New Tobacco Industry Strategy Is to Appear Anti-Tobacco, UCSF Study Concludes

The tobacco industry has developed an elaborate strategy to craft, lobby, and campaign for proposed pro-tobacco laws that masquerade as tobacco control measures, says a University of California San Francisco health policy researcher.

“The tobacco industry was nearly successful in tricking California voters into repealing their own tobacco control laws, and in preventing enactment of the new statewide smoke-free bar law that just took effect on January 1,” concludes Stanton A. Glantz, phd, a professor of medicine at UCSF and senior author of a new case study of the California Uniform Tobacco Control Act, proposition 198 on the 1994 statewide ballot.

Glantz, a UCSF faculty member with the Institute for Health Policy Studies and the Division of Cardiology, and coauthors Heather Macdonald and Stella Aguinaga, reported their findings in the December 1997 issue of the American Journal of Public Health.

Proposition 188 was a tobacco industry-sponsored statewide ballot initiative that went down to defeat in November 1994 after leading in the polls for much of the campaign, and according to Glantz, despite an expenditure of $18 million by tobacco interests.

The tobacco industry continues to employ its new strategy, but these efforts can be successfully fought by novel strategies on the part of health-promoting groups, according to the UCSF research team.

“The tobacco industry now is trying to convince Congress to pass a so-called global settlement of tobacco litigation. This is being presented as anti-smoking legislation, but actually it would be a bailout for the tobacco industry,” Glantz says.

The new UCSF study indicates that nonprofit charitable foundations and public health advocacy groups can affect election outcomes through nonpartisan voter education efforts and independent campaigns that clarify the content of ballot measures and reveal funding sources.

Tobacco Industry Masks Sponsorship of Ballot Question

The proposition 188 campaign was marked by novel strategies by both opponents and proponents of the measure, according to the case study. Tobacco industry giant Philip Morris sought to mask its sponsorship of the ballot measure, and proposition 188 was presented as a tobacco control initiative, but actually it would have invalidated existing local tobacco control measures and prevented enactment of new tobacco control measures, the research team concludes.

This strategy marked a departure from traditional tobacco industry campaigns, which had focused on challenging the scientific evidence that secondhand smoke endangers health and is a leading preventable cause of premature death, according to Glantz.

Consistent with efforts to minimize their exposure as the supporters of proposition 188, Philip Morris hired a consulting group to organize a front organization called Californians for Statewide Smoking Restrictions, the UCSF researchers report.

The organization presented itself as a coalition of small business and restaurant owners and of concerned California citizens, despite the fact that their campaign was almost entirely funded by the tobacco industry, Glantz says. The case study indicates that the tobacco industry campaign relied heavily on direct mail, in an often successful effort to avoid media coverage, and on lack of public awareness regarding the true nature of the ballot measure and of tobacco industry support for it.

Antismoking groups one-by-one developed their own individual responses to the tobacco industry campaign. These generally focused on exposing tobacco-industry support for proposition 188 and on clarifying the potential impact of initiative passage. In the absence of a difficult-to-achieve, but historically sought-after consensus on opposing strategies, the combined individual responses of these groups nonetheless collectively contributed to the defeat of proposition 188, the UCSF researchers suggest.

According to polls, proposition 188 was far ahead in July because the public thought it was an anti-tobacco measure, Glantz says. The initiative still faced even chances of passage in September. But the American Cancer Society had earlier surveyed California voters and determined that they would be likely to vote against a ballot initiative if they knew that it was supported by the tobacco industry. The tobacco industry had acquired similar information from their own survey research, Glantz notes.

In their subsequent efforts to defeat proposition 188, antismoking groups—including the American Lung Association, American Medical Association, American Heart Association, and Americans for Nonsmokers Rights—focused on making it clear to voters that the tobacco industry was behind proposition 188, the UCSF study reports.

Educational Campaigns by Nonpartisan Groups Essential

Tobacco industry efforts to obscure the true nature of the ballot initiative augmented the importance of educational campaigns by nonpartisan groups to clarify the measure for voters, Glantz says.

In this case, the California Wellness Foundation funded a major nonpartisan educational campaign by the Public Media Center, a San Francisco public interest advertising agency. The Public Media Center created a public education campaign that took no position on proposition 188. Instead, the education campaign highlighted important public information already printed in the official voter handbook and identified who was actually supporting and opposing the initiative, Glantz says.

On November 8, 1994, proposition 188 failed, receiving the support of just 29% of California voters. Almost one-fifth of these supporters still believed that the initiative was an antismoking measure, the study notes.

According to Glantz, “Funding by charitable health-promoting foundations of educational campaigns and the strategy of publicizing major donors may be applicable to other issues in which public health interests conflict with the goals of large industries. These include campaign finance reform, insurance reform, alcohol control, and environmental issues.”