Michael S. Givel

Tobacco lobby political influence on US state legislatures in the 1990s

BACKGROUND Throughout the 1990s the tobacco lobby was a potent political force in US state legislatures advancing its pro-tobacco agenda. OBJECTIVE To describe the market and political motivations of the tobacco lobby and the strategies they use to achieve these goals in US state legislatures. DESIGN This study is a content analysis and summary overview of recently released historical tobacco industry documents; tobacco related government documents; and recent state tobacco control policy reports. RESULTS In the 1990s, the tobacco lobby engaged in a comprehensive and aggressive political effort in state legislatures to sell tobacco with the least hindrance using lobbying, the media, public relations, front groups, industry allies, and contributions to legislators. These efforts included campaigns to neutralise clean indoor air legislation, minimise tax increases, and preserve the industrys freedom to advertise and sell tobacco. The tobacco lobby succeeded in increasing the number of states that enacted state pre-emption of stricter local tobacco control laws and prevented the passage of many state tobacco control policies. Public health advocates were able to prevent pre-emption and other pro-tobacco policies from being enacted in several states. CONCLUSIONS The tobacco lobby is a powerful presence in state legislatures. Because of the poor public image of the tobacco lobby, it seeks to wield this power quietly and behind the scenes. State and local health advocates, who often have high public credibility, can use this fact against the tobacco lobby by focusing public attention on the tobacco lobbys political influence and policy goals and expose links between the tobacco lobby and its legislative supporters.

Tobacco control and direct democracy in Dade County, Florida: future implications for health advocates.

In 1979 and 1980 in Dade County, Florida, a small grassroots advocacy group, Group Against Smoking Pollution (GASP), attempted to enact a clean indoor air ordinance through the initiative process. The tobacco industrys successful efforts to defeat the initiatives were expensive high-tech media-centered campaigns. Even though GASPs electoral resources were extremely limited for both initiatives, GASP utilized similar media-centered tactics. This approach attempted to defeat the tobacco industry in its own venue, in spite of the tobacco industrys vastly greater resources. Nevertheless, the industry defeated these ordinances by narrow margins because of broad voter support for the initiatives before the industry started its campaigns. Health advocates will never have the resources to match the tobacco industry in expensive high-tech media-centered initiative campaigns. Rather, their power lies in the general popularity of tobacco control legislation and their ability to mobilize broad grassroots efforts combined with an adequately funded media campaign.

Consent and counter-mobilization: the case of the national smokers alliance.

Throughout the 1990s, health advocates engaged in a significant mobilization against the dangers of tobacco use and the tobacco industry. In 1993, the tobacco industry countermobilized through the National Smokers Alliance (NSA), a public relations created front group funded by the tobacco industry, which operated nationally from 1994 to 1999 to advocate for adults using tobacco products without vigorous regulation or increased tobacco taxes. The mobilization by health groups utilized traditional political lobbying and education of the public and public officials without a national public relations created front group to mold public opinion. The countermobilization by the NSA was based on traditional lobbying approaches in conjunction with the use of the public relations oriented consent engineering theory of Edward Bernays, Harold Lasswell, and others. This consent engineering theory calls for public relations specialists using public relations to mold public opinion to support a clients preferred public policy outputs. Despite the use of traditional lobbying in conjunction with the use of public relations efforts, attempts by the NSA to dominate public policy to weaken or neutralize stronger tobacco regulations and taxes were effective only for some campaigns.

Limited state progress in regulating secondhand tobacco smoke.

From 1990 to 2005, U.S. state legislation on secondhand tobacco smoke significantly increased in eight public areas: general public areas, government buildings, private workplaces, schools, child care facilities, health care facilities, restaurants, and bars. Despite the U.S. Surgeon Generals proclaiming in 2006 that “rapid progress” is being made in state legislation on clean indoor air, vigorous state smoke-free secondhand tobacco smoke legislation in six public area categories was minimal, which has favored the policy agenda of the corporate tobacco lobby. Two exceptions include smoke-free legislation for child care facilities and schools. While public interest group health advocates have traditionally used insider lobbying of public officials in the “halls of power” to pass smoke-free legislation, this should be supplemented with astute outsider advocacy tactics such as public demonstrations or issue advertisements to increase the likelihood of passage of more state-level smoke-free legislation.

Neoliberal and Public Health Effects of Failing to Adopt Osha's National Secondhand Tobacco Smoke Rule

From the early 1980s to the present, neoliberal doctrine has called for government policies of privatization, funding cutbacks, and deregulation of public health and other domestic social programs in the belief that the market rather than the public sector can best organize and distribute crucial societal services. Proponents of a neoliberal and deregulatory mixed approach of command and control and self-regulation argue this approach provides the most adequate means to conduct regulation in the legalistic and adversarial U.S. regulatory process. In April 1994, the Occupational Safety and Health Administration issued a proposed rule to eliminate tobacco smoking in most workplace rooms, arguing secondhand tobacco smoke annually killed up to 13,700 nonsmokers. The tobacco industry purposely delayed public hearing procedures (later halted altogether by Congress and the president) primarily to advance unhindered private property rights and profits rather than submitting to a public command-and-control regulatory framework to reduce deaths due to secondhand tobacco smoke.

