Suchergebnisse

Objective: To describe the strategies pursued by the tobacco industry (TI) to interfere with the ratification of the WHO Framework Convention on Tobacco Control (FCTC) in Argentina.Methods: We conducted semi-structured interviews about the FCTC, the TI and the legislative process with 3 legislators, 4 public health officials, 1 representative of the tobacco growers and two tobacco control advocates. We reviewed 6 newspapers from the 4 tobacco growing provinces, searched TI documents in the Legacy Tobacco Documents Library and reviewed 1624 documents. Proposed legislation and related documents on tobacco control from Argentina's National Congress and the Provincial Jujuy Congress were reviewed.Results: The principal strategy used by the TI was lobbying of provincial legislators and federal officials from the Ministry of the Economy by the tobacco growers associations. These legislators prevented the passage of comprehensive bills on tobacco control or of less comprehensive national laws. A typical legislative strategy used was to request additional analyses of the proposed bills from committees that prioritized economic issues over health. FCTC was mentioned in regional newspapers three to seven times per week in articles about alleged adverse economic effects of tobacco control. Direct physical threats to legislators who were openly supportive of FCTC ratification were made.Conclusion: Tobacco producers and TI opposed FCTC ratification in Argentina by lobbying elected representatives and placing stories in regional media to obstruct approval of tobacco control laws. These activities have led to a delay in consideration of Argentina's ratification of the FCTC despite the President's signature in 2003.

AbstractIn the late 19th and early 20th century, tobacco exports from the Ottoman Empire rapidly increased. Thousands of workers began to earn their livelihoods in warehouses, sorting and baling tobacco leaves according to their qualities. Ottoman towns where tobacco warehouses were concentrated soon became the sites of frequent labor protests. This article analyzes strikes that broke out in two such towns, İskeçe (Xanthi) and Kavala, in 1904 and 1905. It underlines the active role of the Ottoman government in the settlement of these strikes. It also shows that mobilized tobacco workers devised effective protest tactics and often secured a say in key decisions, such as when and under what conditions the warehouses operated. However, in both towns, labor activism was characterized by fragmentation as well as unity. The workers who took to the streets did not equally share the burdens and benefits of their collective actions. That inequality, the article argues, was rooted in gendered power relations, intercommunal rivalries, and other social tensions among the workers.

The tobacco industry is a major political and legal force in the state of Washington through campaign contributions, lobbying, and filing lawsuits. The tobacco industry has become a major source of campaign contributions to legislative candidates. In the 1985-86 legislative session, the tobacco industry contributed $31,100 to legislative candidates. Contributions reached a peak during the 1989-90 legislative session when the tobacco industry contributed $119,059 to legislative candidates. During the current 1995-1996 election cycle, the tobacco industry has contributed $69,573 to legislative candidates between January 1, 1995 to September 30, 1996. Tobacco industry contributions to legislative candidates is expected to exceed the 1993-1994 amount of $70,524. During the 1993-1994 legislative session, the combined contributions of Philip Morris, RJ Reynolds, and the Tobacco Institute ranked eighth among top contributors to legislative campaigns in Washington. In the past few election cycles, there has been a significant shift in tobacco industry contributions away from the Democratic party and towards the Republican party in Washington. During the 1989-90 election cycle, 47 percent of tobacco industry contributions to legislators, legislative candidates, political parties and party controlled committees went to the Republican party. Contributions to Republicans increased to 60 percent in the 1991-1992 election cycle and 66 percent in the 1993-1994 election cycle. Between January 1, 1995 and September 30, 1996, the tobacco industry contributions to the Republican party has increased to 83 percent. The tobacco industry makes significant contributions to legislative leaders. House Speaker Clyde Ballard has received $11,880 in tobacco industry contributions since 1986, more than any other current legislator. All Republican House Leaders have received tobacco industry contributions and generally had more pro-tobacco industry policy scores. In the Senate, where the Democrats held a one vote majority during the 1995-1996 session, Majority Leader Sid Snyder received $3,600 from the tobacco industry throughout his career. Valoria Loveland, the Democratic Caucus Chair, received $1,600 in tobacco industry contributions during the 1995-1996 electoral cycle. In addition to providing campaign contributions, the tobacco industry is active in lobbying members of the legislature and the administration. In 1993 and 1994, the tobacco industry spent $643,188. The trend suggests that the tobacco industry will exceed that amount during the 1995-1996 session. In 1995, the tobacco industry spent $368,660 in lobbying expenditures, an increase in the rate of lobbying expenditures over the previous election cycle. The tobacco industry became an especially active lobby in 1991 and 1992, after a number of local smoke free and youth access ordinances were passed in Washington cities and counties. A statistical relationship exists between tobacco industry campaign contributions and state legislative behavior. The more money a legislator receives, the less likely he or she is to support tobacco control efforts. The tobacco industry also tends to contribute more money to legislators that have supported the industry in the past. Besides campaign contributions and lobbying, the tobacco industry has used legal tactics to slow down tobacco control activity in the state of Washington. Legal action by the tobacco industry has 1) lead the city of Puyallup to rescind a smoke-free restaurant ordinance, 2) forced the Department of Labor and Industries to defend their clean indoor air regulations in Superior court, and 3) has created an atmosphere of intimidation among organizations associated with Project ASSIST. Despite the highest tobacco tax in the nation, none of the money raised from tobacco taxes has been earmarked for tobacco prevention or cessation programs. The state of Washington is among 19 states and counties that is suing the tobacco industry in order to recover health and medical costs associated with tobacco related illnesses.

