Preface............................................................................iii
Introduction................................................................... vi
Targeted Populations: Youth, Minorities, Women
and the Educationaily Disadvantaged................................1
Tobacco Excise Taxes: Raising the Cost
of Tobacco.......................................................................10
Restrictions on Smoking in Public Places.........................16
Sources Of Additional Information..................................22
Scott D. Ballin, J.D., Vice President, Public Affairs and Legislative Counsel
Richard Hamburg, National Affiliate Legislative Coordinator, American Heart
Steve Largent, Communications Director, American Heart Association, Utah
Joe Patterson, Director of Public Education, Division Services, Government
Carl Booberg, Executive Director, American Lung Association of Virginia,
Harry Holmes, Ph.D., Director of Governmental Relations, Univertity of
John H. Madigan, Jr., Assistant Vice President, Public Affairs, American
Fran Du Melle, Director, Office Of Government Relations, American Lung
Russell Hinz, Manager, Health Care Policy, American Lung Association/American
John Pinney, Corporate Health Policies Group, Washington, DC
Dorothy Stake, Volunteer, Member, National Public Issues Committee, American
Angela T. Mickel , Director, Tobacco-Free America Legislative Clearinghouse,
Michael Pertschuk, Co-Director, The Advocacy Institute, Washington,DC
In recent decades, the U.S. tobacco manufacturers have spent
untold billions of dollars to protect and expand the sales of
their addictive and deadly products. These peddlers of destruction
pose an enormous and well-financed challenge to voluntary health
agencies. And yet, in the face of nearly overwhelming odds. the tide
of public opinion has been turned by scientfic facts and by a strong
coalition of tobacco-control forces who are as creative as the tobacco
marketers, and even more energetic.
Having led the way in this battle during the past decade at
the national level as the Coalition on Smoking Or Health, the American
Cancer Society, American Heart Association and American Lung
Association united as Tobacco Free America (TFA), now bring important
additional resources to a growing trend evidenced in states and localities
across the nation. Our course of action for the 1990s will be set at Countdown
2000, a landmark conference in Washington, DC, on September 9-11, 1990.
Countdown 2000, sponsored by Tobacco-Free America and its member
organizations, will develop the strategy and enhance the skills needed by
state and local voluntary leaders in their pursuit of a tobacco-free America
by the year 2000.
Essential to the achievement of this goal is the release of
this Blueprint for Success. The document is an action plan for achieving
consistent nationwide policy in states and localities. It provides guidelines
to address the following three major tobacco issues: 1) marketing targeted
at special populations, 2) tobacco excise taxes and 3) restrictions
on smoking in public places. This draft will eventually form
the basis for achieving the goals we share for the year 2000.
Following are summaries of recommendations for the three primary issues.
The tobacco industry has long targeted youth, women, minorities
and the educationally disadvantaged through massive advertising
and publicity campaigns needed to replace the thousands of consumers
lost each year as smokers die from smoking-related illnesses
or decide to kick their habit. The report of this subcommittee
clearly identifies the tactics used by tobacco companies to target
population groups with sophisticated market research and advertising.
The subcommittee makes a number of recommendations to curb these
efforts. Included are severe limitations on sales and access of tobacco
products. tobacco education for children in grades K-12, tobacco-counter
promotion for youth and minorities and the creation of state offices on
tobacco and health. The subcommittee also proposes a modificaton in the
Public Health Cigarette Act of 1969 to allow states to take more effective
action in curbing cigarette advertising. Existing constitutional
authority allows a ban on most promotional activities. This
subcommittee argues that states and local entities must "regulate
what the tobacco industry has failed to do on its own."
The subcommittee on tobacco excise taxes reviews well-known
studies and data analyzing taxes as deterrents to smoking, particularly
for young Americans who never have used tobacco. Recognizing
that most revenue generated by increased tobacco excise taxes
is needed by the states for general purposes, the subcommittee
recommends that a portion be devoted to health care goals such
as prevention, education, media campaigns and smoking cessation.
A primary focus of any excise tax increase should be to apply
that increase to all tobacco products. The subcommittee also
recommends that the Tobacco-Free America Legislative Clearinghouse
serve as a key resource center to help states increase their tobacco
excise taxes.
The subcommittee on smoking in public places has developed
a strong set of recommendations for consolidating and strengthening
state and local smoking-control effort. To achieve the Countdown
2000 goals, the subcommittee specifies the following minimum standards:
smoking should be prohibited in child day care centers, on school
property, In all public and private work places, in retail stores.
in health care facilities and on any form of public transportation.
Most other indoor areas open to the public would be smoke-free
under these proposals. Restaurants would provide smoke-free
space based
on the ratio at nonsmokers to smokers. Any state-level preemption
provision must be opposed because it would preclude potentially stronger
action in localities. Finally, the subcommittee opposes statutes providing
civil rights protection for smokers.
Ours is not an easy task. We have a great deal more to do
to assure that our nation enters the next century free from the deadly scourge
of tobaccco. More than 50 million Americans continue to smoke. Many young
people -- seduced by the allure of tobacco advertising and promotion at vulnerable
points in their lives -- take up the addicting habit every day. To
help people stop smoklng -- and keep countless others from starting -- state
and local advocacy efforts at the ACS. AMA and ALA must be strengthened.
While we have reason to celebrate our numerous victories,
we cannot rest. Our strength lies not only in our resolve to
preserve and promote public health, but also in our "natural
resources," the millions of dedicated volunteers who lend
their time, talents and services to our effort. Our objective in releasing this Blueprint
for Success is to provide a focal point for public policy action over the next ten
years and beyond. Our plan requires a full commitment to tobacco-control advocacy
from each organization and at all levels. Material and human resources dedicated to
this effort must be increased, and the commitment of both volunteers and professional
staff further encouraged, supported and rewarded.
Most importantly, the joumey ahead will take commitment resources
and brainpower. This conference will be a catalyst for action in that quest.
The American Cancer Society, American Heart Association and
American Lung Association began working together in the earty 1960s to
educate Americans about the serious health hazards associated with
tobacco use. In 1985, the three agencies created Tobacco-Free
America (TFA). and its programs, including the Smoke-Free class of 2000,
Tobacco-Free Schools and the Legislative Clearinghouse , to meet the
following three specific goals:
..........to form strong state and local coalitions of the
three agencies to focus the attention of legislators, regulators and other
public officials, as well as the general public, on the health hazards of
tobacco use and the need for enactmentt of tobacco-control legislation:
..........to foster public perception that smoking is a socially unacceptable
behavior and encourage smokers to quit and young persons not to
start; and
..........to attain a smoke-free society by the year 2000, as called
for by former U.S. Surgeon General C. Everett Koop.
The TFA Legislative Clearinghouse was established to help
achieve TFA'S goals for tobacco-control advocacy, by serving as
an information bank and advisory resource to the state and local
offices of the three organizations, as well as to government
agencies, private citizens and corporations and the media.
