Suchergebnisse

In November 2007, Oregonians defeated Measure 50, an 84.5-cent cigarette tax increase to fund children's health insurance, by a vote of 59% no to 41% yes. This ballot measure would have established the Healthy Kids Program for otherwise uninsured children. Measure 50 revenues would also expand the Oregon Health Plan (Oregon's health care coverage for low-income residents) and provide additional funding for rural health and safety net clinics. Only 5% of the new revenues were dedicated to tobacco control. Measure 50 was a legislative referral of a bill that failed to pass as a statute during the regular legislative session. The Governor's Office and health and labor advocates tried several times to secure the three-fifths majority vote needed to pass a revenue-raising measure. Deprived of crucial votes with a Republican lockdown in the House, the Governor's Office and local contract lobbyist for the American Cancer Society (ACS) decided to support a legislative referral of the Healthy Kids Plan as a constitutional amendment, which only required the approval of a simple majority in the Legislature, to the ballot in the 2007 special election. Campaign spending for Measure 50 was the costliest in Oregon's history. The Yes on Healthy Kids PAC spent $3.7 million. The tobacco industry spent $12.1 million opposing the measure ($7.1 million from Philip Morris' Stop the Measure 50 Tax Hike PAC and $5.0 million from RJR's Oregonians Against the Blank Check PAC). From the outset, the Yes campaign faced several issues that put them at a disadvantage: the short timeline of less than five months from referral to election for a public education and media campaign, the unfavorable recourse of amending the constitution, and relatively low initial levels of public support (59% in March, falling to 53% in August). During the campaign, leadership was concentrated among three individuals who had experience in Oregon initiatives and politics, but who lacked the ability to effectively communicate and mobilize other advocates and volunteers involved in the campaign. RJ Reynolds and Philip Morris ran separate campaigns against Measure 50. Their combined $12 million directed at defeating the measure went to paid media and continuous polling that allowed the tobacco companies to define messages and hone in on issues that resonated most with voters throughout the state. The RJ Reynolds campaign had an effective spokesperson who was visible and stayed on message, unlike the Yes on Healthy Kids campaign, which lacked a strong identity with several speakers and changing messages. Measure 50 supporters blamed massive tobacco industry spending for their loss. This conclusion ignored flaws in the legislation itself; its small allocation to tobacco control and amendment to the constitution made it susceptible to attack from the tobacco industry. The Yes campaign also suffered from a lack of communication and cooperation within the campaign and did not learn lessons from other cigarette tax increase initiatives throughout the United States. The tobacco control community will continue to be disappointed with their campaign efforts to increase tobacco taxes until they begin to learn from these repeated past mistakes.

• Tobacco use is the leading preventable cause of death in Virginia, taking more than 9,200 lives each year. Tobacco-induced healthcare costs are $1.92 billion annually, including $369 million in Medicaid payments. • The growth of tobacco, and its importance to the economy of Virginia, has declined significantly. In 2008, tobacco was only the fifth most harvested and valuable crop, behind hay, corn, soybeans, and wheat, and constituted only 2.3% of the value of all Virginia agricultural products sold. • Virginia is becoming increasingly urban and its citizens are less concerned with Virginia's tobacco heritage. Significant majorities of Virginians support stronger clean indoor air laws and higher cigarette taxes. In 2009, 75% polled supported strong clean indoor air laws. • The tobacco industry has a significant presence in Virginia: Philip Morris has a large manufacturing and corporate presence in the Richmond area. • The tobacco industry's lobbying expenditures have significantly exceeded spending by tobacco control advocates. The industry also built strong ties to hospitality groups, trade associations, and tobacco growers to oppose tobacco control measures. • Republican legislators are significantly more supportive of the tobacco industry control than Democrats, who are more supportive of public health. • The tobacco industry gave about twice as much money to Republicans than Democrats. Controlling for party and legislative house, greater tobacco industry campaign contributions are statistically significantly associated with more pro-tobacco industry policy behavior. • Between 1970 and 2008, 70 cities and two counties imposed local cigarette excise taxes, an attractive and politically nonvolatile source of revenue. The tobacco industry has not been able to counter this activity. • Prior to 1990, many localities enacted local clean indoor air ordinances. Despite strong support among Virginians for clean indoor air laws and a growing movement among localities for local tobacco control, these measures were blocked in 1990 by the passage of the weak preemptive statewide Virginia Indoor Clean Air Act (VICAA). • Virginia was selected by the National Cancer Institute in 1990 to participate in the 17-state American Stop Smoking Intervention Study (ASSIST). ASSIST established a network of local tobacco control coalitions through Virginia Department of Health. Organizational issues and strong