Tobacco use is the leading preventable cause of death in South Carolina. Smoking-related medical costs amount to $1.1 billion each year, including $393 million for Medicaid. Tobacco growing in South Carolina declined by over 50 percent from 1997 to 2008. Tobacco accounted for less than 10% of the state's cash receipts from all crops in 2007. Despite the low levels of actual tobacco growing and the small role tobacco played in the state's economy in 2008, the cultural construct of being a "tobacco growing state" continued to have a disproportionately large impact on tobacco control policy making. Between 1997 and 2008, the tobacco industry lost its alliances with the Farm Bureau Federation and Commissioners of Agriculture, former staunch industry allies, because of negotiations over the Master Settlement Agreement, the buyout of the Tobacco Price Support system, and increasing purchase of foreign tobacco. Tobacco control Policy Score rankings of 2007/2008 legislators by knowledgeable tobacco control advocates revealed that legislators from the Pee Dee region, historically the stronghold of tobacco agriculture, were similar to the rest of the state's legislators in their attitudes towards tobacco control. Tobacco area legislators were formerly strong allies of the tobacco industry and historically worked with industry lobbyists to ensure defeat or manipulation of tobacco control bills. The 2007/2008 Policy Scores indicated that this was no longer the case. Tobacco control advocates should take advantage of the growing distance between tobacco companies and its former tobacco-growing allies and the decline in the actual importance of tobacco agriculture to challenge the rhetoric and resistance to tobacco control policies in the state. The tobacco industry built significant political influence in South Carolina through lobbyists, alliances with prominent trade associations, campaign contributions and other political expenditures. From 1996 to 2006, tobacco companies, trade associations and producers contributed a total of $680,541 to candidates for state office and to political parties. There is a measurable relationship between tobacco industry contributions and legislative behavior. As rated on a Policy Score scale from 0 to 10, with 10 being extremely receptive to tobacco control and 0 being extremely pro-tobacco industry, for every $1,000 received from the tobacco industry during the 2006 election cycle, a legislator's Policy Score decreased by 1.5 points. Democrats were on average 3.6 points more favorable towards tobacco control than Republicans, after controlling for campaign contributions. South Carolina was selected by the NCI in 1990 to participate in the 17-state ASSIST program. ASSIST funded tobacco control programming within the Department of Health and Environmental Control and established the state's first formal tobacco control coalition, the Alliance for a Smoke-Free South Carolina. The Alliance disbanded in 1997, leaving tobacco control advocacy disorganized and ineffective through 2003. ASSIST ended in 1999 and was replaced by a minimally-funded DHEC Tobacco Division supported primarily by about $1 million annually from the US Centers for Disease Control and Prevention. In 1998, the state signed the Master Settlement Agreement, securing approximately $70 million per year from the major cigarette companies. In 2000, the state securitized its settlement revenue, receiving a lump sum of $900 million up front in lieu of its annual payments through 2019. Refinancing in 2008 moved this date back to 2012. The 2000 General Appropriations bill set up 4 trust funds from the securitized MSA funds, with 73% ($574 million for healthcare), including tobacco control. Only $3.34 million of the MSA revenue was spent on tobacco control between 2000 and 2008. The state allocated an additional $6 million from the General Fund to the DHEC Tobacco Division between 2002 and 2008, with no state funding for the program between 2003 and 2006 and again in 2008. The Tobacco Division developed small-scale but innovative tobacco control programming, particularly community programs to promote policy change and the Rage Against the Haze youth movement. The DHEC leadership did not prioritize tobacco control between 2000 and 2008, although its support increased gradually due to efforts by the Tobacco Division, DHEC regional staff and the voluntary health groups. Funding requests remained at $2 million, significantly below the CDC recommended $62.2 million per year. Limitations by DHEC leadership on the role that DHEC staff play in local community-wide policy change efforts changed in 2007 to allow direct participation, but remained limited in scope. The voluntary health groups failed to prioritize increased funding for the DHEC Tobacco Division relative to their other lobbying focuses and continued in 2008 to act hesitantly in their lobbying of DHEC leadership to support tobacco control funding and policy change. In 2001, tobacco control advocates formed the South Carolina Tobacco Collaborative. It received 83% of its funding from the state health department, limiting its advocacy capacity. Increased funding from voluntary health groups and national partners between 2005 and 2008 allowed the Collaborative