In this paper, we examine efforts by health organizations seeking comprehensive smokefree ordinances over Louisiana casinos and bars between 2010 and 2020 to determine best practices for increasing coverage. Bars and casinos remain less protected from secondhand smoke compared to other workplaces in the United States. Casino behavior is compared to the Policy Dystopia Model (PDM), a tobacco industry strategy framework. We performed a historical case study using snowball searches for news on the Access World News Database and the internet. We performed web searches using the names of key actors, organizations, and locations and interviewed nine participants. Starting in 2010, the Louisiana Campaign for Tobacco-Free Living ran ordinance campaigns supplemented by an ongoing statewide smokefree media initiative. Utilizing consistent strategies, including promoting performers as cultural emblems deserving protection, health organizations coalesced in New Orleans during 2014 and Baton Rouge in 2016 and 2017 to pursue ordinances. The coalitions secured ordinances in Louisiana's population and tourism centers despite business resistance. Organizations obtained 30 smokefree laws across Louisiana by 2021. Casinos used PDM strategies to resist ordinances, indicating the framework may predict strategies by non-tobacco entities resisting tobacco control. Louisiana shows that ongoing local campaigns, social justice themes and cultural messaging with coalitions in cities can secure smokefree laws covering casinos and bars and that local ordinance campaigns are a viable method for advancing smokefree protections over those venues in states where the state legislatures are resistant to action.
Following the passage of Measure 44, which raised the cigarette tax by $0.30 in 1996, Oregon created its comprehensive Tobacco Prevention and Education Program (TPEP) in 1997 funded by 10% of Measure 44 revenues. The Tobacco Free Coalition of Oregon (TOFCO) was a broad coalition of the voluntary health organizations and community partners that facilitated media advocacy and grassroots opportunities for clean indoor air policies and funding for TPEP. Successful tobacco control efforts in Oregon at the state and local levels were instrumental in reducing per capita cigarette consumption by 11.3% in two years (1997-1999). Local tobacco control coalitions were successful in passing (and defending) tobacco control policies from 1997 to 2001. The local ordinances in Corvallis (1998) and Eugene (2000) were regarded as model language for their 100% smokefree laws. In contrast, the Multnomah County smokefree workplace ordinance (1999) passed with a number of exemptions, including bars and bar areas of restaurants, and was later used as a model for the preemptive statewide smokefree workplace law. In Oregon, the tobacco industry spent a total of $3,145,553 on lobbying and campaign contributions to legislators, political parties, and constitutional officers from 1997 to 2006. Republican political action committees (PACs) received nearly five times more than Democratic PACs; tobacco companies spent more than four times more on Republicans than Democrats in the legislature. The tobacco industry attempted to hamper tobacco control efforts through several hospitality and retail organizations, but their most powerful ally was the Oregon Restaurant Association (ORA), which had one of the largest PACs in the state and was a major political player. With an increasing number of local clean indoor air ordinances, the tobacco industry fought tobacco control efforts at the state level, where they had an obvious advantage with campaign contributions and well-connected lobbyists. In 2001, tobacco industry lobbyists attacked TPEP with legislation that attacked TPEP's credibility, infrastructure, and success passing local clean indoor air ordinances. In this negative policy environment, the ORA cut a deal with the Democratic Governor to enact the Indoor Clean Air Act of 2001, which preempted local governments from passing stronger laws and exempted bars, bar areas of restaurants, bingo halls, and bowling alleys. These exemptions were not removed until 2007 and will not actually be removed until 2009. In another blow to tobacco control during the 2001 legislative session, TPEP was subject to "illegal lobbying" allegations, a tobacco industry tactic previously employed in California and elsewhere. The result of these claims was a "budget note" added to the TPEP appropriation by the Legislature that specifically restricted TPEP from lobbying for tobacco control ordinances and requiring local programs to advocate for passing tobacco control ordinances. Among tobacco control advocates, the 2001 budget note initiated a more cautious attitude that outlasted the budget note's applicability to the 2001-03 budget cycle. The passage of the preemptive state law in the same session further limited the advocate's ability to pass effective tobacco control policies. Oregon and 45 other states settled