industry interference prevented ASSIST from accomplishing its mission of reducing smoking through policy change. • Virginia was awarded a Robert Wood Johnson Foundation SmokeLess States (SLS) grant in 1994 to support lasting statewide coalitions to reduce tobacco use; the effort failed in Virginia. • Virginia SmokeLess States was involved with the successful Southern Communities Tobacco Project to bring tobacco farmers together with tobacco control advocates; this effort accomplished little substantive change in tobacco control policy in Virginia. • In 1998, Virginia was part of the Master Settlement Agreement (MSA) between 46 states and the tobacco industry and will to receive about $4 billion from the settlement over 25 years. Virginia committed 10% of the proceeds to a youth-only tobacco control program; 40% was directed at financially supporting tobacco-growing communities negatively affected by declining growth of tobacco in the state, and the rest went to the General Fund. • Virginia Tobacco Settlement Foundation (VTSF)was founded in 1999 with the 10% of MSA funds. VTSF mounted a youth multimedia campaign, but little data are available on the effectiveness of VTSF programming. • In 2009, the General Assembly expanded VTSF's mission to include youth obesity prevention and changed its name to Virginia Foundation for Healthy Youth without any additional funding. The consequences for tobacco control programming are not known, but are likely to be negative if resources are diverted from tobacco control. • Virginia had the lowest cigarette tax in the nation from 1993-2004. The 2004 "2.5 Cents to Common Sense" campaign run by Virginians for a Healthy Future (VFHF), comprised of the Virginia chapters of AHA, ALA, and ACS, successfully used polling data to show popular support for an increase, targeted key legislators, and ran an effective media campaign. This effort resulted in a tax increase of 30 cents per pack in 2004. None of the increased tax went to fund tobacco control. • In 2006, with encouragement from VFHF, Governor Tim Kaine (D) issued Executive Order 41, prohibiting smoking in most executive branch buildings and state-owned vehicles. • In 2007, VFHF worked closely with Gov. Kaine and Sen. Brandon Bell (R) to introduce SB 1161, a strong expansion of the VCIAA to extend make most public places, including restaurants, smokefree. This effort failed. • The City of Norfolk decided to pass an ordinance prohibiting smoking in restaurants in 2007, arguing that it not preempted by the VCIAA because of the city's inherent police powers. The ordinance was rescinded before it went into effect because of complaints by local restaurateurs and the likelihood of a statewide law passing. Statewide public health advocates did not effectively support this effort to test state preemption. • In 2009 VFHF focused an intense "district campaign" on Assembly Speaker William Howell's (R) home district of Fredericksburg, forcing Howell to stop blocking all clean indoor air legislation. Instead of supporting 100% smokefree legislation, he proposed a weak amendment to the VCIAA that created exemptions for smoking rooms in restaurants. The member organizations of VFHF split in 2009 over support for the Kaine-Howell compromise legislation. After securing an agreement with Gov. Kaine in a back-room meeting, the Kaine-Howell bill passed and was signed into law by Kaine. The law prohibited most smoking in restaurants and bars but allowed separately vented smoking rooms. • Given strong support from Virginians for stronger clean indoor air laws, Virginia tobacco control advocates should reexamine their strategies. VFHF and its member organizations should provide financial and political resources to expand their successful 2009 Fredericksburg district campaign to repeal preemption. They should also consider identifying and supporting local efforts to enact stronger laws using the Norfolk model.

The tobacco industry successfully blocked or displaced strong tobacco control legislation in Costa Rica for nearly 40 years using similar strategies used in the U.S. and the rest of the world, until the country successfully passed a strong tobacco control law in March 2012. During the 1970s and 1980s, the tobacco companies displaced strong tobacco control legislation on tobacco advertising by endorsing weaker executive decrees. In response to increased tobacco control pressure, the industry successfully weakened the 1995 law by secretly hiring scientific consultants to counter the SHS threat and using the hospitality industry to rollout the Courtesy of Choice program in Costa Rica (then Latin America). Tobacco companies then used Costa Rica as a model to rollout industry youth smoking prevention programs and corporate social responsibility campaigns throughout Latin America and the Caribbean. The industry continued its dominance in Costa Rica during the 2000s by developing a cooperative relationship with the Ministry of Health. Although theNational Anti-Tobacco Network(RENATA), a new coalition ofgovernmental health institutions and nongovernmental tobacco control associationsformed in 2007, generated enough public pressure on Legislative Assembly to ratify the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in 2008 and secure Bill 17.371's introduction in 2009 to implement the treaty, the industry once again worked through the Ministry of Health to delay the bill's passage. However, RENATA's abilityto alert the media and mobilize a coalition of international health advocates to effectivelyinform lawmakers on the importance of the FCTCbetween 2010 and 2012 helped pass a strong tobacco control law in March 2012.