The Clearinghouse monitors state and local tobacco-control
legislation and regulations and analyzes trends and effects of
the information collected. This information is used to --
..........advise and assist coalitions and agencies in formulating and
implementing strategies for involvement in tobacco-control advocacy;
..........develop and update model guidelines, legislation and testimony
for use by state and local agencies and coalitions to facilitate tobacco-control
advocacy;
..........compile public attitude surveys, cost-benefit analyses, fact
sheets and scientific studies for use by coalitions and agencies: and
..........educate volunteers and staff of TFA's member organizations.
The work of the Clearinghouse enables the three agencies to
adopt a unified approach to tobacco-control advocacy and to learn
from and respond to tobacco industry tactics used across the country.
If the tobacco-control movement is to achieve its public policy
goals in the last decade of the 20th century, the advocacy efforts
of the ACS, AHA and ALA must be strengthened and better coordinated.
While the economic dominance held by the tobacco industry has proved
to be a significant
barrier in our battle for public health, it is in no way impenetrable.
The strength of our organizations lies not only in our commitment to the
preservation and promotion of public health, but also in the overr 5 million
persons who volunteer their services.
Currently, one may question whether our grassroots are not
merely Astroturf, an artificial roster of vounteers who may or
may not respond to a call for action. We are most effective when
we have a core group of dedicated advocates who will act on a moments
notice. In the wake of major tobacco- control victories, such
as the passage of the New York State Clean Indoor Air Act and
the overwhelming approval by Califomia voters of Proposition 99,
the ballot inititative that increased the state cigarette excise
tax by 25 cents, there have also been setbacks. For instance,
Colorado, Kentucky, Oregon, Tennessee and Virginia enacted anti-discrimination
protections for smokers by prohibiting employers from establishing
as a condition of employment that employees and prospective employees
must be nonsmokers; thus, putting smokers into a "protected"
class. In addition, several states have adopted restrictions
on smoking in public places that prevent localities from enacting
further restrictions. These regressions, when viewed from a global
perspective, signify a negative trend for the tobacco-control
movement that began in the late 1980s, in spite ot the great
progress made during the bulk of that decade. Our ability to organize,
energize and mobilize our vast base of dedicated volunteers to affect public
policy will determine our degree of success in the 1990's.
Our objective in setting into motion this national "plan
of action" is for states and localities to use public policy
to the fullest extent over the next ten years, and beyond, to
achieve a tobacco-free society. This plan may be illusory without
total commitment to tobacco-control advocacy from each organization,
at all levels. To be successful in our campaign, the ACS, AHA
and ALA must adopt tobacco~control advocacy as a major organizational
priority and act accordingly. Public policy can have an enormous
impact on our efforts to eradicate the diseases upon which our
organizations where founded.
We must transcend turf battles, institutional rivalries,
bureaucatic resistances and intrainstitutional inertia in the
common pursuit at the overriding public goal. The movement needs
both professional advocacy resources and dedicated, trained, empowered
voIunteers. To accomplish these goals, we need mutual commitment
and support at the local, state and national levels; a coordinated
strategic plan; interactive communications networks; and advocacy
training and skills building.
To provide the necessary support and assistance to achieve
the objectives in the Blueprint for
Success, two management goals must be adopted
to reaffirm commitment to public policy advocacy for tobacco-control
and to continuing and expressing the TFA Legislative Clearinghouse
as a resource for the respective ACS, AHA and ALA field organizations.
GOAL #1: ..........Acceptance and affirmation that public policy advocacy
is absolutely essential to fulfill the mission of health promotion and disease
prevention through tobacco- control regulation stated by the American Cancer
Society, American Heart Association and American Lung Association.
..........National, state and local boards should adopt tobacco-control
advocacy as a priority. This action requires the education of volunteer boards
as to the efficacy of tobacco-control advocacy as a way to achieve the overall
mission of our respective organizations.
..........Staff and resources of national, state and local agencies
must be dedicated to the political education. recruitment, confidence-building
and institutional recognition of their volunteer members who advocate tobacco-
control policies at each level of government.
..........Tobacco-control advocacy committees must be organized.
or strengthened. at all levels to reflect a clear priority within the organizations.
..........Staff positions of experienced government relations/public
affairs professionals must be created at the state level.
..........State and local coalitions must be organized or strengthened
with the following:
.......... -- added human and financial resources;
..........-- aggressive outreach to new and potential alliances. We
must reach out to and enlist in our quest other sectors that
have a vested interest in tobacco regulations,-such as:
---------Consumer groups-----------------------------Health professionals' groups
.......... -- professional advocacy personnel: and
.......... -- strategic planning and communications capability.
GOAL #2:..........The Tobacco-Free America Legislative Clearinghouse
will continue to provide its sevices to the field to assist in the achievement of the
goals that are essential to attaining the objectives of the Countdown 2000 Blueprint
for Success.
...........Develop a national, uniform, multi-tiered, interactive communications
and dlstribution network in conjunction with me ACS, AHA, ALA
national govemment relations/public affairs offices and other systems whose
design is consistent with the goals articulated in the Bluprint for Success.
..........Provide strategic planning counseling support services that
includes a team of experts in tobacco-control strategies, similar to a SWAT team,
who are available to travel to states and localities that require immediate
strategic support to kill or pass a measure.
..........Provide training for staff and volunteers in tobacco-control advocacy skills,
lobbying techniques, media relations and coalition management.
..........Develop resource materials, including policy research and
guidebooks. Compile case studies that provide detailed accounts of major
tobacco-control campaigns successes and failures and lessons learned from
those campaigns that may be applied elsewhere; efficacy studies of existing laws.
GOAL:.............It is a primary goal of Tobacco-Free America
to decrease or deter consumption of tobacco products by groups of individuals
targeted by the tobacco industry.
RATIONALE:..Tobacco use by youth, minorities, women and the
educationally disadvantaged continues at higher rates than other segments of
the population.
The tobacco industry has long targeted youth, minorities, women
and the educationally disadvantaged with advertising campaigns. The
industry spends massive amounts at money to sponsor community and
sporting events traditionally attended by these target groups. And, the industry
places its tobacco advertisements in locations that will maximize exposure
to these specific groups.
In fact, the media has featured many examples of such targeted
"philanthropy and promotion.
In April 1990, the Washington Post reported that RJR
Nabisco contributed $30 million for "innovative education
programs" to schools across the country, including $1.2
million to two schools in Washington, DC. At around the same
time, Philip Morris contributed $1 million to District of Columbia
public schools.
An Arlington, Virginia woman wrote the following to the Post:
..........The companies are desperate to develop new clients,
since so many of their old ones have either quit or died young. This is
only the latest in a series of calcutated efforts to lure youngsters to smoke
through careful public image building.
..........Added a District of Columbia man,
..........That's a great ethics lesson the District (of Columbia) has
presented to the young men and women in the Nation's capital city: take
the money and run, regardless of the source or the strings attached. [If]
Philip Morris really wanted to promote good health for the kids of Washington,
it should have removed every sign and symbol of smoking and any mention of its name -
from its contribution and the programs that that contribution would fund.
