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Tobacco War: Inside the California Battles

Stanton A. Glantz
Edith D. Balbach
Copyright Date: 2000
Edition: 1
Pages: 486
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  • Book Info
    Tobacco War
    Book Description:

    Tobacco Warcharts the dramatic and complex history of tobacco politics in California over the past quarter century. Beginning with the activities of a small band of activists who, in the 1970s, put forward the radical notion that people should not have to breathe second-hand tobacco smoke, Stanton Glantz and Edith Balbach follow the movement through the 1980s, when activists created hundreds of city and county ordinances by working through their local officials, to the present--when tobacco is a highly visible issue in American politics and smoke-free restaurants and bars are a reality throughout the state. The authors show how these accomplishments rest on the groundwork laid over the past two decades by tobacco control activists who have worked across the U.S. to change how people view the tobacco industry and its behavior.Tobacco Waris accessibly written, balanced, and meticulously researched. The California experience provides a graphic demonstration of the successes and failures of both the tobacco industry and public health forces. It shows how public health advocates slowly learned to control the terms of the debate and how they discovered that simply establishing tobacco control programs was not enough, that constant vigilance was necessary to protect programs from a hostile legislature and governor. In the end, the California experience proves that it is possible to dramatically change how people think about tobacco and the tobacco industry and to rapidly reduce tobacco consumption. But California's experience also demonstrates that it is possible to run such programs successfully only as long as the public health community exerts power effectively. With legal settlements bringing big dollars to tobacco control programs in every state, this book is must reading for anyone interested in battling and beating the tobacco industry.

    eISBN: 978-0-520-92468-0
    Subjects: Health Sciences

Table of Contents

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  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-xii)
  3. List of Figures and Tables
    (pp. xiii-xiv)
  4. Preface
    (pp. xv-xviii)
    Stanton A. Glantz and Edith D. Balbach
  5. CHAPTER 1 Introduction
    (pp. 1-6)

    New Year’s Day 1998 was crisp and clear along the coast just north San Francisco, a fine day for a hike. Stanton Glantz, a professor at University of California, San Francisco, and longtime tobacco control advocate, joined a group of friends to hike from high on Mt. Tamalpais down to the ocean. At the end of the trail, the hikers would meet other friends at a bar in Stinson Beach for a drink and lunch. As they the bar, Glantz wondered what would happen there. On I, 1998, after all, every bar in California was to become smoke free. Glantz...

  6. CHAPTER 2 Beginnings: The Nonsmokers’ Rights Movement
    (pp. 7-32)

    In the early 1970s a few people had the radical idea that nonsmokers should not have to breathe secondhand tobacco smoke. At that time was considered impolite to ask people not to smoke. Smoking was only acceptable; it was the norm. The executive director of the California division of the American Lung Association was a chain-smoker, and American Heart Association distributed ashtrays and packs of cigarettes at its hoard meetings. Offering someone a cigarette was a way to open discourse. Even the most ardent nonsmokers’ rights advocates only seeking nonsmoking sections in public places. No one dared think of a...

  7. CHAPTER 3 Proposition 99 Emerges
    (pp. 33-49)

    In November 1988, in spite of a massive statewide campaign by the tobacco industry, California voters enacted Proposition 99. The proposition, which increased the tobacco excise tax by twenty-five cents per pack of cigarettes and comparable amounts on other tobacco products, financed the largest, most ambitious tobacco control program in the world. Using the Proposition 99 tax revenues, the state spent as much as $100 million annually fighting tobacco, which dwarfed the federal government’s activities. At its most effective, in the early 1990s, the proposition 99 anti-tobacco education program tripled the rate of decline in tobacco consumption. It spawned an...

  8. CHAPTER 4 Beating the Tobacco Industry at the Polls
    (pp. 50-75)

    Having laid the groundwork for going directly to the voters with proposal to increase the tohacco tax, proponents still had to finalize initiative and develop the necessary political and financial resources withstand the huge campaign that everyone knew the tohacco industry would mount.