outstanding lawsuits against the four largest tobacco companies with the Master Settlement Agreement (MSA) in 1998. Since the first payment in 1999, no money has been dedicated to tobacco prevention and education in Oregon as of 2007. Tobacco control advocates defeated two ballot measures in 2000 that would have dedicated either none or a minimal amount of the MSA's revenue stream to tobacco prevention and education. Until 2004, Oregon's cigarette tax was comprised of a permanent tax and a $0.10 temporary tax enacted in 1993 and dedicated to the Oregon Health Plan (OHP). The 10-cent tax was renewed every two years by the legislature. In 2002, Measure 20 increased the cigarette tax by $0.60 to a total of $1.28 to generate new revenue anticipated to fill budget shortfalls. Advocates were unable to secure a permanent percentage of the tax increase for tobacco control, but TPEP received a onetime transfer of $2 million. Oregon's cigarette tax fell to $1.18 in 2004 after the tobacco industry funded anti-tax group, Citizens for a Sound Economy, attached the extension of the $0.10 temporary tax to Measure 30, a revenue-raising measure that included unpopular personal income and corporate tax increases in the midst of a statewide recession. Measure 30 failed, and Oregon's cigarette tax decreased. Using the state's difficult budget shortfalls as a reason, legislators in the 2003 session completely defunded TPEP, shutting it down in March 2003. (Other programs funded by Measure 44 were cut, but only TPEP was shut down.) Some funding was reinstated in December 2003, with a biennial budget that was 34% of its 2001-03 budget and 17% of the CDC's minimum for state tobacco control programs. This disruption in funding had serious negative impacts on program staffing and continuity. TPEP operated on a severely reduced budget during the 2003-05 and 2005-07 bienniums because Measure 44 funds were diverted by the state legislature to pay for OHP. Since the significant reductions in TPEP's budget, per capita cigarette consumption declined at a much slower rate than before, and now appears to have plateaued. TOFCO has often been restrained by other political priorities of its member organizations, and tobacco control advocates have over-relied on contract lobbyists to set policy agendas and steer negotiations. Oregon may be entering a period of resurgence after several setbacks caused the program to fall out of the national spotlight. The tobacco control movement in Oregon needs strong leaders who are less cautious and can mobilize public support throughout the state, not just the metropolitan hubs.
Abstract Rather than clearly and unequivocally requiring 100% smokefree workplaces and public places (including restaurants, bars and other entertainment venues), Israeli law contains several elements that parallel the tobacco companies' "accommodation" program, which is designed to maintain the social acceptability of smoking and protect industry profits. Rather than 100% smokefree workplaces, smoking is permitted in private offices despite the fact that it then wafts throughout the building. Bars and pubs are allowed to set aside a quarter of their space for smokers, as long as it is in a separate room, and this explains the dangerous levels of secondhand smoke air pollution in Israeli bars and pubs. The weaknesses in the current Israeli laws are sending Israeli citizens to the hospital for secondhand smoke-induced heart attacks, asthma and other diseases. The Israeli government needs to catch up with the rest of the developed world and enact and implement a strong smokefree law.This is a commentary on http://www.ijhpr.org/content/2/1/20/.
Using the Truth Tobacco Industry Documents Library and Congressional records, we examined the tobacco industry's involvement with the 1990 Americans with Disabilities Act (ADA). During legislative drafting of the ADA (1989-1990), the Tobacco Institute, the tobacco industry's lobbying and public relations arm at the time, worked with industry lawyers and civil rights groups to include smoking in the ADA's definition of "disability." Focus was on smoking as a perceived rather than actual disability so that tobacco companies could maintain that smoking is not addictive. Language that would have explicitly excluded smoking from ADA coverage was weakened or omitted. Tobacco Institute lawyers did not think the argument that smokers are "disabled" would convince the courts, so in the two years after the ADA was signed into law, the Tobacco Institute paid a lawyer to conduct media tours, seminars, and write articles to convince employers that hiring only non-smokers would violate the ADA. The ultimate goal of these activities was to deter employers from promoting a healthy, tobacco-free workforce and, more broadly, to promote the social acceptability of smoking. Employers and policy makers need to be aware that tobacco use is not protected by the ADA and should not be misled by tobacco industry efforts to insinuate otherwise.
