groups attempted to strengthen Iowa's Clean Indoor Air Act (passed in 1987), however the tobacco industry, represented primarily by Charles Wasker, co-opted the bill, stripping meaningful tobacco control provisions and using it to include ambiguous language to preempt localities from passing clean indoor air laws, which chilled local clean indoor air action for a decade. - In 1993 the voluntary health organizations founded Tobacco Free Iowa (TFI), a dedicated statewide tobacco control coalition to advocate for tobacco control policy change. In 1995 TFI hired Serge Garrison, a former R.J. Reynolds (RJR) lobbyist, to lobby to repeal clean indoor air preemption. Garrison, who helped draft the preemption clause when working for RJR, questioned whether Iowa's ambiguously worded clause actually preempted local clean indoor air action. - Iowa, represented by Attorney General Tom Miller (D), was a party in the 1998 Master Settlement Agreement. Miller and the Iowa Attorney General's Office, have been strong allies to tobacco control in Iowa. - After the MSA, in 2000, Iowa created the Division of Tobacco Use Prevention and Control within the Iowa Department of Public Health to implement a state tobacco control program funded with MSA revenue. - In 2001 the General Assembly passed legislation to securitize the MSA revenue stream to receive an upfront lump sum in lieu of most future MSA payments. Politicians framed MSA securitization as a way to create stable funding for health programs, including tobacco, but the vast majority of the money went to infrastructure projects. - The Health Iowans Tobacco Trust created through securitization to fund tobacco and other health programs was continually raided by the General Assembly from 2001 to 2008, and zeroed out in 2009. - The Iowa Tobacco Division has never been funded at or near the CDC recommended best practices for tobacco control and tobacco control advocates have not mobilized enough political pressure to demand and protect funding for the Tobacco Division. - From 1998 to 2008, $44,577 in campaign contributions were given to Iowa legislative candidates and party committees by five tobacco companies: Altria/Philip Morris, Farner-Bocken (an Iowa-based distributor), Myers-Cox Company (an Iowa-based distributor),R.J. Reynolds, and US Smokeless Tobacco. - Tobacco industry contributions spiked in 2000 when the Iowa General Assembly was considering legislation to create the Iowa Tobacco Division and deciding the use of their MSA payments. Contributions dropped in 2004 after the General Assembly mandated that the Tobacco Division have a youth focus (a pro-industry position) and securitized most of their MSA revenue. In 2004, industry contributions jumped back up (and steadily increased though 2008) concurrent with an increase in the introduction of tobacco control initiatives (which were repeatedly killed until 2007). - The tobacco industry focused contributions on legislative leaders. Rep. Christopher Rants(R-Woodbury) former Iowa House Majority Leader (1999-2003) and Speaker of the House (2003-2006) received the most industry money from 1998-2008 ($7,397). Rants was a key player in killing tobacco tax and local control bills throughout the 2000s. Representative Jamie Van Fossen (R- Scott) who served as the Chair of the House Ways and Means Committee received the second greatest amount ($6,050), followed by Sen. Stewart Iverson, Jr. (R-Wright), Senate Majority Leader from 1997-2006 ($2,220). - From 1998 to 2008, tobacco industry contributions to Republican candidates and the Republican party ($27,947) far outweighed contributions to their Democratic counterparts($15,130). From 1998 to 2007, Republicans controlled both houses (except in 2006 when the Senate was tied). - Republican legislators were significantly more pro-tobacco than Democrats. - Legislators who accepted campaign contributions from the tobacco industry were significantly more pro-tobacco than those who did not, controlling for party. - The tobacco industry maintains a significant lobbying presence, between 2003 and 2008 the tobacco industry reported $667,875 in lobbying expenditures in Iowa. - After an inquiry prompted by Serge Garrison in the late 1990s, Attorney General Tom Miller (D) issued an opinion in November 2000 stating that state law did not preempt local clean indoor air ordinances. - From 1999 to 2003 there was a tide of local clean indoor air action. In March 2002, Ames passed Iowa's first clean indoor air ordinance. Ames' ordinance included a tobacco industry inspired "hours" provision that allowed smoking after 8:30pm, advocated for by hospitality interests, making the ordinance weak. Its passage created momentum for other localities to pass clean indoor air measures. - In January 2002, Iowa City passed Iowa's first 100% smokefree restaurant ordinance. Other localities, aided by the Iowa Attorney General's Office and TFI, began considering ordinances and enactment of voluntary clean indoor air policies. - Local clean indoor air progress was blocked in 2003, after a group of Ames business owners, funded by Philip Morris, challenged the Ames ordinance in court. In May 2003, the Iowa Supreme Court ruled that the 1990 Clean Indoor Air Act was preemptive. - In 2003, TFI collapsed, leaving Iowa without a functioning tobacco control coalition until 2006. In 2003 some advocates reorganized to create CAFE Iowa and CAFE Iowa CAN, primarily to repeal preemption. - Beginning in 2005, under the direction of Iowa Tobacco Division Director Bonnie Mapes, Iowa advocates reorganized and created a strategic plan. In 2006 the Iowa Tobacco Prevention Alliance was created to assume the role of Iowa's statewide tobacco control coalition. - The combination Democrats taking control of the legislature in 2007 and the reorganization of tobacco control advocates in 2006 led to substantial tobacco control policy changes. - In 2007 the Iowa General Assembly passed a $1 increase in the cigarette tax, the first increase in 16 years. - In 2008 the General Assembly passed the strong Iowa Smokefree Air Act that extended smokefree environments to 99 percent of Iowa employees and repealed preemption. - Following the 2007 tax increase, adult smoking rates in Iowa fell from 18 to 14% in two years (2006 to 2008). - Youth smoking rates increased from 2004 to 2006 following a substantial cut in allocations to the Tobacco Division in 2002, leading to a substantial decrease in expenditures for Just Eliminate Lies, Iowa's youth counter-marketing campaign. - Tobacco control advocates must make securing and maintain adequate funding for Iowa's Tobacco Division a top priority. The CDC recommends that tobacco control programs in Iowa be funded at $36.7 million per year. In FY 2009, the Tobacco Division received only $11.0 million, less than a third of the CDC recommended level. An increase in funding is particularly important because of the increase in youth smoking rates since JEL's 2002 funding cut. - Given the Tobacco Division's limited budget and the increasing levels of youth and young adult smoking, the Tobacco Division should focus less on funding individual level cessation services (other than the Quitline, which is a public health intervention) and instead increase its emphasis on media and community-based programs that are more cost effective public health interventions to reduce tobacco use. - Advocates should work to require health insurance to provide cessation services through the medical services budget, not public health. - Advocates need to expand their base beyond major cities to rural areas of Iowa to broaden the base of support for smokefree environments and expand the political base to maintain and expand funding for tobacco control efforts.