    By mid-May 1987, Curt Mekemson (ALA), Tom Najera (ALA), Betsy Hlte (ACS), and Assembly Member Lloyd Connelly (D-Sacramento) had begun discussing the transition from the legislative to the initiative process.¹,² Tim Howe, Connelly’s chief of staff, took responsibility for writing the initiative. His goal was to present something clear and understandable to the public that was as...

  9. CHAPTER 5 Moving to the Legislature
    (pp. 76-96)

    Proposition 99 raised over $600 million a year in new tobacco taxes, over $150 million of which was allocated by the voters to anti-tobacco education and research, creating the largest tobacco control program in the world. The public health groups turned to the initiative process to secure the tax increase because the tobacco lobby had successfully blocked at least thirty-six attempts to pass a tax increase in the Legislature since 1967.¹ Unfortunately, after winning at the polls, the health advocates had to return to the same Legislature to pass implementing legislation to turn the promise of Proposition 99 into a...

  10. CHAPTER 6 Proposition 99’s First Implementing Legislation
    (pp. 97-119)

    Governor George Deukmejian’s proposals for Proposition 99 revenues did not carry much weight with the Legislature. Legislators had their own ideas ahout how to allocate the money from the Health Education and Research Accounts and what programs should be established with the money. By introducing a bill, a legislator could jockey for a dominant position in the allocation of the Proposition 99 revenues. A total of thirty-eight pieces of legislation were introduced in the Senate or the Assembly to implement Proposition 99’s six accounts. The simplicity of the initiative language helped win the support of the voters and minimize political...

  11. CHAPTER 7 Implementing the Tobacco Control Program
    (pp. 120-146)

    Despite the budgetary compromises that tobacco control advocates had made in AB 75, they still emerged with the largest budget ever allocated to a tobacco control program. The field of play shifted to the state bureauracy, which had to implement California’s Tobacco Control Program. While the Department of Health Services (DHS) ran the anti-tobacco media campaign and some competitive grants, the vast majority ot the money flowed through DHS and the California Department of Education (CDE) to the county health departments, county offices of education, and local school districts. This program design meant that two state-level agencies, sixty-one local health...

  12. CHAPTER 8 The Tobacco Industry’s Response
    (pp. 147-156)

    The organizational and program design barriers faced by Proposition 99’s Tobacco Control Program would have been hard for any new program to overcome. But, unlike traditional public health programs that involve attacking bacteria or viruses, tobacco control advocates were dealing with an intelligent and rapidly evolving adversary—the tobacco industry. Far from sitting quietly while the new program was put in place, the tobacco industry undertook a major etfort to dissect the program, to identity its strengths and weaknesses, and to shift money away from its strengths. The tobacco companies appreciated the importance and effectiveness of two parts of the...

  13. [Illustrations]
    (pp. None)
  14. CHAPTER 9 The Battle over Local Tobacco Control Ordinances
    (pp. 157-181)

    Unlike the media campaign and school programs, which started from scratch after the voters passed Proposition 99, the effort to pass local tobacco control ordinances was already well under way by the time that the Department of Health Services (DHS) set up its tobacco control program. By the time DHS started to implement Proposition 99 in 1990, 213 California communities, working with Americans for Nonsmokers’ Rights (ANR), had pssed local clean indoor air ordinances. After Proposion 99 passed, this effort received a substantial boost. DHS, the local lead agencies (LLAs), and the local coalitions rapidly adopted the local ordinance strategy...

  15. CHAPTER 10 Continued Erosion of the Health Education Account: 1990–1994
    (pp. 182-211)

    Proposition 99’s Anti-tobacco programs were off to a good start. The media campaign had achieved high visibility within California and attracted international acclaim. The local programs were up and running, and local clean indoor air ordinances and tobacco control measures were passing at a faster rate. On October 30, 1990, the Department of Health Services (DHS), which was implementing all the Proposition 99 anti-tobacco education programs except the school-based programs, estimated thet California had 750,000 fewer smokers than it would have had if Proposition 99 had not passed, that the percentage of smokers over the age of twenty had dropped...