and the other prominent tobacco control advocacy groups, the South Carolina African-American Tobacco Control Network and the Smoke-Free Action Network, to increase advocacy between 2005 and 2008. These developments led to notable successes in clean indoor air policies and attempts to increase the state's tobacco tax. The cigarette tax in South Carolina remained the lowest in the nation in 2008, at 7 cents per pack. The last cigarette tax increase was in 1977, with nearly annual attempts to increase the tax defeated by coordinated efforts from the tobacco industry. Tobacco control advocates began to push for a cigarette tax increase in 2000, without success. Between 2006 and 2008, the Collaborative developed a well-funded and well-coordinated public education and lobbying campaign to support a cigarette tax increase. In 2008, the General Assembly passed a 50-cent increase, with $5 million of the annual revenue directed to the DHEC Tobacco Division, over active opposition from the tobacco industry and its allies. Governor Mark Sanford vetoed the bill for its lack of revenue neutrality, and Speaker of the House Bobby Harrell successfully prevented a veto override in the House. The 2006-2008 cigarette tax increase campaign showed that well-funded tobacco control advocacy could be successful over tobacco industry opposition in the legislature. The defeat of the increase bill demonstrated the need for stronger grasstops lobbying and relationship building with legislative leadership. Between 1977 and 1989, local policymakers passed 19 limited clean indoor air ordinances, building momentum for consideration of a state-level clean indoor air bill. In 1990, tobacco control advocates compromised with tobacco industry lobbyists to allow the passage of a weak statewide Clean Indoor Air Act, halting significant progress on clean indoor air through 2005. In 1996, the tobacco industry succeeded in using the Synar Amendment to integrate preemption into a youth access to tobacco amendment. The tobacco industry and tobacco control advocates assumed the provision also preempted local clean indoor air activity. Beginning in 1999, local policymakers in Charleston began to support local clean indoor air ordinance attempts despite assumed preemption. While Charleston did not pass an ordinance until 2006, news coverage of the city's efforts began a wave of consideration of local ordinances, eventually supported by state and local tobacco control advocates and the Municipal Association. Between May 2006 and December 2008, 21 local clean indoor air ordinances passed, 12 of which passed before the state Supreme Court rejected the argument that preemption applied to clean indoor air ordinances. Two localities were sued over their ordinances on preemption grounds, but won both cases in the Supreme Court. During the 2007/2008 legislative session, tobacco control advocates joined together to successfully defeat multiple attempts to institute express preemption through weak clean indoor air legislation supported by the tobacco industry. Given the success of local clean indoor air efforts, the strategy of tobacco control advocates developed during 2008 should be maintained: continue to promote comprehensive local smoke-free ordinances, while avoiding any action on clean indoor air in the General Assembly.

The tobacco industry is a major political and legal force in Ohio through campaign contributions, lobbying and litigation. The tobacco industry has become a major source of campaign contributions to legislative candidates and political party committees. In the 1981-1982 election cycle, the tobacco industry contributed $3,970 to candidates and parties. In 1995-1996, the tobacco industry contributed $55,440 to candidates and parties. A majority of tobacco industry contributions to legislative candidates and political are contributed to the Republican party. During the 1991-92 and 1993-1994 electoral cycles, the tobacco industry contributed 54% and 53%, respectively, of their legislative and political party contributions to the Republican party. During the 1995-1996 electoral cycle, the tobacco industry contributed 77% of their legislative and political party contributions to the Republican party. In contrast to other states, there is not a statistically significant relationship between tobacco industry campaign contributions and legislative behavior in Ohio. Several health related groups, such as Anthem Blue Cross and Blue Shield, and United Health Care of Ohio, Association of Physician Assistants, the Ohio Health Information Management Association, and Ohio Dietetic Association are represented by lobbyists who also represent the tobacco industry. This pattern of representation raises the possibility of conflict of interests among lobbyists who represent the tobacco industry and health groups. Franklin County in 1994 and Knox County in 1995 had formulated regulations making almost all or all public places smokefree. These regulations were rejected in Ohio courts. Since these defeats, there has been no progress (except voluntarily) on smokefree public places. Tobacco control advocates and organizations have effectively organized in preventing preemptive youth access legislation from passing in the Ohio state legislature.