Tobacco policy has been an issue in Indiana since 1893, when the legislature passed a law prohibiting selling tobacco to people under 16. Beginning as early as 1969, Indiana General Assembly members and tobacco control advocates launched uncoordinated efforts to pass a law restricting smoking in government buildings. The tobacco industry responded with a well-financed and well-connected network of lobbyists, campaign contributions and third-party allies which's lobbyists that defeated every statewide clean indoor air proposal from 1969 to 1986. In 1986, tobacco control advocates formed the Indiana Campaign for a Tobacco-Free Society and, in 1987, successfully advocated for Indiana's first clean indoor air law that created nonsmoking areas in government-owned buildings. Participating in the National Cancer Institute's American Stop Smoking Intervention Study (ASSIST; 1991 to 1999) provided Indiana with its first funded tobacco control local infrastructure, which laid the foundation for future progress. In 1997, despite opposition from tobacco control advocates, the Tobacco Institute, the tobacco industry's lobbying organization, convinced the Indiana Legislature to preempt local governments from regulating the sale, distribution or display of tobacco products. Between 2000 and 2009, the tobacco industry spent over $4 million on lobbying. From 1994 to 2008, the tobacco industry contributed $560,884 to elected officials. Nine of the 10 officials who accepted the highest amounts of money held high-ranking leadership positions. Industry contributions were associated with more pro-industry behavior by legislators. Tobacco Industry campaign contributions peaked during 1999-2000, when legislators were considering how to spend money from the Master Settlement Agreement (MSA), and during 2003-2004, when legislators cut the state tobacco control budget by 70 percent. In 2000, the Legislature created the Indiana Tobacco Use Prevention and Cessation (ITPC) Agency as an independent agency governed by an Executive Board with $35 million of MSA money for FY 2001, meeting the US Centers for Disease Control and Prevention's minimum funding recommendation. The ITPC Executive Board created the Hoosier Model, an adaptation of CDC's Best Practices for Comprehensive Tobacco Control Programs, with a particularly strong emphasis on community programs. In 2002, with active support from tobacco control advocates and ITPC, the Governor proposed and the Legislature enacted a 40¢/pack cigarette tax increase, the first increase since 1987. None of the money went to tobacco control. In 2007, again with support from the health advocates and ITPC, the Legislature enacted Governor Mitch Daniels' (R) Healthy Indiana Plan financed by a 44¢/pack cigarette tax increase (to 99.5¢). Only $1.2 million of the new tax revenues were allocated to ITPC, and even this small amount ended after just one year. As of 2010, Indiana's cigarette tax was still 45.5¢ below the national average. Bloomington passed Indiana's first comprehensive smokefree ordinance in 2003 which prohibited smoking in public places and enclosed workplaces, followed by bars in 2005. Indianapolis-Marion County passed an ordinance in 2005 prohibiting smoking in public places and enclosed workplaces, except for bars and private clubs. Thirty-five local ordinances passed after the Indianapolis-Marion County ordinance, 21 of which exempted bars and 28 exempted private clubs, mirroring the Indianapolis-Marion County ordinance. In 2006, tobacco control advocates adopted statewide "deal breaker" agreements establishing a minimum standard for comprehensive local smokefree ordinances without exemptions. These agreements resulted in fewer but stronger ordinances: from 2003 through 2006, only 5 of 28 ordinances included bars; between 2007 and 2009, 6 of 10 ordinances included bars. Decreases in ITPC funding to local communities has made it difficult for local coalitions to maintain staff levels and program efficacy. Advocates have been too focused on strengthening the 2005 Indianapolis-Marion County clean indoor air ordinance; advocates should reinvigorate local activity throughout the state to pass comprehensive ordinances in smaller communities. In 2009, statewide tobacco control advocates made a strategic error in not actively supporting a non-preemptive clean indoor air bill covering everything but casinos. In 2010, in an arrangement with House Speaker B. Patrick Bauer, Representative Charlie Brown (D-Gary) introduced essentially the same bill that the advocates passed on in 2009, which again failed without their support. Tobacco control advocates were divided which weakened their coalition. ITPC's funding was never secure; between FY 2001 and FY 2004, legislators cut ITPC's funding by 70%. ITPC received $10.9 million for FY 2010, just 14% of Best Practices. Despite the cuts, ITPC's programs decreased youth smoking. From 2000 to 2008, smoking prevalence