...........Reed V. Tuckson, M.D., former Commissioner of PublIc Health
for the District of Columbia asks,
..........Where do the cigarette companies go to find these new recruits
for the death march to the land of profit and greed? To get not only to the chiIdren,
but also the other vulnerable and oppressed segments of our country. They go to
the people of color, to women and to the poor... The tobacco industry is
subjugating people of color through disease.
In the spring of 1990, a black minister, the Rev. Calvin 0.
Butts, pastor of the Abyssinian Baptist Church In New York City, became so upset
with cigarette advertisements in nearby neIghborhoods that he whitewashed
billboards containing liquor and cigarette advertisements targeted at blacks. Said
Reverend Butts, "The prevalence of alcohol and cigarette advertisements in...America's
inner cities
manifests the elastic ruthlessness of these companies' greed
and proclivity to exploit the poor and disenfranchised people."
Much of the concern for industry targeting is tied to the increased
rate of tobacco-related mortality and morbidity in certain segments
of the population. For example, black men experience a 20 percent
higher mortality rate from heart disease and 58 percent higher
incidence of lung cancer than white men. Black women have a
50 percent higher mortality rate from heart disease than white
women. Overall, blacks are 1.32 times more likely to die from malignant
neoplasms, including lung cancer. They are 1.34 limes more likely to die
from diseases of the heart.
Inexorably tied to these statistics is tobacco prevalence data.
Prevalence differs when factored for race, sex and level of education.
According to the National Health Interview Surveys, 28.8 percent of whites
as opposed to 34 percent of blacks continued to smoke in 1967. Other studies
show that Hispanic men smoke at even higher rates, as high as 40 percent.
Although smaller percentages of women than men smoke (26.8
percent vs 31.7 percent), the overall decline has been four times
greater for males over a 20-year period. By educational level,
tobacco use is almost double for those with no more than a
high school education when compared with college graduates. For
blue collar and white collar workers, the prevalence disparity
is 39.7 percent to 27.5 percent, respectively.
Further, according to the Final Report of the 1989 Tobacco
Use in America Conference --
There also appear to be specific cigarette brand purchasing
patterns within minority populations. Of those who smoke, 47 percent of
Mexican-American men smoke Marlboro and 20 percent Winston; 30 percent
of Mexican American women smoke Marlboro, 20 percent Winston and 16
percent Salem. Use of menthol cigarettes is very common among blacks,
with 76 percent reporting that they smoke that type of cigarette.
Such purchasing patterns are a result, in large part, of continued
tobacco industry targeting of these groups.
Early In 1990, R.J. Reynolds introduced a new product, called
Uptown, clearly targeted to blacks. Said Secretary of Health and Human Services Louis
W. Sullivan, M.D.. at a time when our people desperately need the message of health
promotion, Uptown's message is more disease, more suffering and more death."
The test marketing of Uptown in Philadelphia was stopped only
after a public uproar was led by a coalition of more than 40 groups and
given greater credence by Sullivan's comments. While addressing a
press conference in February 1990, Sullivan said --
..........It is frightening to realize that studies have found that the
younger the age at which one begins to smoke, the more likely that a person
will become a long-term smoker and develop smoking-related diseases. In fact,
90 percent of smokers begin a cigarette addiction as children or adolescents.
Advertisers (must) shun temptation of this tainted money, stained by addiction,
disease and death. Finally I call upon smokers and potential smoker -- inclucding
young people, women, miorities and blue-collar workers -- to excercise good
judgement and personal responsibility. The life you save may not only be your
own but also the life of someone you love or maybe don't even know, who
might passively breathe the deadly tobacco fumes.
In February 1990, R.J. Reynolds caused an uproar when the
public learned that a new brand, Dakota, would be test marketed
to young, poorly educated white women described by the cigarette
manufacturer as 'virile females." The preferred Dakota
smoker was described by R.J. Reynolds as "a woman with no
education beyond high school, whose favorite television roles
are 'Roseanne' and evening soap opera 'bitches' and whose chief
aspiration is to get married in her early 20s and spend her free time
'with her boyfriend doing whatever he is doing.' "
The Women VS. Smoking Network, a coalition of women's groups
based in Washington, DC, noted the parallels between Dakota and
Uptown. According to a director of the group, Anne Marie O'Keefe,
"When you target for marketing you target for death."
Tobacco industry product manipulation has included promotional
efforts such as the marketing of the ill-fated "smokeless
cigarette," Premier in 1988. The cigarette was advertised as
providing "The Cleaner Smoke." Under intense public pressure,
led by the Coalition on Smoking OR Health and other pro-health groups, the
product was pulled off the market in late 1988. The Coalition had previously
petitioned the Food and Drug Administration to investigate low tar cigarettes,
incIuding Premier, in an attempt to expose their use as a drug delivery
system. The Coalition argued that the tobacco companies' advertising was
tantamount to a health claim.
Tobacco companies frequently sponsor sporting events, including
bowling, skiing, speedboat racing, truck and tractor pulls, fishing,
tennis (Virginia Slims circuit), stock car racing (Winston Cup),
soccer (Marlboro Cup) and horse racing (Marlboro Stakes). Although
tobacco advertising is prohibited
on television, the strategic placement of tobacco product ads
in baseball stadiums, hockey rinks and other sporting venues is quite visible
when American families (and their children) watch TV. In early 1990, USA
Today-reported that tobacco company sponsorship of sports and cultural events
amounted to $150 million in 1989, with about 70 percent spent on sports.
Dr. Alan Blum, of Doctors Ought to Care, an outspoken critic
of the tobacco industry and its advertising and promotional strategies,
states, "You watch an auto race and you see cars going around tracks
with cigarette logos. You watch tennis and you see logos in the background.
Truth is good, but juxtaposition is better."
States Joe Chemer, president of Smoke-Free Educational Services
in New York City, "I have found that the average sixth-grade girl actually
thinks women tennis players smoke. Jennifer Capriati plays Virginia Slims
(tournaments) at 13 (years of age). That means she is not old
enough to smoke but she is old enough to be a walking billboard for a cigarette
company.
A recent Winston advertisement included a "900"
number to call for sports scores. The brand was advertised as
"Your ticket to the best in sports."
Tuckson says, "The tobacco industry seeks to gain 'innocence
by association' through sponsorship of events. They attempt to
make cigarette brand names synonymous with community
events like the Ebony Fashion Fair, the Kool Jazz Festivals
and Salsa Festivals in the Latino community."
Helen Munoz, of the National Coalition of Hispanic Health and Human Services
Organizations, sheds further light on the subject 'Perhaps most disturbing
of all" she says, "a study of 4th and 5th graders in Los Angeles revealed
that Hispanic boys and girls are more likely to say they used cigarettes (than their
non-Hispanic counterparts) and that Hispanic boys were six times as likely
as their non-Hispanic white counterparts to be smokers."
