The High Cost of Compromise: Tobacco Industry Political Influence and Tobacco Control Policy in Virginia, 1977-2009

• Tobacco use is the leading preventable cause of death in Virginia, taking more than 9,200 lives each year. Tobacco-induced healthcare costs are $1.92 billion annually, including $369 million in Medicaid payments. • The growth of tobacco, and its importance to the economy of Virginia, has declined significantly. In 2008, tobacco was only the fifth most harvested and valuable crop, behind hay, corn, soybeans, and wheat, and constituted only 2.3% of the value of all Virginia agricultural products sold. • Virginia is becoming increasingly urban and its citizens are less concerned with Virginia’s tobacco heritage. Significant majorities of Virginians support stronger clean indoor air laws and higher cigarette taxes. In 2009, 75% polled supported strong clean indoor air laws. • The tobacco industry has a significant presence in Virginia: Philip Morris has a large manufacturing and corporate presence in the Richmond area. • The tobacco industry’s lobbying expenditures have significantly exceeded spending by tobacco control advocates. The industry also built strong ties to hospitality groups, trade associations, and tobacco growers to oppose tobacco control measures. • Republican legislators are significantly more supportive of the tobacco industry control than Democrats, who are more supportive of public health. • The tobacco industry gave about twice as much money to Republicans than Democrats. Controlling for party and legislative house, greater tobacco industry campaign contributions are statistically significantly associated with more pro-tobacco industry policy behavior. • Between 1970 and 2008, 70 cities and two counties imposed local cigarette excise taxes, an attractive and politically nonvolatile source of revenue. The tobacco industry has not been able to counter this activity. • Prior to 1990, many localities enacted local clean indoor air ordinances. Despite strong support among Virginians for clean indoor air laws and a growing movement among localities for local tobacco control, these measures were blocked in 1990 by the passage of the weak preemptive statewide Virginia Indoor Clean Air Act (VICAA). • Virginia was selected by the National Cancer Institute in 1990 to participate in the 17-state American Stop Smoking Intervention Study (ASSIST). ASSIST established a network of local tobacco control coalitions through Virginia Department of Health. Organizational issues and strong industry interference prevented ASSIST from accomplishing its mission of reducing smoking through policy change. • Virginia was awarded a Robert Wood Johnson Foundation SmokeLess States (SLS) grant in 1994 to support lasting statewide coalitions to reduce tobacco use; the effort failed in Virginia. • Virginia SmokeLess States was involved with the successful Southern Communities Tobacco Project to bring tobacco farmers together with tobacco control advocates; this effort accomplished little substantive change in tobacco control policy in Virginia. • In 1998, Virginia was part of the Master Settlement Agreement (MSA) between 46 states and the tobacco industry and will to receive about $4 billion from the settlement over 25 years. Virginia committed 10% of the proceeds to a youth-only tobacco control program; 40% was directed at financially supporting tobacco-growing communities negatively affected by declining growth of tobacco in the state, and the rest went to the General Fund. • Virginia Tobacco Settlement Foundation (VTSF)was founded in 1999 with the 10% of MSA funds. VTSF mounted a youth multimedia campaign, but little data are available on the effectiveness of VTSF programming. • In 2009, the General Assembly expanded VTSF’s mission to include youth obesity prevention and changed its name to Virginia Foundation for Healthy Youth without any additional funding. The consequences for tobacco control programming are not known, but are likely to be negative if resources are diverted from tobacco control. • Virginia had the lowest cigarette tax in the nation from 1993-2004. The 2004 “2.5 Cents to Common Sense” campaign run by Virginians for a Healthy Future (VFHF), comprised of the Virginia chapters of AHA, ALA, and ACS, successfully used polling data to show popular support for an increase, targeted key legislators, and ran an effective media campaign. This effort resulted in a tax increase of 30 cents per pack in 2004. None of the increased tax went to fund tobacco control. • In 2006, with encouragement from VFHF, Governor Tim Kaine (D) issued Executive Order 41, prohibiting smoking in most executive branch buildings and state-owned vehicles. • In 2007, VFHF worked closely with Gov. Kaine and Sen. Brandon Bell (R) to introduce SB 1161, a strong expansion of the VCIAA to extend make most public places, including restaurants, smokefree. This effort failed. • The City of Norfolk decided to pass an ordinance prohibiting smoking in restaurants in 2007, arguing that it not preempted by the VCIAA because of the city’s inherent police powers. The ordinance was rescinded before it went into effect because of complaints by local restaurateurs and the likelihood of a statewide law passing. Statewide public health advocates did not effectively support this effort to test state preemption. • In 2009 VFHF focused an intense “district campaign” on Assembly Speaker William Howell’s (R) home district of Fredericksburg, forcing Howell to stop blocking all clean indoor air legislation. Instead of supporting 100% smokefree legislation, he proposed a weak amendment to the VCIAA that created exemptions for smoking rooms in restaurants. The member organizations of VFHF split in 2009 over support for the Kaine-Howell compromise legislation. After securing an agreement with Gov. Kaine in a back-room meeting, the Kaine-Howell bill passed and was signed into law by Kaine. The law prohibited most smoking in restaurants and bars but allowed separately vented smoking rooms. • Given strong support from Virginians for stronger clean indoor air laws, Virginia tobacco control advocates should reexamine their strategies. VFHF and its member organizations should provide financial and political resources to expand their successful 2009 Fredericksburg district campaign to repeal preemption. They should also consider identifying and supporting local efforts to enact stronger laws using the Norfolk model.