In Search of the Less Hazardous Cigarette

Since the 1950s, despite considerable and long-term tobacco industry and government efforts, attempts to develop a less risky cigarette that reduces harmful ingredients, generally or specifically, have failed. Moreover, even under ideal conditions with adequate scientific testing, the efficacy of purportedly reducing the severe health effects cannot be scientifically verified for up to 20 years after introduction of a product on the market. A key and central provision in the 2009 U.S. Food and Drug Administration (FDA) legislation is to reduce the risk or harm of cigarettes. Because creating a less risky cigarette is not currently possible, this renders the efficacy of the 2009 FDA legislation highly uncertain, with a large risk that the proposed program may not reduce harm.

History of Bhutan's prohibition of cigarettes: Implications for neo-prohibitionists and their critics

BACKGROUND Recently, cigarette neo-prohibitionists have argued that a cigarette ban can be obtained from a de-facto phase-out of cigarettes based on a combination of effective anti-tobacco regulations and high taxes in conjunction with aggressive application of nicotine replacement therapies. The purpose of this study was to ascertain whether these claims were valid in Bhutan, which enacted a national cigarette sales prohibition law in 2004. Did Bhutan from 2004 to 2009 eliminate or nearly eliminate cigarette consumption and avoid a significant cigarette black market and smuggling? METHODS This study is a historical, qualitative, descriptive statistical, and archival content overview from 2004 to 2009 of smoking prevalence rates and smuggling and black market trends subsequent to the enactment of the Bhutan Penal Code Act of 2004. RESULTS For adults in Bhutan, tobacco prevalence rates are fairly low compared with other nations but in 2008 remained a serious health issue for those who consumed cigarettes. For minors, tobacco consumption and second hand smoke exposure in 2008 was a significant health issue. In addition, the best available evidence indicates that illegal tobacco smuggling including black market sales due to the sales ban in Bhutan remains robust. CONCLUSIONS So far, in Bhutan, cigarette neo-prohibitionist arguments that stringent anti-tobacco tax and regulatory approaches including a sales prohibition will induce tobacco consumption to cease or nearly cease has not occurred. In addition, the best scientific evidence indicates that a harm reduction-oriented nicotine replacement therapy approach will not be entirely effective. The results of this study provide an important lesson learned for health practitioners and advocates considering or advocating, albeit a gradual, but total cigarette ban as public policy.

Modern Neoliberal Philanthropy: motivations and impact of Pfizer Pharmaceutical’s corporate social responsibility campaign

Abstract One of Pfizer Pharmaceutical’s general corporate goals is that no person anywhere should be restricted from receiving essential and affordable medicines. From 2009 to 11 Pfizer’s internal corporate social responsibility (csr) programmes were private corporate efforts that were discretionary and limited in scope and impact. All Pfizer’s csr preferred public policy governmental positions encompassed neoliberal government requirements based on market and profit considerations, with no positions demonstrating, in detail, how universal provision of drugs for all would be provided. Currently Pfizer’s csr efforts represent a dichotomy when compared with the general corporate goal of not restricting essential and affordable medicines in order to provide medicines for all.

Deconstructing Social Constructionist Theory in Tobacco Policy: The Case of the Less Hazardous Cigarette

Scholars in tobacco control have utilized a social construction approach to test and explain tobacco control policy and advocacy. Some recent tobacco control policy research has contended that Philip Morriss support of the U.S. Food and Drug Administration (FDA) regulation of tobacco (including purportedly reducing the harm of cigarettes) is to obtain the social construction goal of a socially responsible company. However, the primary motivation for Philip Morriss support of proposed FDA regulation and harm reduction for cigarettes was to maintain the companys market stability and profitability implemented by U.S. political process and institutions. In tandem with this, Philip Morris also sought political stability, a new company image, and federal preemption of conflicting and costly state requirements for harm reduction and tobacco ingredients. Social construction theory did not explain Philip Morriss motivation for seeking FDA regulation of tobacco. Only by reducing tobacco industry markets and customer use will there be a significant reduction in tobacco consumption.

Campaign to counter a deteriorating consumer market: Philip Morris's Project Sunrise

OBJECTIVES From 1997 to 2000, Philip Morris implemented Project Sunrise. This paper discusses the impact of this project on national and Philip Morriss cigarette unit sales, public opinion about smoking and secondhand tobacco smoke, and national prevalence trends for tobacco use. STUDY DESIGN A qualitative archival content analysis of Project Sunrise from 1997 to 2000, and a descriptive statistical analysis of cigarette unit sales and operating profits, acceptability of smoking and secondhand tobacco smoke, and national prevalence trends for tobacco use from 1996 to 2006. METHODS Qualitative data sources related to Project Sunrise found on WebCat, Pubmed.com, LexisNexis Academic and Philip Morriss website, and archived tobacco industry documents were analysed using NVivo Version 9.0. A descriptive statistical analysis of cigarette unit sales, public opinion about smoking and secondhand tobacco smoke, and national prevalence trends for tobacco use was undertaken. RESULTS Project Sunrise was a high-level strategic corporate plan to maintain profits that included four possible scenarios resulting in seven interwoven strategies. However, national prevalence rates for tobacco use declined, sales of national and Philip Morris cigarettes declined, operating profits remained at substantially lower levels after 2000 from 2001 to 2006, and a large majority of Americans agreed that there were significant health dangers associated with smoking and secondhand tobacco smoke. CONCLUSION The impact of Project Sunrise, including countering the anti-tobacco movement, was less than successful in the USA.