decreased among high school students by 42 percent, from 31.6 percent to 18.3 percent and among middle school students by 58 percent, from 9.8 percent to 4.1 percent. During this period adult smoking prevalence remained stable, while per capita consumption dropped, indicating that smokers were smoking fewer cigarettes. The continuing decline in youth smoking while adult prevalence stagnated probably reflected the ITPC Executive Board's decision to give priority to reducing youth smoking in response to cuts in total funding available. State policy makers were correct to establish ITPC as an independent agency and to fund it at CDC-recommended levels. In 2010, tobacco control advocates defeated a proposal from Governor Mitch Daniels and Senator Luke Kenley (R-Noblesville) to dissolve the ITPC Executive Board and transfer the Agency's functions to the Indiana State Department of Health (ISDH). States that have dissolved or transferred their independent tobacco control programs into state health departments have historically raided funds and been left with ineffective programs. In 2011, advocates again fought a similar last minute amendment to the state budget bill to dismantle ITPC introduced by Sen. Kenley, but were unsuccessful in part. ITPC was dissolved and the program's budget transferred to ISDH and reduced by 25 percent. However, the public outcry generated by ITPC supporters influenced ISDH to create a new, high level division reporting directly to the State Commissioner of Health focused solely on tobacco prevention and cessation and to make a commitment to maintaining ITPC"s effective program focus. If advocates can successfully transition ITPC's programs into ISDH, broaden its program focus to reintegrate adults, and restore full funding, it will likely yield rapid decreases in health care costs and other economic losses stemming from tobacco-related illnesses and so contribute not only to the physical health of Hoosiers, but also the fiscal health of their government and businesses.

Tobacco policy has been an issue in Indiana since 1893, when the legislature passed a law prohibiting selling tobacco to people under 16. Beginning as early as 1969, Indiana General Assembly members and tobacco control advocates launched uncoordinated efforts to pass a law restricting smoking in government buildings. The tobacco industry responded with a well-financed and well-connected network of lobbyists, campaign contributions and third-party allies which defeated every statewide clean indoor air proposal from 1969 to 1986. In 1986, tobacco control advocates formed the Indiana Campaign for a Tobacco-Free Society and, in 1987, successfully advocated for Indiana's first clean indoor air law that created nonsmoking areas in government-owned buildings. Participating in the National Cancer Institute's American Stop Smoking Intervention Study (ASSIST; 1991 to 1999) provided Indiana with its first funded tobacco control local infrastructure, which laid the foundation for future progress. In 1997, despite opposition from tobacco control advocates, the Tobacco Institute, the tobacco industry's lobbying organization, convinced the Indiana Legislature to preempt local governments from regulating the sale, distribution or display of tobacco products. Between 2000 and 2009, the tobacco industry spent over $4 million on lobbying. From 1994 to 2008, the tobacco industry contributed $560,884 to elected officials. Nine of the 10 officials who accepted the highest amounts of money held high-ranking leadership positions. Industry contributions were associated with more pro-industry behavior by legislators. Tobacco Industry campaign contributions peaked during 1999-2000, when legislators were considering how to spend money from the Master Settlement Agreement (MSA), and during 2003-2004, when legislators cut the state tobacco control budget by 70 percent. In 2000, the Legislature created the Indiana Tobacco Use Prevention and Cessation (ITPC) Agency as an independent agency governed by an Executive Board with $35 million of MS money for FY 2001, meeting the US Centers for Disease Control and Prevention's minimum funding recommendation. The ITPC Executive Board created the Hoosier Model, an adaptation of CDC's Best Practices for Comprehensive Tobacco Control Programs, with a particularly strong emphasis on community programs. In 2002, with active support from tobacco control advocates and ITPC, the Governor proposed and the Legislature enacted a 40¢/pack cigarette tax increase, the first increase since 1987. None of the money went to tobacco control. In 2007, again with support from the health advocates and ITPC, the Legislature enacted Governor Mitch Daniels' (R) Healthy Indiana Plan financed by a 44¢/pack cigarette tax increase (to 99.5¢). Only $1.2 million of the new tax revenues were allocated to ITPC, and even this small amount ended after just one year. As of 2010, Indiana's cigarette tax was