The tobacco industry is a major political and legal force in Pennsylvania through campaign contributions, lobbying and litigation. The tobacco industry has become a major source of campaign contributions to legislative candidates, state constitutional office candidates, and political party committees. In the 1979-1980 election cycle, the tobacco industry contributed $3,600 to candidates and parties. In 1995-1996, the tobacco industry contributed $65,850 to candidates and parties. A majority of tobacco industry contributions to legislative candidates and political parties have shifted from the Democratic party to the Republican party. During the 1991-92 and 1993-1994 electoral cycles, the tobacco industry contributed 40% and 38%, respectively, of their legislative and political party contributions to the Republican party. During the 1995-1996 electoral cycle, the tobacco industry contributed 53% of their legislative and political party contributions to the Republican party. A relationship exists between tobacco industry campaign contributions and state legislative behavior. The more money a legislator receives, the less likely he or she is to support tobacco control efforts. The tobacco industry also tends to contribute more money to legislators that have supported the industry in the past. Legislative behavior significantly influenced the level of tobacco industry contributions in 1993-1994, but did not in 1995-1996. Several health related groups, such as Abington Memorial Hospital, Blue Cross-Blue Shield, Blue Cross of Northeastern Pennsylvania, Lehigh Valley Hospital and the Family Health Council are represented by lobbyists who also represent the tobacco industry. This pattern of representation raises the possibility of conflict of interests among lobbyists who represent the tobacco industry and health groups. Pennsylvania was one of the first states to pass statewide legislation (the 1988 Clean Indoor Air Act) that preempts localities from enacting stronger clean indoor air ordinances than that of statewide law. Lower Merion township was the first locality in Pennsylvania to ban all cigarette vending machines in 1991. However, an injunction sought by local cigarette vending machine companies prevented Lower Merion from enforcing its ordinance. Although the constitutional merits of the case were never decided, the failure of health organizations and public officials to defend the ordinance and the threat of lawsuits by cigarette vending machine companies stopped the spread of ordinances that completely ban cigarette vending machines. The creation of the Uptown Coalition represented a significant broadening of the tobacco control community to explicitly include the African-American community, and represented the first time a specific tobacco brand was derailed in 1990. The Uptown Coalition remains active in Philadelphia local tobacco control efforts. Pennsylvania tobacco control organizations have unsuccessfully attempted to pass statewide youth access legislation. The inclusion of preemption in statewide youth access legislation has divided the Pennsylvania tobacco control community.

This paper seeks to examine the way in which transnational tobacco firms operate in the tobacco industry in Zimbabwe, which after independence became once again the second largest exporter in the world of flue cured tobacco (next to the United States of America)

The tobacco industry is a major political and legal force in Wisconsin through campaign contributions, lobbying and litigation. The tobacco industry is a major source of campaign contributions to legislative candidates, state constitutional office candidates, and political party committees. In the 1987-88 election cycle, the tobacco industry directly contributed $9,079 to legislators and candidates. In the 1995-96 election cycle the tobacco industry directly contributed $41,125. A majority of tobacco industry campaign contributions to legislative candidates and political parties have shifted from the Democratic party to the Republican party. In the 1987-1988, 1989-1990, and 1991-1992 elections cycles, the tobacco industry contributed 47%, 30% and 44%, respectively, of their legislative and political party contributions to the Republican party. During the 1993-1994 and 1995-1996 electoral cycle, the tobacco industry contributed 51% and 62%, respectively, of their legislative and political party contributions to the Republican party. A relationship exists between tobacco industry campaign contributions and state legislative behavior. The more money a legislator receives, the less likely he or she will support tobacco control efforts. Several health related groups, such as the Health and Hospital Association, the Wisconsin Association of HMOs, and the Employer Health Care Cooperative Alliance, are represented by many of the same lobbyists as the tobacco industry. This pattern of representation raises the possibility of conflict of interests among lobbyists who represent the tobacco industry and health groups. Madison was the first city in Wisconsin to pass a smokefree restaurant ordinance. Middleton and Shorewood Heights, suburbs of Madison, have also passed smoke free restaurant ordinances. Attempts at other smokefree ordinances have failed. Fond du Lac passed a ban on self service displays in 1991. However, a state circuit court and a state appellate court ruled that a 1985 state law preempts localities from passing more stringent local ordinances regarding minors' access to tobacco. Tobacco control efforts in Wisconsin have been characterized by a series of isolated initiatives with little structure or institutional support. This failure of the public health community to develop an institutional base capable of following through on victories or retooling from defeats may explain the lack of progress in tobacco control in Wisconsin.

