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Tobacco Control Policy Making: United States

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Tobacco Control Policy Making: United States UCSF Tobacco Control Policy Making: United States Title Tobacco Control in California, 2007-2014: A Resurgent Tobacco Industry While Inflation Erodes the California Tobacco Control Program Permalink https://escholarship.org/uc/item/4jj1v7tv Authors Cox, Elizabeth Barry, Rachel Glantz, Stanton A. et al. Publication Date 2014-10-23 eScholarship.org Powered by the California Digital Library University of California Tobacco Control in California, 2007-2014: A Resurgent Tobacco Industry While Inflation Erodes the California Tobacco Control Program Elizabeth Cox, BA Rachel Barry, MA Stanton A. Glantz, PhD Richard Barnes, JD Center for Tobacco Control Research and Education School of Medicine University of California, San Francisco San Francisco, CA 94143-1390 October 2014 Tobacco Control in California, 2007-2014: A Resurgent Tobacco Industry While Inflation Erodes the California Tobacco Control Program Elizabeth Cox, BA Rachel Barry, MA Stanton A. Glantz, PhD Richard Barnes, JD Center for Tobacco Control Research and Education School of Medicine University of California, San Francisco San Francisco, CA 94143-1390 October 2014 Supported in part by National Cancer Institute Grant CA-61021 and UCSF funds. Opinions expressed reflect the views of the authors and do not necessarily represent the sponsoring agency. This report is available on the World Wide Web at http://www.escholarship.org/uc/item/4jj1v7tv Reports on other states are available at http://tobacco.ucsf.edu/states and for other countries at http://escholarship.org/uc/search?entity=ctcre_tcpmi. 1 2 Executive Summary • California's position as a leader in tobacco control is under threat by the resurgence of the tobacco industry, the emergence of new unregulated tobacco products, and the decreasing spending power of the tobacco control program. • Countering a resurging tobacco industry will require advocates to be much more visible and assertive in challenging politicians who take tobacco money. • Progress on tobacco control has been concentrated at the local level where policymakers are relatively more sensitive to public support for public health and less susceptible to industry campaign contributions and lobbyists. State Politics and Policymaking • The tobacco industry has dominated tobacco control policymaking at the state level in California between 2007 and 2014. • Between 2007 and 2013, the tobacco industry spent $64,428,254 on state-level political activity, including $4,983,156 in campaign contributions to candidates and party committees, $4,903,209 to non-party committees, $8,567,268 on lobbying, and $48,974,621 on initiatives. • During 2003-2013, the tobacco industry contributed nearly eight times as much to Republicans ($7,058,438) as to Democrats ($903,750). • Industry contributions to Democrats have been rising. During the 2011-2012 election cycle Democrats accepted $176,200, nearly twice the $101,800 they accepted in 2007-2008. In 2013, the Democratic Party accepted the first tobacco industry campaign contribution ($100,900) since 2003-2004. • State Democratic leadership including Governor Jerry Brown ($55,500), Assembly Speaker John Peréz ($36,300), and Assembly Government Organization Committee Chair Isadore Hall ($39,700) accepted tobacco industry contributions. • In the 2011-2012 election cycle, over three-fourths of all tobacco industry campaign funding was made to political parties and non-party campaign committees, which makes tracing it to specific candidates difficult. • Seventeen bills to close loopholes in California’s 1994 state smokefree law (AB13) were introduced, seven passed the Legislature. Governor Arnold Schwarzenegger vetoed bills that would have prohibited smoking on state beaches and in acute care hospitals. Governor Jerry Brown vetoed bills that would have restricted smoking in health facilities and nursing homes. Only three were signed into law. The three bills signed into law had little practical effect, simply permitting universities, multi-unit housing property owners, and state mental health facilities to implement smokefree policies, something they could do without the law. • Despite the fact that California has the 33rd lowest cigarette tax in the nation and a concerted lobbying effort by health advocates, only 7 bills were introduced to increase the cigarette excise tax; none moved past the legislature. • Enforcement activities under both the 1998 Master Settlement Agreement (that settled state litigation against the major cigarette companies) and state tobacco laws declined under both Attorneys General Jerry Brown and Kamala Harris. • Public health advocates need to press politicians of all parties to refuse tobacco industry money and to support public health over the tobacco industry. 