Using such practices, the tobacco industry regularly violates
its own "voluntary adverttsing and sampling code." The
code prohibits advertisements and sampling practices aimed at
persons under the age of 21.
For example, the industry also has resorted to 'couponing,'
whereby cigarette smokers can send in coupons to redeem 'prizes' ranging
from additional packages of cigarettes to compact discs. A recent giveaway
promised a free pack of Alpine cigarettes. The only protection against minors
participating was a disclaimer on the advertisement that 'by accepting this offer
you certlty that you are a
smoker 21 years of age or older."
R.J. Reynolds sponsored a "Millionaire Cash Quiz Game"
whereby contestants were urged to submit ten or more correctly answered game
tickets in order to win $2. The more packs smoked, the more money you
could win.
The industry also targets the economically disadvantaged and
the young through the marketing of generic products. This sector of the market
has risen dramatically in recent years and now holds a substantial market share.
The tobacco industry also targets these groups with promotional giveaways
of items such as hats, T-shlrts and sporting equipment. These
items are often distributed at areas of high concentrations of
youth. such as sporting events, rock concerts and public beaches.
Most cigarette vending machines remain unsupervised, inviting
purchase by youth. Free samples are distributed on street corners
and at athletic and music events well-attended by those under
18 years of age.
By mid-1990, 45 states had minimum-age laws for the purchase
of cigarettes. Yet, enforcement of these laws is a serious problem.
Most current licensing laws do not address the issue of enforcing
the minimum age for purchasing tobacco products.
Officer Bruce A. Talbot of the Woodridge (IL) Police Department,
testifying before Congress in April 1990, described a new law passed in
his hometown. He said he had --
..........received complaints from teachers. parents and even the students
themselves that Woodridge merchants are selling cigarettes to minors. On one
occasion, a gym teacher observed a 13-year-old female student purchase a pack
of Marlboros from a Mobil gasoline station just two blocks from the school.
Woodndge...has reduced tobacco sales to minors from 83 percent to zero. But
without this legislation our local efforts may have been for naught because the
merchants whose stores border Woodridge contlnue to sell cigarettes to 13-year-old
children 94 percent of the time.
In 1989. the tobacco industry contributed millions of dollars
to the National Archives to help promote the 200th anniversary of the Bill of Rights.
This action placed the Philip Morris name on millions of television sets for the first time
since tobacco advertising was banned on television nearly 20 years ago. The Coalition on
Smoking OR Health called the campaign -
..........a corporate image advertising blitz that was cleverly designed
to wrap the tobacco company and, by implication, its marketing practices in the
American flag and the first ten amendments to the United States Constitution... The
so-called bill of rights campaign is not about freedom or good corporate citizenship.
It is intended to further the cigarette company's goal of continuing to market its products
to children, minorities, women and blue-collar workers....
Tuckson points out that Philip Morris gave $2.4 milllon to the local chapters of 180 black,
hispanic and women's groups in 1987. Says Tuckson, "The United Negro College
Fund received $267,000 from R.J. Reynolds, $120,000 from Philip Morris and
$32,000 from Brown and Willamson. So they are telling the 18-year-olds going to college,
"We gave you all the money for your education, so you owe us access to your markets.
Although the tobacco industry has developed its own "Code
ot Cigarette Sampling Practices," which details certain standards to be observed
to avoid distributing cigarette samples to under-age children, reports of random
spot-checking of sampling and distribution points prove that such restrictions
are not being observed. Trials observing minors attempting to
purchase cigarettes in Boston, MA, Baltimore, MD, Allentown, PA. Decatur, IL,
Brookline, MA, Worcester, MA. New Brunswick, NJ and many other cities found that minors
were able to purchase tobacco products more than 70 percent of the time.
..........As interim objectives, the following measures are acceptable public policy:
..........a ban on unsupervised vending machines and/or
..........a ban on multi-use vending machine.
Note: Any state law enacted to limit access to tobacco product
vending machines must also clearly recognize that the mere posting of signs is ineffective
in deterring access by minors to tobacco products sold via vending
machines.
..........Additional Countdown 2000 objectives include the following:
..........establish, as the standard, a minimum purchase age for tobacco
products of 18 years of age;
..........adequate and meaningful penalties should be set for both retailer
and minors;
..........require the licensing of retailers comparable to the licenses
issued for the sale of alcoholic beverages. The use of the licensing
fee could be applied toward the costs of enforcement and public education activity;
..........ban the distribution of free or discounted samples; and
..........prohibit, via the mail system, access to tobacco products.
..........Critical to any law that adequately addresses the problems
at access to and distribution of tobacco products to young people is the enforcement
of such laws and regulations. Careful attentlon must be paid to --
..........provision of adequate resources to state and local agencies
charged with enforcement responsibilities,
..........authority to conduct random monitoring of restrictions on
access and distribution of tobacco products to minors, and
..........establishment of mechanisms to facilitate the reporting of
citizen or other complaints to a designated office or department concerning violation
of laws that restrict or prohibit the sale and/or distribution of tobacco products to minors.
Inspection responsibilities should be clearly delegated to such designated offices.
To curb advertising abuses by the tobacco industry, TFA recommends
as a Countdown 2000 objective, enactment of state and local bans
on advertising to the fullest extent permitted by the U.S. Constitution
and not in violation of federal preemption law (Public Health
Cigarette Act of 1969).
Countdown 2000 Objective: As allowed by the U.S. Constitution
and federal law, ban the advertising of tobacco products within each state.
..........Specific objectives could be --
..........a ban on all billboard advertising and advertising on other
public visual displays (scoreboards, etc
..........a ban on all advertising within state supported mass transit
systems; and
..........a ban on all advertising in intrastate media.
Note: There is considerable case law distinguishing the power
at the federal government under the Commerce Clause of the U.S.
Constitution from the powers of the states over Intrastate commerce.
There is even a Supreme Court decision upholding a state's
right to regulate billboard advertising. However, the federal preemption clause
applies to advertising that addresses the relationship between smoking and health.
Therefore, bans on billboard advertising must be inclusive of all advertising.
There is growing dependence by the tobacco industry on promotional
activity to secure new smokers. This is especially true for youth, minorities.
women and the educationally disadvantaged.
Countdown 2000 Objective: Ban tobacco product promotion to
the fullest extent permitted by the U.S. Constitution, including but not limited
to product manipulation, sponsorship, pricing. give-aways (i.e.: T-shirts, hats, etc.),
coupons and product placement.
..........An added objective could be -
Much can be done through grassroots efforts to decrease or
deter the consumption of tobacco products by youth. In the area of education
and empowerment. TFA recommends that grassroots advocates consider the
following additional activity:
..........network with the non-health based institutions (religious
groups, youth clubs, social organizations and community groups) to foster
education, and to ensure promotion of self-esteem;
..........seek mandatory comprehensive school education programs (K-12)
that include tobacco education, emphasizing that tobacco is an addictive gateway
drug and that the tobacco industry deliberately advertises and promotes cigarettes
in ways that lure youth into becoming addicted to their products; and
..........promote and encourage funding for counter-advertising and
counter-promotion aimed at youth.