Maine has a small population, with a relatively high proportion of people living in the state's major population centers, making Maine politics function more like a large city than a state, fostering bipartisan efforts to pass progressive tobacco control legislation despite the presence of tobacco industry lobbyist from the late 1970s throughout the 1980s. Credit for Maine's successes in tobacco prevention and control can be attributed to two major factors: A cohesive and collaborative partnerships among tobacco control advocates with effective lobbying strategies (individually tailored campaigns rather than a one-size-fits-all approach) and diversified funding strategies. Since 1983, the Maine Coalition on Smoking or Health partnered with more than 100 state and municipal agencies, including the American Cancer Society, New England Division, the Maine Lung Association, Anthem Blue Cross Blue Shield, the American Heart Association, and the Maine Center for Public Health. Strong and consistent individual commitment to tobacco control, including support from the Maine Department of Health and numerous legislators, gave an advantage to tobacco control bills and laws. Early tobacco control legislation focused on the protection of indoor air, and struggled against powerful tobacco industry lobbyists. Throughout the 1980s and 1990s, the Maine legislature passed significant and progressive smoke-free air laws , including but not limited to smoke-free restaurants (1999), bars (2003), and cars (2008), as well as tobacco excise tax increases (the latest, in 2005, raised the excise tax from $1 to $2 per pack) and the establishment of a state tobacco control program. Tobacco control advocates in Maine were successful because they were able to sell a collective vision to health organizations in the state, and convinced these organizations to give up a little for the greater good of Maine's residents. Tobacco prevention and control efforts did not begin in earnest until the mid 1990s, when Maine was faced with highest youth smoking rates in the country. In 1997, Maine's network of health advocates worked with Governor Angus King (I), to promote a tobacco excise tax increase to fund a tobacco prevention and control program. This success was followed in 1999 with the statewide smoke-free restaurant bill, and smoke-free bars in 2003. By 2008, cars and outdoor dining areas were also smoke-free, passing easily without significant opposition from tobacco industry lobbyists. After the tobacco excise tax was doubled in 1997, Maine experienced with a dramatic reduction in youth smoking rates from 35% in 1997 to 20% in 2003. Adult smoking rates also declined steadily in Maine from 25% in 1996 to 18% in 2008. This was accomplished mainly through the state quit line along with the Partnership for a Tobacco-Free Maine's (PTM) media campaigns targeting parents and adults. Despite the successes of the state tobacco control program, PTM at reducing youth smoking, the program's narrow focus was at the expense of other vulnerable demographics, most significantly, young adults age 18-25. In 2007, 35% of young adults in Maine smoked at rates similar to 1992 levels (35%). Maine's tobacco control advocates have worked tirelessly to protect the Fund for a Healthy Maine (FHM), Maine's funding mechanism for the Master Settlement Agreement (MSA), the result of the 1998 lawsuit filed against the major US tobacco companies, which secured more than $40 million annually for the state. The statewide support of the FHM has been a result of the careful orchestration of the FHM's diverse funding structure that has enlarged the circle of recipient beneficiaries. In 2001, PTM began receiving funds from the Master Settlement Agreement. Because of these funds, despite severe budget shortfalls since 1998, the PTM reported that tobacco control in Maine was funded at or just short of the CDC Best Practices for Comprehensive Tobacco Control Recommended Guidelines each year. In 2008, the Maine Center for Disease control acknowledged that their tobacco control funding, dedicated by the Legislature from the FHM, had been allocated to fund a variety of chronic disease programs in addition tobacco control, and that their reported spending had not been accurate. A portion of tobacco control funds were either unaccounted for or had been allocated to chronic disease programs. Beginning in 2009, PTMs accounting reflected the actual reduced funding level for tobacco control. The Partnership for a Tobacco-Free Maine's misrepresentation of spending resulted in the diversion millions of dollars from tobacco control to other healthcare programs since 1999. Despite the state's successes in reducing youth and adult smoking rates, there is a significant amount of work to be accomplished. To continue to reduce the burden of tobacco-induced disease, PTM must increase spending for tobacco prevention and control, and fund programs at levels recommended by the US CDC Best Practices for Comprehensive Tobacco Control Recommended Guidelines.
INTRODUCTION: Tobacco imagery in films and television increased in India after it ended conventional tobacco advertising in 2004. The Ministry of Health and Family Welfare (MoHFW) introduced rules to eliminate this tobacco imagery in 2005 which took effect in amended form in 2012. This study presents the enablers and barriers in development and implementation of the regulations to curb tobacco imagery in films and television in India. METHOD: We reviewed legislation, evolving regulations, parliamentary questions, judicial decisions, Bollywood trade publications and relevant news articles from 2003 to 2019 and interviewed key informants. RESULTS: Based on the WHO reports and civil society demands, the MoHFW issued a complete ban on tobacco imagery in movies and television programmes in 2005. The Ministry of Information and Broadcasting (MoIB) joined the film industry in opposing the rules. A filmmaker challenged the rules in court, which ruled that they violated constitutional freedoms. On appeal by MoHFW, the Supreme Court allowed the rules to take effect. Continuing opposition by MoIB and the film industry weakened the rules and delayed implementation until 2012. As of 2020, rather than a ban, all films with tobacco imagery require strong editorial justification, 100 s of antitobacco messages produced by the MoHFW, and a static health warning at the bottom of screen during tobacco imagery display. In 2015, less than 48% of movies had tobacco imagery compared with 89% in 2005. CONCLUSIONS: Although, not a ban, MoHFW, supported by local advocates and WHO, issued regulations that resulted in a substantial drop in on-screen tobacco imagery and increased exposure to antitobacco messages. India's experience informs WHO Framework Convention on Tobacco Control parties as they develop and implement policies to curb tobacco imagery in entertainment media.