The tobacco industry is a potent force in Albany. Since 1983 (not including 1988-89, were data are not available) tobacco interests spent $1.3 million on campaign contributions to candidates and political party committees. Of this, $277,905 went to legislative candidates, $38,650 went to candidates for constitutional office, and the remaining $1 million went to party committees. The members of the 1997-98 legislature who collected the most money from campaign contributions were Assemblymember Jeffrey Klein(D-Bronx)($16,275), Assembly Speaker Sheldon Silver (D-Manhattan)($10,425), Assemblymember Michael Bragman (D-Onondaga)($8,420), Senator Ronald Stafford (R-Plattsburgh)($7,500), and Senate Majority Leader Joseph Bruno (R-Brunswick)($7,300). The tobacco industry spent $5.9 million on lobbying expenditures between 1992 and 1998. Of the $998,884 contributed to party committees between 1983 and 1998 (not including 1988-89), $815,840 (81.7%) was donated after 1994, when contributors realized that contributions to party committees were unlimited. As in other states, the tobacco industry donates more to Republicans than Democrats; Republican party committees received $752,709 (75%) of the money between 1983-98, while Democrats received $191,175 (19%). The information we have on tobacco industry political activity is incomplete and underestimates the magnitude of tobacco industry activity. Between 1998 and 1999, the tobacco industry was found to have under-reported its lobbying expenses on several occasions. In 1998, the Tobacco Institute admitted to under-reporting by $443,572 and in 1999, Philip Morris admitted to under-reporting lobbying expenses 15 times over the period 1993-96. These developments indicated that the lobbying law was ineffective at providing accurate information for public disclosure, and prompted a revision of the law in 1999. However, the revision is insufficient to prevent this kind of influence to be accumulated by an industry such as the tobacco industry. These contributions are having an effect on policy making. On the average, for each $1000 contributed to an individual legislator, that legislator scored 1.82 points more pro-tobacco on a 0 to 10 scale. At the same time, legislators who support the tobacco industry are rewarded; for each 1 point more pro-tobacco, contributions increase by an average of $380. Republican legislators were more pro-tobacco than Democrats by an average of 1.39 points. As in most states, in New York State, progress in tobacco control begins at the local level. New legislation is generally passed first on Long Island, which inspires New York City to do the same. Legislation passed in New York City sparks progress in the upstate area, and until the Pataki Administration, at the state level. The importance of localities passing restrictions to initiate the momentum to pass state legislation is why preemptive state legislation is a major threat to tobacco control in New York State. The documents released through state litigation of the tobacco industry have played a critical role in the passage of tobacco control legislation in the face of an unsympathetic legislature and Governor. Advocates in other states should recognize that researching the documents can help them pressure political leaders and recognize industry front groups. The Long Island counties of Suffolk and Nassau lead the tobacco control movement in the downstate area, whereas Erie County sets the standard upstate. The ASSIST program has been successful in setting up local coalitions and galvanizing against industry tactics. The industry organizes and finances "grassroots" coalitions, and "smokers' rights" groups such as the National Smokers Alliance, mobilizes its Tobacco Action Network, forms alliances with other organizations affected by anti-tobacco bills and finances groups such as the United Restaurant, Hotel, and Tavern Association to oppose clean indoor air legislation. It promotes "studies" claiming that tobacco control legislation will hurt the hospitality business, even though objective studies have consistently shown no effect or a positive effect on the hospitality industry. At the state level the industry has sought to preempt local tobacco control activity; at the local level, the industry tries to pass weak laws promoting "accommodation" to prevent the passage of effective tobacco control policies. New York tobacco control advocates have vigorously – and generally successfully – opposed these efforts. Since 1986, New York City has distinguished itself as a national leader in tobacco control legislation. While its clean indoor air laws have not been the strongest in the country, they are remarkable in light of the city's size and the fact that Philip Morris' corporate headquarters are located in New York City. The city was also one of the first localities to sue the tobacco industry. Both Nassau County and Niagara County Boards of Health enacted regulations (in 1994 and 1998, respectively) to eliminate smoking in restaurants. However, both were overturned in lawsuits sponsored by the tobacco industry. Both rulings determined that the Boards of Health were in violation of the state constitution because they considered economics in their decisions. These decisions have discouraged counties from using Boards of Health to pass clean indoor air regulations. When Republican George Pataki succeeded Democrat Mario Cuomo as governor in 1994, state tobacco control legislation abruptly ceased. Pataki ignored the Health Department's tobacco advisory panel, the Commission for a Healthy New York, and only formulated tobacco control programs when he feared criticism from the media. Between 1990 and 1998 Pataki accepted $8050 from the tobacco industry. In November 1998, forty-six states agreed to a $206 billion