For minorities, TFA has the following additional goals:
..........Increase the cultural and language relevancy of educational
messages, and
..........increase state funding for minority health programs to support
programs to prevent tobacco use and to address tobacco use cessation.
As a final action, TFA recommends support of applicable sections
of federal legislation that would -
..........provide grants to states for activities that will prevent
the initial use of tobacco products by minors,
..........encourage the cessation of the use of tobacco products among
youth though prohibitions on the sale of tobacco products to minors,
..........improve the enforcement of existing provisions,
..........prohibit the sale of tobacco products in vending machines
unless the presence of minors is not allowed on the premises where the
machine is located.
..........promote and enforce a minimum age of at least 18 for the purchase
of tobacco products,
..........enhance the ability of state health departments to implement
comprehensive planning and intervention activities for anti-tobacco use, and
..........provide education and training to teachers and health care
professionals.
As stated in the Final Report of the Tobacco Use in America
Conference, held in Houston in January 1989.
Studies have shown a relationship between media dependence
on tobacco advertising revenue and coverage of smoking and health topics
Tobacco sponsorship of organizations and events appear to discourage those
organizations from speaking out and educating their constituents about smoking and health.
Cigarette advertizing and promotion also seem to affect and/or promote an
atmosphere in which tobacco use is legitimate, even wholesome, and certainly
acceptable."
We are dealing with an industry whose voluntary code states
that "cigarette advertising shall not suggest that smoking
is essential to social prominence, distinction, success or sexual
attraction." State and local public policy makers must work
within their constitutional and federal legislative constraints
to regulate what the tobacco industry has obviously failed to
do on its own.
Tobacco was one of me first goods taxed in North America, initially
by the British and then by the newly independent Republic in the early 1790s.
The early tax on snuff was eliminated in 1804 and revived briefly as a wartime
measure in 1814. Various federal tobacco taxes were imposed in 1884, including
a tax on cigarettes, as part of a package of taxes to finance the Civil War. In
one form or another, federal excise taxes on tobacco have remained a part of the
tax system. The tax on tobacco was a particularly important source of revenue to
the federal government prior to enactment of the income tax in 1913.
The federal tax on cigarettes over the 120-year period from 1864-1983 tended to
fluctuate with the revenue requirements of the government, corresponding to
alternating periods of war and peace. The federal tax on cigarettes, introduced during
the Civil War, was raised briefly during the Spanish American war, and again during
World Wars I and II. During the Korean War, the federal excise tax was increased
from seven to eight cents per pack. It remained at this level for more than three decades,
and was then temporarily doubled to 16 cents a pack as part of the Tax Equity and
Fiscal Responsibility Act of 1982. After several temporary extensions, Congress made
the l6cent rate permanent in 1986. A federal excise tax on smokeless tobacco was
levied by the Omnibus Budget Reconciliation Act of 1985.
In 1987, federal tobacco taxes grossed $4.8 billion, with more than 98 percent of revenues
provided by the tax on cigarettes. But cigarette excise taxes have contributed a declining
share of total federal revenue since World War II. Moreover, the federal
excise tax has declined in real terms since 1964, despite rising concern about the adverse
health effects of smoking that followed release of the 1964 Surgeon General's Report and
adoption of specific federal tobacco-control policies. One reason for the decline was the
lack of legislated increases in the tax rate.
Inflation also eroded the real excise tax because these taxes tend to be unit rather than
ad valorem taxes. A unit tax is a constant nominal rate per unit of a well-defined
product, whereas the ad valorem tax is a constant fraction of either
wholesale or retail price. Current federal taxes on cigarettes,
cigarette paper and tubes, smokeless and smoking tobacco. and
small cigars, as well as most state, and local taxes on cigarettes, are unit
taxes. Federal taxes on large cigars and most state taxes on non-
cigaratte tobacco products are ad valorem taxes. Cigarette
taxes fall relative to the price cigarettes when cigarette taxes are not changed
by at least as much as the rate of general inflation or the rate of increase in
cigarette prices.
One of the first principles learned in Economics 101 is the
law of downward sloping demand. that Is, the demand for a product declines
as the price increases. Many studies have shown that this theory holds
for tobacco products, especially cigarettes.
Several studies have been conducted to measure the reliability of teenage elasticity.
The General Accounting Office (GAO). in a June 1989 study. concluded
that teenage smokers do respond substantially to changes in cigarette prices.
The GAO report indicates that the range of estimates for teenage elasticity
(ages 12-17) vary from -0.76 to -1.2. Thus, a 10 percent increase in cigarette prices
will result in a decrease in teenage smoking from 7.6 percent to 12 percent.
In 1988 the National Institute on Drug Abuse indicated that 18 percent of high school
seniors (aged 17 and 18) smoked. If you determine that you want to cut this rate in
half or 9 percent, a 10 percent tax increase should accomplish your goal since such
an increase will cut consumption anywhere from 7.5 percent to 12 percent. Should
you determine that you want to eliminate smoking by high school seniors, according
to the elasticity model, an increase of 20 percent or more would be necessary.
Kenneth Warner, PhD., contends in his article, "Health
and Economic implications of a Tobacco-free Society," that the arguments
of both the tobacco industry and tobacco-control activists are fundamentally flawed,
or miss the point. Warner believes that the economic impact of a tobacco-free
society would be modest and of far less consequence than the
principal implication: a significantly enriched "quality and quantity of llfe."
The Warner article, which appeared in the Journal of the
American Medical Association In October 1987, clearly states that the use of
cigarettes causes more premature deaths than AIDS, use of
heroin, cocaine and alcohol, fire, automobile accidents, homicides
and suicides combined. Attainment of a tobacco-free society by
the year 2000 would eliminate 350,000 premature deaths; those
persons spared a tobacco-related death could add 15 years to their
lives. Warner implies that altering the causes of death in the country will
reduce the burdens on health care facilities and shift medical specialties to
other disease areas. He is concerned that the tobacco industry
cites that the demise of the tobacco industry will ruin the U.S. economy, while
tobacco-control activists falsely suggest a multi-billion dollar
fiscal dividend. Both are wrong, according to Warner.
While some in the voluntary health agencies concerned
with tobacco might argue with Warner's characterization of the
debate. we must not lose sight of our goal, which is to increase
the excise tax on tobacco products to deter consumption of these
deadly products. How the additional revenues are spent by our political leaders
is their decision. Although we may be asked to comment on the use of
those funds, our interest is the public's health.
Public policy considerations entrenched in this debate
include the following:
..........How much do you raise the tobacco excise tax at the state
and local level? How does the federal tobacco excise tax effect state and local
taxes? What are the benefits of switching from a specific unit tax to an ad valorem
tax?
