Tobacco Control Policy Making: United States
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UCSF Tobacco Control Policy Making: United States Title Tobacco Control in North Dakota, 2004-2012: Reaching for Higher Ground Permalink https://escholarship.org/uc/item/2jk5n8p5 Authors Rosenbaum, Daniel J. Barnes, Richard L. Glantz, Stanton A. Publication Date 2012-05-01 eScholarship.org Powered by the California Digital Library University of California Tobacco Control in North Dakota, 2004-2012: Reaching for Higher Ground Daniel J. Rosenbaum, B.A. Richard L. Barnes, J.D. Stanton A. Glantz, Ph.D. Center for Tobacco Control Research and Education School of Medicine University of California, San Francisco San Francisco, CA 94143-1390 May 2012 Tobacco Control in North Dakota, 2004-2012: Reaching for Higher Ground Daniel J. Rosenbaum, B.A. Richard L. Barnes, J.D. Stanton A. Glantz, Ph.D. Center for Tobacco Control Research and Education School of Medicine University of California, San Francisco San Francisco, CA 94143-1390 Supported in part by National Cancer Institute Grant CA-61021 and endowment funds available to Dr. Glantz. 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://escholarship.org/uc/item/2jk5n8p5. Reports on other states and nations are available at http://escholarship.org/uc/ctcre_tcpmus. EXECUTIVE SUMMARY Tobacco use in North Dakota has been falling, but tobacco remains a major problem that costs North Dakota nearly half a billion dollars annually. As of 2010, overall smoking had declined to the national average and youth smoking and smokeless use remained well above the national average; adult smoking rates were high among American Indian/Alaskan Native and Hispanic populations. North Dakota lobbyists are not required to report how much they were paid by their clients, which makes it impossible to track changes in the tobacco industry’s expenditures on lobbying over time. From 2000 to 2010 the tobacco industry made campaign contributions primarily to North Dakota political party organizations, mostly Republican (72 percent), but rarely contributed directly to individual legislative candidates. The largest increase in tobacco industry campaign contributions took place in the 2009- 2010 election cycle when Republican political party organizations accepted $38,850, an increase of nearly 430 percent from the 2007-2008 election cycle. The legislature was considering Measure 3-approved tobacco control program funding in 2009. From 1985, when Tobacco Free North Dakota formed, to 2012, tobacco control advocates usually had a statewide tobacco control coalition, though the coalition’s level of organization depended on whether funding and leadership were available. North Dakota created the Department of Health (DOH) Tobacco Prevention and Control Program in 1989 but did not fund it at a level that could have an impact until the 2001- 2003 biennium, when the Legislature created the Community Health Grant Program. Though still below CDC Best Practices funding levels, from 2001 to 2008 the Community Health Grant Program substantially funded local communities to work on tobacco control for the first time. Local Public Health Units built policy-focused coalitions in cities throughout North Dakota and passed two local clean indoor air laws which were stronger than the statewide law and two comprehensive local smokefree air laws. The Legislature refused to fund a statewide media campaign, so, in 2002, Local Public Health Units formed the Public Education Task Force on Tobacco and pooled their money to create a statewide media campaign. The Task Force’s campaigns increased public understanding of the dangers of secondhand smoke and contributed to passage of the 2005 statewide clean indoor air law and local smokefree ordinances. In 2005, the Healthy North Dakota Tobacco Policy Subcommittee was successful in getting the Legislature to pass a statewide clean indoor air law that prohibited smoking in public places and workplaces but that exempted bars and enclosed bars within restaurants, hotels and bowling alleys. In 2007, a smokefree air bill that would have closed the loopholes in the 2005 law did not have support in the Legislature and went nowhere. In 2008, a group of tobacco control program leaders formed the Support Tobacco Prevention Committee and launched a successful campaign to pass Measure 3, an initiative that secured new MSA payments for a fully funded comprehensive tobacco control plan and created a new tobacco control agency, separate from the DOH, to implement the plan which complemented existing DOH programs. 1 Senate Republicans attempted to amend Measure 3 to give the money to the DOH in 2009. Support Tobacco Prevention, Tobacco Free North Dakota, and the TPC Executive Committee mobilized the local advocates who got Measure 3 passed and successfully generated public pressure for the Legislature to make the appropriation. In addition to fighting with the Legislature to appropriate its funding, the TPC Advisory Committee spent the first half of 2009 working with the DOH, CDC and national tobacco control program consultants to create a comprehensive plan and an annual work plan based on CDC Best Practices. The work plan divided program responsibilities among the state partners. The Legislative Assembly divided the state’s $9.3 million (which included federal grants from CDC) funding for tobacco control activities between the DOH and the Center. The Center was required by Measure 3 to follow CDC Best Practices, and the DOH was required to follow Best Practices by the CDC grant that it managed; the DOH did not feel that it was required to spend its MSA funding on tobacco control programs sanctioned by Best Practices. From 2009 to 2011, the TPC Advisory and Executive Committees and the Center exceeded many of the goals established in the five-year state plan, including the implementation of local legislative and voluntary smokefree policies and increased usage of the state Quitline ahead of schedule. From 2009 to 2011, five cities passed comprehensive smokefree ordinances, increasing the fraction of the North Dakota population covered by a comprehensive law to 37 percent. States with limited program funding should consider running initiatives if legislators refuse to appropriate adequate funding for tobacco control. Measure 3 did not provide for a clear division of roles for the new agency and the DOH. Despite early difficulties, the TPC Executive Committee and the DOH are generally working together well but should increase their level of communication, especially as DOH expands its programs, to ensure that there their activities complement each other and are mutually supportive. The TPC Executive Committee and Tobacco Free North Dakota, by mounting aggressive and visible campaigns to mobilize support, defended the program against legislative efforts to gut Measure 3 in 2009 and 2011. While there is much work left to be done, the fact that many of the TPC Advisory Committee’s goals were met ahead of schedule and tobacco use rates among youth and adults declined in recent surveys is an indication that this tobacco control program is maturing and having a positive effect on public health. Opponents of Measure 3 will likely return in future legislative sessions and tobacco control advocates should not assume that North Dakota’s programmatic successes will prevent future attacks. Public health advocates and the Department of Health must be willing to take a publicly active role to protect both the Center and DOH tobacco control programs; attacks on one weaken both. Tobacco control advocates have the support of the public in their favor, which passed Measure 3 and supported numerous smokefree laws, and should continue to use that support to their advantage with legislators to protect and expand their efforts. 2 EXECUTIVE SUMMARY .......................................................................................................... 1 NORTH DAKOTA ORGANIZATIONS, PROGRAMS, AND COALITIONS ..................... 6 CHAPTER 1: BACKGROUND .................................................................................................. 7 Status of Tobacco Control Policies and Tobacco Use in North Dakota as of 2012 ........................... 9 Clean Indoor Air................................................................................................................................... 9 Cigarette Taxes ................................................................................................................................... 10 Funding .............................................................................................................................................. 11 Tobacco Use ....................................................................................................................................... 11 Conclusion ............................................................................................................................................. 13 CHAPTER 2: TOBACCO INDUSTRY INVOLVEMENT IN NORTH DAKOTA ............ 15 Tobacco Industry Allies and Lobbyists .............................................................................................. 15 Campaign Contributions ..................................................................................................................... 16 Total Campaign Contributions ...................................................................................................................... 17