dollar settlement with the tobacco industry. The agreement settled the states' claims for smoking-related Medicaid costs. New York State received $25 billion to be paid over 25 years as a result of the settlement agreement. In December 1999, health advocates, working the other interests, were able to increase the tobacco tax by 55 cents and dedicate part of the tobacco settlement funds to fund health care in New York State. New York's cigarette tax of $1.11 per pack is the highest in the nation. Of the approximately $1.5 billion generated annually by the settlement and additional tobacco tax, only $37 million annually is dedicated to the state tobacco control program. During the 1999 legislative session, the New York Medical Society supported the Civil Justice Reform Act which would provide the tobacco industry protection against product liability litigation. The tobacco industry has probably used every strategy they have developed in fighting tobacco control policies in New York State. Despite these daunting challenges, advocates have achieved many notable successes and recognized and avoided counterproductive compromises. They have done so by exposing tobacco industry front groups and affiliations and holding politicians and organizations accountable for their actions.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Background: Cigarette packs are a form of advertising that distributes brand information wherever smokers go. In the 21st century, tobacco companies began using onserts on cigarette packs to communicate new advertising messages to smokers. Methods: We reviewed tobacco industry documents dated 1926 to 2017 to identify how the tobacco industry developed and used onserts in marketing and to serve the industry's political and legal objectives. Results: Onserts added to cigarette packs became a more cost-effective way for brands to market in the year 2000. Manufacturers then began studying them, finding that new messages were appealing, while repeated messages were ignored. By 2005, tobacco companies were using onserts to effectively communicate about new tobacco products and packaging changes. They also used repeated € corporate responsibility' messages that were, according to the industry's own research, likely to be ignored. Conclusions: Tobacco companies have expanded on cigarette pack-based advertising. Twenty-first century onserts simultaneously seek to increase sales using materials that are novel, attractive and provide independent value, while undercutting public health messages about the risks of tobacco use using materials that repeat over time and are comparatively unattractive. Health authorities can use this industry research to mandate onserts to communicate effective health messages.

The tobacco industry has been active in Texas politics for over 25 years. It spends money on lobbying, campaign contributions, legislative events and gifts in order to gain favor with the legislature and attempt to control the agenda set for tobacco control efforts. Political campaign contributions–reported only by Philip Morris–have remained high throughout the 1990s. Philip Morris reported contributing $556,250 to legislative, judicial and statewide candidates between 1988 and 2001. In recent years, their contributions to statewide officeholders and judicial candidates have decreased as their legislative contributions have increased. In each election cycle, 1998-1999 and 2000- 2001, Philip Morris contributed $51,000 to legislative candidates. The 3 largest lifetime recipients of campaign contributions in the legislature were all Senators: David Cain ($8,250, D-Mesquite), Ken Armbrister ($5,500, D-Victoria), and Chris Harris ($5,500, R-Arlington). The largest recipient of tobacco money from the statewide offices was former Lt. Governor Bob Bullock who received $36,500 from the tobacco industry from 1988-1996. The tobacco industry has also spent heavily on lobbying, although it is impossible to calculate the exact amounts. When lobbyists' report their fees to the Texas Ethics Commission, they are only required to report a fee range for each of their clients, not the exact amount that they were paid by each client. For example, a lobbyist would select between the ranges of $0-$10,000, $10-$25,000, $25-$50,000, etc. However, given these estimates, we can determine that from 1993-2001, the tobacco industry spent between $4,660,000-$9,640,000 on lobbyists' fees to influence the legislature. Texas' only statewide tobacco control laws are Senate Bill 55 (by Senator Zaffarini, DLaredo) and House Bill 119 (by Rep. Hirschi, D-Wichita Falls), both passed during the 1997 legislative session. SB 55 is the "Texas Tobacco Law" which establishes strict penalties for retailers who sell tobacco to minors and for minors in possession of tobacco products. The tobacco industry fought heavily against the legislation. The provisions in SB 55 which impose penalties upon minors are controversial among public health advocates because they distract attention from retailers and clerks who sell tobacco to minors. HB 119 is an ingredient disclosure bill, requiring manufacturers who sell tobacco products in Texas to report their ingredients to the Texas Department of Health. The tobacco industry uses allies like the Texas Restaurant Association, the Texas Retailers Association and the Texas Association of Business and Chambers of Commerce (TABCC) in order to shield its involvement in tobacco control issues. Restaurant owners are mobilized to oppose smoking restrictions and retailers testify against youth access and advertising restrictions. The TABCC opposed the state's lawsuit against the tobacco industry, with coaching on the issue from tobacco industry lobbyists. The tobacco industry has partnered with and heavily sponsored the activities