..........Do we support efforts to earmark or dedicate a portion of the
increase in tobacco taxes for education programs or related health care costs?
..........How do you counter bootlegging/smuggling arguments?
..........How do you accomplish raising the tobacco excise tax - legislative
process or through Initiative and referendum?
Selecting the appropriate level for a state tobacco excise
tax compliments the legislative activity suggested in the previous
section, Targeted Populations: Youth Minoities, Women and the
Educationally Disadvantaged, by adding a further tool
to the arsenal available to deter young people and other targeted
populations from taking up the addictive habit of tobacco use.
State officials continue to be concerned that an increase in
tobacco excise taxes at the federal level would adversely affect their own revenues.
Studies show that this has not happened primarily because some states increased
their excise taxes at the same time as the federal government
Countdown 2000 Objective: Achieve an increase in the state
and/or local tobacco excise tax sufficient to deter tobacco use by young people.
There are a variety of strategy options available to determlne the appropretate level
of increase for a state or local tobacco excise tax, including:
..........With the exception of Hawaii, all federal, state and local
tobacco excise taxes are specific unit taxes, that is a spectfic set amount per
pack of cigarettes. This formula is used because of its administrative simplicity.
Yet the negative effect is that real revenue tends to decline with inflation. Unit excise
taxes must be raised periodically if real revenues and the impact on consumption
are to be maintained. An option for consideration is replacing the unit excise tax
with an equivalent yield ad valorem tax, which is a constant fraction of either
retail or wholesale price.
..........Another option is to index the unit tax to changes in either
the general price level or to a price index for cigarettes and other tobacco products.
..........A final option is to consider use of the teenage elasticity figures (-0.76 to -1.2) to
compute the tax increase for your state or locality.
..........Other issues to consider when determining the level of taxation
include the tax level in neighboring states or localities, date of last increase and
tax level on other tobacco products if only a cigarette tax increase is under consideration.
..........An excise tax increase may be justified based on the fact that
a higher cost for the product may be a deterrent to a practice-tobacco use-that has
an undesirable health consequence. Thus, new revenues may be earmarked to
various public need including the costs of health care, public and/or school education,
or counter-advertising and promotion measures.
..........The possibilities of bootlegging and smuggling are often used
as objections to raising tobacco excise taxes. Officials are concerned about losing
revenues to neighboring states or localities. Such problems can be resolved by raising
the level of taxation to meet or surpass the rate in surrounding areas.
..........State excise taxes can be legislated by governmental jurisdictions
or by citizen petition. The lobbying efforts of tobacco companies frequently make it
difficult to increase state
excise taxes on tobacco products by the state legislature.
In these circumstances, the initiative process has proven to be an effective vehicle for
changes in those states that allow initiatives or referendum.
..........Undertaking the initiative/referendum process requires an abundance
of resources, both human and financial. To be successfull, proponents need a
strategic political/media pian to deal with this high stakes process and the well-financed
tobacco industry. Only 25 states allow initiatives and referendum. The table on the
following page provides information on each state's requirements.
..........In many states, tobacco products are exempt from state or local
sales tax. Consider the removal of any exemption clauses, if your
state has such language in its taxation code.
From a public health policy perspective, a primary focus of
the excise tax increase on all tobacco products is the deterrence of smoking.
Since the tax increase also will generate substantial income, each state will need to
establish guidelines on how to use that revenue.
Support for new tobacco excise taxes can be expected from various
interest groups with sometimes differing perspectives on government funding priorities.
Consequently, it is important to bring together early in the campaign
process those whose perspectives should be reconciled to assure
a successful outcome.
As states begin to implement the Countdown 2000 Blueprint
for Success, the Tobacco-Free America legislative Clearinghouse will play
an extremely important role.
It is essential that the Clearinghouse be considered the primary
resource center in any coordinated effort to secure new excise taxes on tobacco
products.
According to U.S. Surgeon General, as many as 5,000 nonsmoking
die each year of diseases caused by inhaling smoke released into the air tobacco
products. Environmental tobacco smoke (ETS), is second only to asbestos in
causing more deaths than all other known airborne polluants combined.
While much is known about the adverse health consequences of
tobacco use by smokers, recent reports also show a clear health danger to
nonsmokers. As a result, public policy debate by local, state and federal lawmakers
has focused on protecting nonsmokers from ETS.
According to the 1990 Tobacco Free America Legislative Clearinghouse
report, State Legislated Actions on Tobacco Issues, *45
states and the District of Columbia restrict smoking in some manner
in public places. These laws, coupled with those at the local
level, range from simple (banning smoking on school buses while they operate)
to comprehensive (restricting smoking in most public places,
including restaurants and all work places).
While there has been a dramatic proliferation of smoking control
laws over the past three years, the policy debates that have erupted in local and
state legislative chambers have proved that the tobacco industry has raised the
stakes by abandoning the political strategy of opposing all smoking
control laws to pushing for laws that preempt local action
and classify smokers as a protected class.
Across the country, the tobacco industry is working to consolidate
its power In the statehouse. State legislatures provide a forum more conducive to
working through poliItical process, including campaign contributions,
well-placed and well aspected highly paid lobbyists and legislative
maneuvers controlled by institutionalized power brokers. The
tobacco industry is in a damage control mode on smoking control laws and would
prefer to use the state political system where citizens have less access
to lamakers, as opposed to localities where public opinion
generates policy change more rapidly.
To effectively counter this strategy, public health advocates
need to work for public indoor smoking control laws that adhere to the highest
public health standards - standards that meet the daunting health risk posed
by tobacco use and exposure to others' tobacco use.
To meet this challenge,it is vital that public health advocates
establish firm public policy
positions that define basic goals and establish the parameters
for negotiation stategies. While the political climate in a given legislative
body may not be conducive to achieving all of the goals articulated
in this Blueprint for Success, it is crucial for smoking-control
advocates to secure restrictions on smoking in child care facilities, educational
institutions and the work place. These are absolutes. Other provisions in public
indoor smoking-control laws may be used as points of negotiation,
leverage to ensure inclusion of the priority affecting children and occupational
protection.
Restrictions on smoking in public places remain a keystone
in the overall challenge to achieve a tobacco-free society. To accomplish the
public health goals inherent in this arena, TFA recommends that a series of
provisions be adopted to provide uniform protections for the nonsmoker. Priority
emphasis should be placed on achieving restrictions that provide
protection for children and the adult workforce. Protection of children is not only a
public health imperative but is essential to set a healthful example that could prevent
children from becoming addicted to tobacco later in life. The latter requires restrictions
on the use of tobacco products by teachers and other school personnel
while on school property.
The work place is targeted for priority action because working
adults spend a significant portion of their waking hours--eight or more hours per day,
five days per week-at work. Daily exposure to tobacco smoke poses an unnecessary
health risk and therefore; elimination of tobacco smoke exposure
becomes another critical public health goal that should lead
to increased produvtivty, decreased empIoyee health problems and a safer work
environment.