  16. CHAPTER 11 Battles over Preemption
    (pp. 212-245)

    The combined effects of existing local tobacco control ordinances and Proposition 99’s resources for educating the public about the dangers of secondhand smoke dramatically accelerated the rate at which clean indoor air and other tobacco control ordinances were passing at the local level. By 1994, one or two local ordinances were passing every week in California, and the pace of activity was accelerating. The efforts to pass ordinances had raised public awareness about the health dangers of passive smoking, and the issue of clean indoor air was mobilizing the general public to support a broader tobacco control agenda.¹ As a...

  17. CHAPTER 12 The End of Acquiescence
    (pp. 246-269)

    By the beginning of 1994, California’s tobacco control movement had become a national and international model of how to use community-based programs and media to reduce tobacco consumption and exposure to secondhand smoke: 334 communities had passed local tobacco control ordinances, and the Legislature was close to passing AB 13, which would require virtually all workplaces in California to become smoke free. California had the third-lowest per capita consumption of tobacco of any state, and the reduction in smoking in California was costing the tobacco industry hundreds of millions of dollars in lost sales every year. Despite the diversion of...

  18. CHAPTER 13 The Lawsuits
    (pp. 270-283)

    By the conclusion of the AB 816 fight, the principled position that the voluntary health agencies had taken left them free to pursue relief in the courts. The fact that the American Lung Association (ALA), American Cancer Society (ACS), and American Heart Association (AHA) had agreed to the diversions under AB 75 and AB 99 made it both legally and politically difficult for the organizations to reverse their position and challenge the diversions in court when those bills were passed. The AB 816 fight left them with no such encumbrance.

    During the conflict over AB 816, everyone Knew that the...

  19. CHAPTER 14 Doing It Differently
    (pp. 284-329)

    By the fall of 1995, because of the failure of the Legislature to appropriate the Proposition 99 revenues in accordance with the lawsuits, substantial amounts of Proposition 99 money had not been spent for anything. The courts stopped the governor and Legislature from spending the money for medical services, and the governor and the Legislature refused to spend the money for, anti-tobacco education and research. The Health Education Account was projected to contain $191 million by June 1996, and the Research Account $82 million. A total of $274 million had been diverted away from anti-tobacco education and $71 million from...

  20. CHAPTER 15 Political Interference in Program Management
    (pp. 330-366)

    In 1990 the tobacco industry had considered lobbying the Deukmejian administration to weaken the tobacco control program, particularly the media campaign, but it recognized that this strategy was unlikely to suceed.¹ The industry quickly recognized that Governor George Deukmejian had a hands-off approach to day-to-day program management and that Ken Kizer, director of the Department of Health Services (DHS), was committed to the anti-smoking program. Thus it was more productive to concentrate on working with the Legislature and others such as the conservative California Medical Association (CMA) and the liberal Western Center for Law and Poverty to divert anti-tobacco educa...

  21. CHAPTER 16 Lessons Learned
    (pp. 367-380)

    As the 1990s drew to a close, the landscape of tobacco control was worlds away from where it was when a few activists gathered in Berkeley with the odd idea that people should not have to breathe secondhand tobacco smoke. The voters of four states—California, Massachusetts, Arizona, and Oregon—had enacted large tobacco control programs funded through tobacco tax increases. The tobacco industry had been forced to promise to pay over $200 billion to states to settle lawsuits recover the money smoking costs society in medical expenses, and many states were setting up tobacco control programs modeled on Proposition...

  22. APPENDIX A Organizations, Programs, and People Involved in Tobacco Control in California
    (pp. 381-383)
  23. APPENDIX B Important California Tobacco Control Events
    (pp. 384-386)
  24. References
    (pp. 387-426)
  25. About the Authors
    (pp. 427-428)
  26. Index
    (pp. 429-469)
  27. Back Matter
    (pp. 470-472)