of the Texas Civil Justice League (TCJL) in order to enact tort reform legislation which protects the industry from prosecution. In the tort reform and products liability legislation during the 1993 and 1995 sessions, the tobacco industry and TCJL limited punitive damage awards and the rights of plaintiffs to sue the tobacco industry for smoking-related illnesses. In 1996, then- Attorney General Dan Morales was the third Attorney General to sue the tobacco industry. He settled the case in 1998, prior to the 46 state settlement known as the Master Settlement Agreement. Texas' suit against the industry resulted in a $17.3 billion dollar settlement. From the money that the state has received as of 2001 ($1.8 billion), only $30 million has been spent on tobacco control programs from 1999-2001. In 1999, the state legislature deposited $200 million into a tobacco trust fund to be used for statewide tobacco control programs. However, the legislature only allowed for the interest on that money to be spent for tobacco control (about $9 million annually). The Texas Department of Health, charged with developing a tobacco control program with that small amount of money, was required to focus their efforts in East Texas. The Texas Department of Health comprehensive tobacco control program has been very successful, however, their attempts to secure more funding and expand the program statewide have failed. In 2001, the Legislature only increased funding for the program to $12 million annually. The Centers for Disease Control's Best Practices recommends that a state with the size and population of Texas should spend between $103 million - $180 million annually for an effective tobacco control program. Texas' only statewide smoking regulations, the 1975 Clean Indoor Air Act, sets up minimum standards for smoke-free public places. All of the state's effective smoking regulations have been passed by local governments. Most of the regulations simply establish smoking and nonsmoking sections in workplaces and restaurants. In recent years, several communities, including some surrounding the state capitol in Austin and the West Texas town of El Paso, establish 100% smoke-free public places, including workplaces and restaurants. El Paso's smoking ordinance, passed in 2001, also establishes smoke-free bars, the first ordinance of its kind in Texas. Beginning with the initiative of a sixth grade student, Lubbock enacted a strong clean indoor air ordinance. The tobacco industry, working with the Restaurant Association and Libertarians, opposed the ordinance. After the city council enacted the ordinance, the Libertarians forced a referendum. Tobacco control advocates mounted a vigorous defense and the ordinance was ratified by voters in May, 2002, with 64% voting for it. While tobacco control advocates, generally working through the voluntary health agencies, are showing increasing aggressiveness and effectiveness in working at the local level, they are still unwilling to confront the tobacco industry's allies in the state legislature, which explains their failure to force Texas to mount a strong state tobacco control program despite the millions of dollars made available by the state's tobacco settlement.

BACKGROUND: Cigarette packs are a form of advertising that distributes brand information wherever smokers go. In the 21st century, tobacco companies began using onserts on cigarette packs to communicate new advertising messages to smokers. METHODS: We reviewed tobacco industry documents dated 1926 to 2017 to identify how the tobacco industry developed and used onserts in marketing and to serve the industry's political and legal objectives. RESULTS: Onserts added to cigarette packs became a more cost-effective way for brands to market in the year 2000. Manufacturers then began studying them, finding that new messages were appealing, while repeated messages were ignored. By 2005, tobacco companies were using onserts to effectively communicate about new tobacco products and packaging changes. They also used repeated 'corporate responsibility' messages that were, according to the industry's own research, likely to be ignored. CONCLUSIONS: Tobacco companies have expanded on cigarette pack-based advertising. Twenty-first century onserts simultaneously seek to increase sales using materials that are novel, attractive and provide independent value, while undercutting public health messages about the risks of tobacco use using materials that repeat over time and are comparatively unattractive. Health authorities can use this industry research to mandate onserts to communicate effective health messages.

Although governments have imposed controls on tobacco company behaviour, they have not yet aligned tobacco industry goals to public health objectives. As a result, tobacco companies have delayed or diminished the impact of imposed public health measures and have not contributed to curbing the epidemic of tobacco use. Over the past decade, several regulatory innovations have been proposed as ways to better align industry actions with public health needs, but none have been put in place. These policy suggestions share the goal of providing a supply-side complement to conventional demand reduction strategies, but they differ in the assumptions they make and in the regulatory and governance approaches they take. Similarly, differing views on ideology and political context within the tobacco control community and between governments may hinder the establishment of a global consensus on the ideal supply-side intervention. A government willing to implement innovative supply-side strategies as part of a tobacco control endgame may not require such consensus if factors specific to their national public health systems or political contexts are supportive.