still 45.5¢ below the national average. Bloomington passed Indiana's first comprehensive smokefree ordinance in 2003 which prohibited smoking in public places and enclosed workplaces, followed by bars in 2005. Indianapolis-Marion County passed an ordinance in 2005 prohibiting smoking in public places and enclosed workplaces, except for bars and private clubs. Thirty-five local 2 ordinances passed after the Indianapolis-Marion County ordinance, 21 of which exempted bars and 28 exempted private clubs, mirroring the Indianapolis-Marion County ordinance. In 2006, tobacco control advocates adopted statewide "deal breaker" agreements establishing a minimum standard for comprehensive local smokefree ordinances without exemptions. These agreements resulted in fewer but stronger ordinances: from 2003 through 2006, only 5 of 28 ordinances included bars; between 2007 and 2009, 6 of 10 ordinances included bars. Decreases in ITPC funding to local communities has made it difficult for local coalitions to maintain staff levels and program efficacy. Advocates have been too focused on strengthening the 2005 Indianapolis-Marion County clean indoor air ordinance; advocates should reinvigorate local activity throughout the state to pass comprehensive ordinances in smaller communities. In 2009, statewide tobacco control advocates made a strategic error in not actively supporting a non-preemptive clean indoor air bill covering everything but casinos. In 2010, in an arrangement with House Speaker B. Patrick Bauer, Representative Charlie Brown (D-Gary) introduced essentially the same bill that the advocates passed on in 2009, which again failed without their support. Tobacco control advocates were divided which weakened their coalition. ITPC's funding was never secure; between FY 2001 and FY 2004, legislators cut ITPC's funding by 70%. ITPC received $10.9 million for FY 2010, just 14% of CDC's recommended level. Despite the cuts, ITYPC's programs decreased youth smoking. Between 2000 and 2008, smoking prevalence decreased among high school students by 42 percent, from 31.6 percent to 18.3 percent and among middle school students by 58 percent, from 9.8 percent to 4.1 percent. During this period adult smoking prevalence remained stable, while per capita consumption dropped, indicating that smokers were smoking fewer cigarettes. The continuing decline in youth smoking while adult prevalence stagnated probably reflected the ITPC Executive Board's decision to give priority to reducing youth smoking in response to cuts in total funding available. State policy makers were correct to establish ITPC as an independent agency and to fund it at CDC-recommended levels. In 2010, tobacco control advocates were correct in defeating a proposal to dissolve the ITPC Executive Board and transfer the Agency's functions to the Indiana State Department of Health. States that have dissolved or transferred their independent tobacco control programs into state health departments have historically raided funds and been left with ineffective programs. ITPC should be maintained as an independent agency. If advocates can restore full funding and ITPC broadens its program focus to reintegrate adults it will likely yield rapid decreases in health care costs and other economic losses stemming from tobacco-related illnesses and so contribute not only to the physical health of Hoosiers, but also the fiscal health of their government and businesses.

OBJECTIVE: To evaluate how transnational tobacco companies, working through their local affiliates, influenced tobacco control policy-making in Argentina between 1966 and 2005. METHODS: Analysis of internal tobacco industry documents, local newspapers and magazines, internet resources, bills from the Argentinean National Congress Library, and interviews with key individuals in Argentina. RESULTS: Transnational tobacco companies (Philip Morris International, British American Tobacco, Lorillard, and RJ Reynolds International) have been actively influencing public health policymaking in Argentina since the early 1970s. As in other countries, in 1977 the tobacco industry created a weak voluntary self regulating code to avoid strong legislated restrictions on advertising. In addition to direct lobbying by the tobacco companies, these efforts involved use of third party allies, public relations campaigns, and scientific and medical consultants. During the 1980s and 1990s efforts to pass comprehensive tobacco control legislation intensified, but the organized tobacco industry prevented its enactment. There has been no national activity to decrease exposure to secondhand smoke. CONCLUSIONS: The tobacco industry, working through its local subsidiaries, has subverted meaningful tobacco control legislation in Argentina using the same strategies as in the USA and other countries. As a result, tobacco control in Argentina remains governed by a national law that is weak and restricted in its scope.