There has been a global decline in tobacco consumption that, if continued, will negatively impact the tobacco industry's profits. This decline led the industry to invent and market new products, including heated tobacco products (HTP). HTP are an extension of the industry's strategies to undermine government's tobacco regulatory efforts as they are being promoted as part of the solution for the tobacco epidemic. Under the moniker of 'harm reduction', the tobacco companies are attempting to rehabilitate their reputation so they can more effectively influence governments to roll back existing tobacco control policies or create exemptions for their HTP. Rolling back tobacco control policies will make it easier for the companies to renormalise tobacco use to increase social acceptability for all their products. When regulations are absent or when loopholes exist in classifying HTP as a tobacco product (thus subject to all tobacco control regulations), the industry's marketing of HTP is making these products more visible to the public and more accessible. Governments need to ensure that HTP are regulated as tobacco products or drugs and reject partnerships with the tobacco companies to promote 'harm reduction'. The tobacco companies remain the vector of the tobacco-caused epidemic and cannot be part of the global tobacco control solution.
The movement to legalize and regulate retail marijuana is growing. We examined legislation and regulations in the first 4 states to legalize recreational marijuana (Colorado, Washington, Oregon, and Alaska) to analyze whether public health best practices from tobacco and alcohol control to reduce population-level demand were being followed. Only between 34% and 51% of policies followed best practices. Marijuana regulations generally followed US alcohol policy regarding conflict of interest, taxation, education (youth-based and problematic users), warning labels, and research that does not seek to minimize consumption and the associated health effects. Application of US alcohol policies to marijuana has been challenged by some policy actors, notably those advocating public health policies modeled on tobacco control. Reversing past decisions to regulate marijuana modeled on alcohol policies will likely become increasingly difficult once these processes are set in motion and a dominant policy framework and trajectory becomes established. Designing future marijuana legislation to prioritize public health over business would make it easier to implement legalization of recreational marijuana in a way that protects health.
There has been a global decline in tobacco consumption that, if continued, will negatively impact the tobacco industry's profits. This decline led the industry to invent and market new products, including heated tobacco products (HTP). HTP are an extension of the industry's strategies to undermine government's tobacco regulatory efforts as they are being promoted as part of the solution for the tobacco epidemic. Under the moniker of 'harm reduction', the tobacco companies are attempting to rehabilitate their reputation so they can more effectively influence governments to roll back existing tobacco control policies or create exemptions for their HTP. Rolling back tobacco control policies will make it easier for the companies to renormalise tobacco use to increase social acceptability for all their products. When regulations are absent or when loopholes exist in classifying HTP as a tobacco product (thus subject to all tobacco control regulations), the industry's marketing of HTP is making these products more visible to the public and more accessible. Governments need to ensure that HTP are regulated as tobacco products or drugs and reject partnerships with the tobacco companies to promote 'harm reduction'. The tobacco companies remain the vector of the tobacco-caused epidemic and cannot be part of the global tobacco control solution.
Abstract The dominant model of addictive consumption in economics is the theory of rational addiction. The addict in this model chooses how much they are going to consume based upon their level of addiction (past consumption), the current benefits and all future costs. Several empirical studies of cigarette sales and price data have found a correlation between future prices and consumption and current consumption. These studies have argued that the correlation validates the rational addiction model and invalidates any model in which future consumption is not considered. An alternative to the rational addiction model is one in which addiction spreads through a population as if it were an infectious disease, as supported by the large body of empirical research of addictive behaviors. In this model an individual's probability of becoming addicted to a substance is linked to the behavior of their parents, friends and society. In the infectious disease model current consumption is based only on the level of addiction and current costs. Price and consumption data from a simulation of the infectious disease model showed a qualitative match to the results of the rational addiction model. The infectious disease model can explain all of the theoretical results of the rational addiction model with the addition of explaining initial consumption of the addictive good.
On June 20, 1997 a group of attorneys and health advocates proposed a "global settlement" of all public and private litigation against the tobacco industry. This agreement was controversial, and the subsequent implementing legislation was defeated. We sought to determine whether the global settlement represented a "missed opportunity" or a dead end.