• After making substantial progress on tobacco control in the mid-1990s, the tobacco industry has stifled tobacco control activities in Washington through a mixture of campaign contributions and legal challenges. • Political campaign contributions have remained steadily high throughout the 1990s. Philip Morris, RJ Reynolds, the Tobacco Institute, Lorillard, Brown & Williamson, and the Smokeless Tobacco Council contributed $362,298 to campaigns in 1996 through 2000 election cycles: $114,123 in the 1996 election cycle, $109,975 in 1998, and $138,200 in 2000. • From 1996-2000, 92% of these campaign contributions by the tobacco industry were to Republican candidates, party contributions, and soft money. • The largest lifetime recipients of campaign contributions were Clyde Ballard ($16,830, R-East Wenatchee), William Grant ($7,400, D-Franklin), Dan McDonald ($7,246, R-King), and Pat Scott ($5,490, D-Snohomish). Ballard and Grant are both powerful in the House leadership; Ballard is the Co-Speaker of the House of Representatives, and Grant is the House Democratic Caucus Chair. McDonald was the Majority Leader of the Senate from 1996-1999, and prior to that, he chaired the powerful Ways and Means Committee. • The tobacco industry has also spent heavily on lobbying; from 1996-2000, the industry spent $1,864,086 to lobby members of the legislature and the state administrative offices. This includes lobbyists' salaries and perks given to legislators such as holiday gifts, entertainment and meals. • Washington and its Attorney General, Christine Gregoire, played an active role in the state tobacco trials and subsequent 46 state settlement (known as the Master Settlement Agreement) in 1998. The legislature reserved $100 million of the settlement money for a new Department of Health tobacco control program. • Department of Health officials and health advocates had requested $26 million to begin the tobacco control program, but, because of pressure from the Republican members, the legislature only allocated $15 million for the first year, about half of what the federal Centers for Disease Control and Prevention recommends for Washington State. • Attempts to pass local smoking regulations, with provisions stricter than the 1985 Clean Indoor Air Act, have been hampered by an ambiguous legal question about whether the Clean Indoor Air Act preempts local legislation. Puyallup, the only city attempting to pass a smokefree restaurant ordinance, rescinded it after being challenged with an industry-funded lawsuit without seeking a court ruling on the issue of preemption. The fact that the Attorney General's office has not issued a formal decision on this issue has contributed to the reluctance from local governments. This circumstance has allowed the tobacco industry to stop local clean indoor air regulations. • Spokane has adopted a voluntary approach to controlling secondhand smoke in restaurants with their Big Air Program. Many restaurants in the City and County of Spokane have become voluntarily smokefree since the program was initiated in 1996. Although city officials initiated their program independently, it is very similar to the tobacco industry's voluntary smoking regulations through their "accommodation" and "red light/green light" programs. • The industry has also orchestrated legal pressure to attack the federally-funded ASSIST tobacco control project with allegations of "illegal lobbying" and filed a complaint to the Public Disclosure Commission. While the ASSIST project has ended, the tobacco industry successfully used this experience to discourage health departments and advocates from using the policy process to promote tobacco control. • Several counties, including King, Snohomish, Pierce and Spokane passed outdoor and color advertising restrictions between 1996 and 1999. These measures abolished all outdoor billboards and restricted advertising in stores to small, black and white posters. The industry supported challenges that overturned these restrictions on the grounds that they were preempted by federal law and a violation of the First Amendment. The industry prevailed in the federal Ninth Circuit Court of Appeals and the defendants agreed not to appeal in exchange for the industry not demanding that its legal fees be paid. This situation has stopped similar legislation in Washington. Similar laws were upheld elsewhere in the United States and as of early 2001 the issue was under review at the US Supreme Court. If the Supreme Court upholds such laws, Washington authorities may seek to reinstate them. • Health advocates, who could play a decisive role in anti-tobacco campaigns, have been hindered by the lack of a continuously functioning statewide coalition in Washington. The former group, Tobacco Free Washington Coalition, was funded in large part by a grant from ASSIST. Without ASSIST funding, the statewide coalition could not procure the resources to continue operations. Many advocates limited their efforts to smaller, local coalitions which dilutes their strength as a statewide lobbying force. A new group, Washington Alliance for Tobacco Control and Children's Health (WATCH), was created in 1998 to replace Tobacco Free Washington. They are a broad-based coalition funded by their member organizations. They lobbied in 1999 to ensure that money from the tobacco settlement went to fund health services and that the Department of Health's tobacco programs received adequate funding. • WATCH, together with the Washington Restaurant Association, sponsored Senate Bill 5993 which passed the Senate in March 2001. The bill would ensure more smokefree restaurants, but it has several flaws including exceptions for restaurants where minors are prohibited and the creation of a task force to study ventilation systems. The tobacco industry often advocates ventilation systems to dilute smokefree restaurant legislation and perpetuate controversy around the fact that no ventilation system can completely remove secondhand smoke from an enclosed environment. • In general, the tobacco industry has succeeded in stalling tobacco control efforts in Washington State. Although advocates, local public health officials, the Department of Health, the Attorney General, and some influential members of the legislature are all in favor of broad-based, fully funded, tobacco control education programs and increased Clean Indoor Air legislation, these advocates have not mobilized the resources necessary to overcome the legal and political impediments the industry has created.