Tobacco War

Tobacco War charts 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 War is 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.

Stanton A. Glantz is Professor of Medicine at the University of California, San Francisco. Among his books are The Cigarette Papers (California, 1996), Tobacco: Biology and Politics (1999), and Primer of Biostatistics (1997). Edith D. Balbach is Director of the Community Health Program at Tufts University.

List of Figures and Tables
Preface

I. Introduction
The Changing Environment of Tobacco
Recurring Themes
Conclusion
2. Beginnings: The Nonsmokers' Rights Movement
The Berkeley Ordinance
Proposition 5
The Tobacco Industry Joins the Battle
The $43 Million Claim
The Postmortem
Proposition 10
Going Local
The San Francisco Ordinance
The Tobacco Industry's Counterattack
Tobacco Control Advocates Mobilize
The Proposition P Campaign
Lessons from the Proposition P Campaign
Conclusion
3· Proposition 99 Emerges
The Idea
The Coalition for a Healthy California
The Legislative Effort
The CMA and the Tobacco Industry
The Napkin Deal
Conclusion
4· Beating the Tobacco Industry at the Polls
Locking in Money for Prevention
Organizing the Campaign
The Industry Campaign
Getting the Medical Providers to Buy In
Collecting the Signatures
Launching the Election Campaign
Putting the Issue before the Voters
The CMA's Quiet Withdrawal
The Fake Cop Fiasco
Reflections on the Industry's Defeat
Conclusion
5· Moving to the Legislature
The Tobacco Industry's Pricing Strategy
Conflicting Views of Health Education
A Hostile Legislative Environment
California's Fiscal Problems
Down the Legislative Path
The Coalition's Disintegration
The Governor's Budget
The Tobacco Industry's Legislative Strategies
Conclusion
6. Proposition 99's First Implementing Legislation
The Voluntary Health Agencies' Legislation
Other Significant Tobacco Education Legislation
The Child Health and Disability Prevention Program
Negotiations and Agreements
Project 90
The Battle over the Media Campaign
The Research Account
The Outcome
Conclusion
7· Implementing the Tobacco Control Program
Two Different Models
Leadership at DHS
The Media Campaign
The Local Lead Agencies
Encouraging Diversity
The Schools: A Different Approach
Early Leadership Problems
Monitoring and Accountability
Formalizing Noncooperation between DHS and the
Schools
Conclusion
8. The Tobacco Industry's Response
The Industry and the Media Campaign
"It's the Law"
The Industry and the Schools
Conclusion
9· The Battle over Local Tobacco Control Ordinances
Beverly Hills
Lodi
Sacramento
The Escalating Fight over Local Ordinances
Long Beach
Placer County
The Sacramento Battle over Measure
The Tobacco Industry's Plan: "California's Negative
Environment"
The Tobacco Industry and the California
Public Records Act
Conclusion
10. Continued Erosion of the Health Education
Account: 1990-1994
Early Postures
The CMA Position
Governor Wilson's Budget Cuts
The Tobacco Industry's Strategy
The Final Negotiations
AB 99 Emerges
The Governor Tries to Kill the Media Campaign
The First Litigation: ALA's Lawsuit
The I992-I993 Budget Fight
Positioning for 1994
The Governor Kills the Research Account
Conclusion
II. Battles over Preemption
SB 376: The First Threat of Preemption
The Voluntary Health Agencies Accept Preemption
The Birth of AB I3
The Tobacco Industry's Response: AB 996
The View from outside Sacramento
AB I3 and AB 996 on the Assembly Floor
On to the Senate
The Philip Morris Plan
The Philip Morris Initiative
The Continuing Fight over AB I3
The Philip Morris Signature Drive
The Legislature Passes AB I3
AB I3 and Proposition I88
The Stealth Campaign
The "No" Campaign
The Wellness Foundation
The Federal Communications Commission
Conclusion
I2. The End of Acquiescence
The Governor's I994-I995 Budget
The Creation of AB 816
Objections to CHDP
The Hit List
The ANR-SAYNO Lawsuit
The Conference Committee Hearing
The CMA
Last-Minute Efforts to Stop AB 8I6
The Floor Fight
The Final Bill
Conclusion
I3. The Lawsuits
Child Health and Disability Prevention
Comprehensive Perinatal Outreach
The Health Groups' Victory
The Lawsuit's Aftermath: SB 493 in 19995
The SB 493 Lawsuits
Conclusion
I4. Doing It Differently
The Need for a Change
The December Meeting
The CMA
The Governor's Budget
Changes in the Legislature
The Coalitions Form
The "Hall of Shame" Advertisement
The Wellness Grant
The CMA House of Delegates Meeting
The Philip Morris Memo
The Governor's May Revision
Reaction to the Governor's New Budget
Attempted Restrictions on the Media Campaign
The Research Account
The Final Budget Negotiation
Engaging the Media
The End of the Diversions
Conclusion
15. Political Interference in Program Management
Squashing the Media Campaign
"Nicotine Soundbites"
Implementing Pringle's Pro-Tobacco Policies
Shutting Out the Public Health Community
The TEROC Purge
The Strengthened Advertisements
The 1998 Hearings
Trying to Control TEROC
Delayed Implementation of the Smoke-free
Workplace Law
Pulling the Advertisements for Smoke-free Bars
The California Tobacco Survey: TCS "Fires"
John Pierce
Conclusion
I6. Lessons Learned
The Players
The Keys to Success: Ideas, Power, and Leadership
Ideas: Knowing What You Want
Power: Turning Ideas into Action
Leadership: Seizing Opportunities and Challenging
the Status Quo
Conclusion

Appendix A. Organizations, Programs, and People
Involved in Tobacco Control in California
Appendix B. Important California Tobacco Control
Events
References
About the Authors
Index