Countdown 2000 Objective: Enact a comprehensive Clean Indoor
Air statute to ensure elimination of exposure to environmental tobacco smoke.
..........Comprehensive statutes should include the following provisions:
..........A prohibition on smoking in all child care facilities,
including any portion of a facility whose purpose is the care and/or
pre-school education of children.
Note: Regulatory initiatives may be appropriate
to achieve this objective by accessing the jurisdiction of day
care licensing agencies.
..........A prohibition on smoking on school property, including
any portion of a facility whose purpose is the education and/or care of students
in facilities of higher education, every effort should be made to prevent tobacco
use on school property, accept for private residences on such property. Educational
facilities are public and private, schools, elementary and secondary schools,
colleges, universities and other educational and vocational institutions.
Note: Regulatory initiatives may be appropriate to achieve
this objective by accessing the jurisdiction of school boards
and other licensing agencies. Further, many educators and staff
are employed under collective bargaining agreements, therefore, work place
restrictions exceeding state or local restrictions should be negotiated through
the collective bargaining process.
..........A prohibition on smoking in all private and public
work places. Work places are any area in a place of employment where one or
more employees are assigned and perform services for their employer. Work
places include offices, factories, warehouses, food service establishments
and other places of employment. Specified areas should include
meeting and conference rooms, and other areas generally used by employees to
carry out their work.
..........A prohibition on smoking in all health care facilities.
Health care facilities include hospitals, health care clinics and laboratories,
and community health care centers.
Note: Regulatory initiatives may be appropriate
to achieve this objective by accessing the jurisdiction of licensing
agencies responsible for accrediting such facilities.
..........A prohibition on smoking on all forms of public
transportation including buses, trains, subways and taxis.
..........A prohibition on smoking in food service establishments
except in designated areas. The food service establishment (restaurant)
provision should be prevalenced-based. Thus, a restaurant will be smoke-free,
except in a designated area whose size is determined by the
national percentage of nonsmokers to smokers (i.e.: in 1989,
approximately 70 percent of the population was comprised of nonsmokers,
thus, 70 percent of any food service establishment should be designated
smoke-free). A food service establishment is any indoor area open
to the public or portion thereof in which the primary business
is the sale of food for on-premises
consumption including, but not limited to, restaurants, cafeterias,
coffee shops, diners, sandwich shops and short-order cafes. A bar is
defined as any indoor area open to the public and devoted to the sale
and service of alcohol beverages for on-premises consumption of such
beverages. Service of food is considered incidental if the
food service generates less than 40 percent of total gross sales. Any
bar that generates 40 percent or more at total annual gross
sales from the sale at food for on-premises consumption should
be considered a food service establishment.
..........A prohibition on smoking in indoor areas open to
the public including auditoriums, elevators, gymnasiums, enclosed indoor
areas containing a swimming pool, public buildings (any building
owned or operated by the state or any county, city, town, village
or other political subdivision, public improvement, or special district, public
authority. commission, agency or public benefit corporation; or any other
separate corporate instrumentality or unit of state or local government),
theaters, museums, libraries, indoor common areas, waiting
rooms, banks, rest rooms and waiting areas in public transportation
terminals.
..........Any comprehensive Clean Indoor Air statute must
not contain any preemptive clauses that are intended to remove power
and authority to regulate the indoor environment from a unit of local
government. Preemption clauses have been attached to laws restricting
smoking in public places in six states. A new form of preemption was recently
passed in Virginia (1990) that was disguised as a "local option."
Local option permits localities to enact ordinances that further restrict smoking
in public places; however, the local legislation must conform to a "model"
bill laid out in the state law. Because the state law dictates to localities what language
they use, this local option clause serves as a disincentive for localities to take
action. Preemption clauses may serve to weaken stronger pre-existing local laws,
preclude stronger local laws from being passed in the future and run contrary to the
usual legislative procedure of setting minimum standards that local governing
bodies may exceed.
..........Any comprehensive Clean Indoor Air statute must not contain
provisions that provide civil rights protection for smokers against employment
discrimination.
This type of legislation prohibits employers from requiring
as a condition of employment that an individual be a nonsmoker. All employers
in the state would be prohibited from firing or refusing to hire a person who
smokes when not on the job. While such legislation does not allow
smokers to violate smoking restrictions in the work place,
it would deter employers from voluntarily extending smoking restrictions out of fear
of litigation. For those concerned about equal rights regardless of race,
color, sex, religion or other individual characteristics that
we cannot control, anti-discrimination clauses are an offensive.
inserted by the tobacco industry to muddy the public health debate over
tobacco access and use. Some tobacco industry initiated legislation purports
to "protect the civil rights of smokers' by elevating smokers to a protected
class of individuals, putting them on a par with women, minorities,
handicapped persons and the elderly. In fact such legislation
provides greater protectton to smokers by allowing them to take their cases
directly to the courts and, therefore, bypass the state body with jurisdiction over
other discrimination cases. Other civil rights statutes that have been carefully and
thoughtfully crafted by legislatures and interpreted by the courts over the years provide
protection for those who truly need it. Categorizing smokers as a protected class
trivializes and skews the concept of civil right. Cigarette smoking is a dangerous
health hazard. Anti-discrimination laws are designed to protect persons whose basic
individual rights are under attack. Hundreds of smoking-control laws across the country
stipulate that in cases of dispute between a smoker and nonsmoker, the nonsmokers's
wishes prevail. Anti-discrimination laws would serve to negate such stipulations. In
addition, an anti-discimination law would give a smoker the power to bring suit against
both the employer and the nonsmoker with whom there is a grievance.
Despite the tobacco industry's predictions that smoklng-control
laws and policies will cause problems in the work place, hamper
economic development, impose an undue regulatory and financial
burden on business, to date the industry has yet to produce independent
evidence that corroborates these claims.
In fact, the overwhelming popularity of smoking-control policies
has led government and business alike to provide enhanced protection for
their workers and patrons.
The provisions articulated in this Blueprint for Success are not
designed to pit smokers against nonsmokers. They are not intended to force
people to stop smoking. If laws are established based on the public health
principles advanced in this document they will prevent the involuntary exposure
to an indoor environmental toxin.
Many state and local governments already have established
sound smoking-control laws. Many others have taken tentative,
although inadequate, steps to address the health threat posed
by involuntary exposure to environmental tobacco smoke.
The Tobacco-Free America Legislative Clearinghouse serves as
the primary national source for information on tobacco-control
initiatives for the voluntary public health community, state and
local government officials and the media. This is a valuable resource
that tobacco-control advocates are urged to utilize.
American Medical Association. Final Report: Tobacco Use in
America Conference. 1989.
American School Health Association, Association for the Advancement
of Health Education, Society for Public Health Education, lnc.
National Adolescent Student Survey, 1987.>
Munoz, Helen. "Tobacco Advertising: Selling Disease to
Hispanics." Testimony before the Subcommitttee On Transportation
and Hazardous Materials, U.S. House of Representatives. Washington, DC.