3 Electronic Cigarettes • Electronic cigarettes emerged as a new, unregulated threat to tobacco control and several unsuccessful attempts were made to restrict sales to minors and regulate public usage. • The only state bill that became law was SB 882 in 2010 that prohibited the sale of e- cigarettes to minors, but lacked any enforcement measures. • Despite the close linkages between cigarette smoking and e-cigarette use, the California Department of Public Health has not integrated e-cigarettes into its media campaign or other aspects of the California Tobacco Control Program. • Attorney General Harris had taken no legal actions on e-cigarettes despite their rapid growth in sales to youth and undocumented health claims. • In contrast to the state, local governments have been addressing the e-cigarette issue. • As of August 2014, thirty-one cities and counties in California, including Los Angeles and San Francisco, included e-cigarettes in their clean indoor air laws, prohibiting use of electronic cigarettes in workplaces, restaurants, bars, and casinos. • 15 cities and counties, including Los Angeles and San Francisco included e-cigarettes in local retail licensing legislation. • The tobacco companies (which own e-cigarette companies) mounted a major campaign against the Los Angeles retail licensing and public usage e-cigarette ordinances, including hiring major lobbyists, paid media, and “Twitter bombs” directed at the City Council; even so the Council enacted strong e-cigarette regulations. Local Policymaking • Local policymaking also filled loopholes in the state smokefree law, particularly by prohibiting smoking in multi-unit housing, declaring secondhand smoke a nuisance, and prohibiting smoking outdoors. • California lea the nation on efforts to introduce multi-unit housing ordinances. By 2014, 37 localities had passed ordinances restricting smoking in multi-unit housing. • Between 2007 and 2014, 14 strong local tobacco retail licensing ordinances passed due to efforts by the tobacco control community. • California Tobacco Control Program facilitated local action through funding Local Lead Agencies and competitive grantees and through the use of effective media campaigns. Proposition 29 Tobacco Tax Initiative • In 2012, the voters defeated Proposition 29 (No-50.2% to Yes-49.8%) an initiative that sought to increase the cigarette excise tax by $1 per pack for medical research and reinvigorating the California Tobacco Control Program. • The tobacco industry and third party allies spent $47.7 million to defeat Proposition 29, 5 times what health advocates spent to support it ($8.4 million). • Health advocates, led by the American Cancer Society, spent $8.4 million supporting Proposition 29. • The narrow outcome of Proposition 29 makes it difficult to pinpoint one reason for the defeat, but one thing that was under control of the “yes” campaign that likely contributed was the soft media campaign that failed to engage the tobacco industry. • The small margin by which Proposition 29 lost shows that a public health victory is within reach for a future tax initiative that is properly framed, particularly to give funding for 4 tobacco control efforts clear top priority to make the initiative easier to defend to the public and public opinion leaders. • Overcoming tobacco industry opposition and increasing the tobacco tax to restore purchasing power to the California Tobacco Control Program and Tobacco Related Disease Research Program through legislation or the initiative process would pay rapid dividends in reduced tobacco use, youth initiation, and associated health care costs in both the short and long term. The California Tobacco Control Program • The voters created the California Tobacco Control Program when they enacted Proposition 99 in 1988, which increased the cigarette tax by 25 cents and allocated 20 percent to be deposited in the Health Education Account and 5 percent in a Research Account. • Between 1989, when the California Tobacco Control Program started, and 2012, adult smoking prevalence in California dropped from 22.7% to 12.6%. Between 2000 and 2012, smoking among California high school students dropped from 21.6% to 10.5%. • Between 1989 and 2008 the California Tobacco Program cost $2.4 billion and led to cumulative healthcare expenditure savings of $134 billion. • Smoking remained the leading cause of death in California, accounting for 14.8% of deaths and imposing an economic burden of $18.1 billion. The California Tobacco Control Program media campaign has become increasingly muted and failed to engage the rapidly emerging problem of e-cigarettes. • The purchasing power of funds for the California Tobacco Control Program was reduced by inflation, as of 2014 it was 53% of what it was when voters enacted Proposition 99. • Revenue
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