March l, l990.
Rivo. Marc L, Kofie, Vincent, Schwartz, Eugene, Levy, Martin
E., Tuckson, Reed V. "Comparisons of Black and White Smoking: Attributable
Mortality, Morbidity and Econontic Costs In the District of Columbia," Journal at
the National Medical Association. Vol.81, No.11, 1990.
Sullivan, Louis W. Remarks at news conference. Washington.
DC. February 23, 1990.
Talbot, Bruce R. Testimony before the Committee on Labor and
Human Resources, U.S. Senate. Washington, DC. April 3, 1990.
Tobacco-Free America. Tobacco Sampling: There is No Free Lunch.
April 1990.
Tye, Joe B. "Tobacco and Youth Reporter." All issues.
Palo Alto. CA
U.S. Department of Health and Human Services. Smoking and Health:
A National Status Report 1990.
American Medical Association. Final Report: Tobacco Use in
America Conference. 1989.
Council of States Governments. Book of the States: 1990-91.
Manning, Willard G., et al. 'The Taxes of Sin," Journal
of the American Medical Association. March 17, 1989.
Office at the U.S. Surgeon General. Reducing the Health Consequences
at Smoking: 25 Years of Progress, a Report at the Surgeon General. U.S.
Department at Health and Human Servicet 1989.
U.S. General Accounting Office. "Teenage Smoking: Higher
Excise Tax Should Significantly Reduce the Number at Smokers."
June 1989.
Warner, Kenneth. "Health and Economic Implications at
a Tobacco Free Society.~ Journal at the American Medical Association.
October 16.1987.
Advocacy Institute and Public Citizen. The Advocates Guide
to Preemption: Preserving State and Local Protection for Public
Health and Safety. Washington, DC. 1990.
Garner, Donald. Fair Treatment for the New Minority. 1990.
Sylvester, Kathleen."The Tobacco Industry Will Walk a
Mile to Stop an Anti-Smoking Law." Governing.. May 1990.
Tobacco-Free America Legislative Clearinghouse. Anti-discnmination
Protection for Smokers. Washington, DC. 1990.
Tobacco-Free America Legislative Clearinghouse. Guidelines
for State Legislative Procedures. Washington, DC. 1990.
Tobacco-Free America Legislative Clearinghouse. Preemption:
Restrictions on Smoking in Public Places. Washington, DC. 1990.
Tobacco-Free America Legislative Clearinghouse. State Laws
Restricting Smoking on School Property. Washington, DC. 1989.
Tobacco-Free America Legislative Clearinghouse. State Legislated
Actions on Tobacco Issues. Washington, DC. 1990.
U.S. Department of Health and Human Services. The Health Consequences
of Involuntary Smoking: A Report of the Surgeon General. Washington,
DC. 1986.
Drafting Committee
Charles A. LeMaistre, M.D., Chair
President, University of Texas M.D. Anderson Cancer Center,Houston, Texas
TARGETED POPULATIONS: YOUTH, MINORITIES, WOMEN AND THE EDUCATIONALLY
DISADVANTAGED
Reed V. Tuckson, M.D., Subcommittee Chair
Volunteer, American Lung Association
Senior Vice President for Programs, March of Dimes, White Plains,New York
Former Commissioner, District of Columbia Public Health Commission,
Washington, DC
American Heart Association, Washington, DC
Association, Washington, DC
Affiliate, Salt Lake City, Utah
Relations and Special Projects, American Cancer Society, Atlanta, Georgia
TOBACCO EXCISE TAXES: RAISING THE COST OF TOBACCO
Mary Sandberg, Subcommittee Chair
Assistant Director of Public Issues, American Cancer Society, California
Division, Los Angeles, California
Richmond, Virginia
Texas, M.D. Anderson Cancer Center, Houston, Texas
Cancer Society, Washington, DC
RESTRICTIONS ON SMOKING IN PUBLlC PLACES
Hon. Alexander "Pete" Grannis, Subcommittee Chair
New York State Assemblyman, New York, New York
Association, Washington, DC
Thoracic Society, Office Of Government Relations, Washington,DC
Former Executive Director, Institute for the Study of Smoking Behavior and
Policy, Harvard University, Cambridge, Massachusetts
Cancer Society, Lennox, South Dakota
ADVOCACY
Patricia M. Hudgins, Ph.D., Subcommittee Chair
Volunteer, American Heart Association
Kirksville College of Osteopathic Medicine, Kirksville. Missouri
Washington, DC
BLUEPRINT FOR SUCCESS
Preface
Targeted Populations
Tobacco Excise Taxes
Restrictions an Smoking in Public Places
The Challenge
Introduction
---------Environmental groups---------------------- Smokers for tobacco-control
---------Minority groups ------------------------------Religious organizations
---------Older Americans -----------------------------Unlikely allies
---------Women's groups -----------------------------Other professional associations
---------Educational groups --------------------------Political parties
---------Civic and community organizations------Sports organizations
---------State and local governments---------------Celebrities
---------Youth groups-----------------------------------Arts and cultural organizations
---------Non-tobacco related businesses-----------Insurance companies
---------Unions -------------------------------------------Victims
and the Educationally Disadvantaged
Facts & Figures
Tobacco Promotion
Access & Distribution
Philanthropy
Countdown 2000 Legislative & Regulatory Objectives
Access to and Distribution of Tobacco Products
Countdown 2000 Objective: Achieve a ban on cigarette and tobacco
product vending machines.
Advertising
Promotion
funds raised through tobacco product excise taxes should be
earmarked to support altematlve sponsorship of community-related activities.
Other Policy Considerations
Conclusion
Raising the Cost of TobaccoGOAL:
..........To increase, at a substantial rate,
the existing state and local excise taxes on all tobacco products to deter
consumption, especially among young people.
RATIONALE:
.....Sixty percent of current smokers start
by age 14, 90 percent by age 19. Research indicates that teenagers are
more price-responsive and use less tobacco when the price increases.
Price Elasticity & Demand for Tobacco Products
Health Impact of Tobacco Excise Taxes:
A Look at the Debate
Policy Considerations
Countdown 2000 Legislative & Regulatory Objectives
Tobacco Excise Taxes
..........Strategy Option 1: Level of Taxation
..........Strategy Option 2: Earmarking
..........Strategy Option 3: Bootlegging and Smuggling
..........Strategy OPtion 4: The Legislative Process vs. An
Initiative or Referendum
..........Strategy Option 5: Exemption Clauses
Conclusion
GOAL:
..........To protect public health, exposure
to environmental tobacco smoke should be eliminated.
Rationale:
..........Establishment of public indoor control
laws will protect public health by effectively reducing involuntary exposure to
environmental tobacco smoke.
Countdown 2000 Legislative & Regulatory Objectives
Restrictions on Smoking in Public Places
Conclusion
Sources of Additional Information
Targeted Populations
Tobacco Excise Taxes
Restrictions on Smoking in Public Places
END OF DOCUMENT