Using Research to Drive Tobacco Control Practice and Policy Advocacy in VA

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Using Research to DriveTobacco Control Practice
and Policy Advocacy in VA
Danny McGoldrick Vice President,
Research Campaign for Tobacco-Free Kids 2009
Virginia Forum on Youth Tobacco Use Richmond,
Virginia April 14, 2009
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Overview

• Research/The Evidence Base is the Key
• We Know What to Do
• We Are Not Doing Enough of It
• How We Can Use Research to Do More

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Evidence-Based Tobacco Control

• Tobacco Taxes
• Smoke-free Laws
• Comprehensive Prevention Cessation Programs
• Limits on Industry Behavior (e.g., FDA)
• TO BRING ABOUT
• Social Environmental Change

4
THE TRIFECTA
Smoke-Free
Tax
Program Funding
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TOBACCO EXCISE TAXES

• A win for public health
• A win for state budgets
• A win among voters

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Cigarette Pack Price Trend vs. Youth Smoking
Prevalence, 1991-2007
Sources Tax Burden on Tobacco, 2007 Youth
Behavioral Risk Surveillance System, 2007 U.S.
Bureau of Labor Statistics.
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• Calls to Wisconsin Tobacco Quit Line Break All
  RecordsDate Posted  February 28, 2008As
  February winds down, the Wisconsin Tobacco Quit
  Line today announced that in the first two months
  of 2008 it has fielded a record-breaking 20,000
  calls from Wisconsinites looking for help to
  quit. To put this in context, during a typical
  year, the quit line provides services to about
  9,000 state residents. This unprecedented
  success in assisting Wisconsin smokers through
  1-800-QUIT-NOW breaks all previous state
  records, said Dr. Michael Fiore, director of the
  University of Wisconsin Center for Tobacco
  Research and Intervention, which manages the quit
  line. National peers who provide quit services
  in other states report they have never before
  seen such a successful state effort to help
  smokers quit. Three factors led to this
  increase in quit attempts by Wisconsin smokers
• A 1 increase in the states tobacco excise tax
• New Years resolutions
• Free coaching and medication provided through the
  Wisconsin

As February winds down, the Wisconsin Tobacco
Quit Line today announced that in the first two
months of 2008 it has fielded a record-breaking
20,000 calls from Wisconsinites looking for help
to quit. To put this in context, during a typical
year, the quit line provides services to about
9,000 state residents.
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Impact of Federal Tobacco Tax Increase
Statistics Call volume to 17 states (tobacco
users registered) Source Free and Clear, Inc.
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Cigarette Tax Rates(cents per pack)State
Average is 1.23 Per Pack
VA ranks 48th
WASHINGTON 202.5
MONTANA 170
MAINE 200
NORTH DAKOTA 44
VT199
MINNESOTA 150.4
OREGON 118
VT
IDAHO 57
NH 133
NH
WISCONSIN 177
SOUTH DAKOTA 153
NEW YORK 275
MA
MA251
WYOMING 60
MICHIGAN 200
CT
RI346
CT200
IOWA 136
PENNSYLVANIA 135
NJ258
NEBRASKA 64
NEVADA 80
OHIO 125
DELAWARE115
UTAH 69.5
IN 99.5
ILLINOIS 98
WV 55
30 VIRGINIA
MARYLAND200
COLORADO 84
KANSAS 79
MISSOURI 17
DC200
87
KENTUCKY 60
CALIFORNIA
NORTH CAROLINA 35
TENNESSEE 62
OKLAHOMA 103
ARKANSAS 115
ARIZONA 200
NEW MEXICO 91
SOUTH CAROLINA 7
GEORGIA 37
ALABAMA 42.5
MS 18
TEXAS 141
36 LOUISIANA
ALASKA 200
HAWAII 200
FLORIDA 33.9
States that have not passed tax increases since
1999
States that have recently passed or implemented a
cigarette tax increase (since 1999)
April 2009
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Benefits of a 1.00 Tax Increase in Virginia

• 68,000 fewer kids become smokers
• 40,000 adult smokers quit
• Saving 32,400 premature deaths from tobacco in
  Virginia
• 15 Billion in lifetime health care savings
• 280 million in new revenue for the state

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SMOKE-FREE WORKPLACE LAWS
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Effects of Smoke-free Laws

• Protect everyone from secondhand smoke
• Prompt more smokers to try to quit
• Increase the number of successful quit attempts
• Reduce the number of cigarettes that smokers
  consume
• Discourage kids from starting
• Do NOT hurt business

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Smoke-Free Restaurant and Bar Laws
December, 2009 ???
State Smoke-free Laws Including Restaurants Bars
State Smoke-free Laws Including Restaurants
March 2009

• NE law effective 6/1/09, SD law effective 7/1/09
• MT law extends to bars 10/1/09.

Local Smoke-free Laws Including Restaurants
Local Smoke-free Laws Including Restaurants
Bars
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COMPREHENSIVE PREVENTION CESSATION PROGRAMS
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• Evidence Base

.
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If every state funded TP at CDC minimum, states
would prevent nearly two million kids alive today
from becoming smokers, save more than 600,000 of
them from premature, smoking-caused deaths, and
save 23.4 B in smoking-related HC costs.
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If every state funded TP at CDC minimum, states
would prevent nearly two million kids alive today
from becoming smokers, save more than 600,000 of
them from premature, smoking-caused deaths, and
save 23.4 B in smoking-related HC costs.
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States with best funded and most sustained
tobacco prevention programs during the 1990s
AZ, CA, MA and OR, reduced cigarette sales more
than twice as much as the country as a whole
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Best Practices 2007

• State and Community Interventions
• Media Interventions
• Cessation Interventions
• Surveillance/Evaluation
• Administration/Management

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FY2009 Funding for State Tobacco Prevention
Programs
WASHINGTON
MAINE
NORTH DAKOTA
MONTANA
MINNESOTA
OREGON
VT
NH
IDAHO
WISCONSIN
SOUTH DAKOTA
MA
NEW YORK
MICHIGAN
CT
RHODE ISLAND
WYOMING
IOWA
PENNSYLVANIA
NEW JERSEY
NEBRASKA
NEVADA
OHIO
DELAWARE
IN
UTAH
ILLINOIS
WASHINGTON, DC
WV
MARYLAND
COLORADO
KANSAS
MISSOURI
VIRGINIA
CALIFORNIA
KENTUCKY
NORTH CAROLINA
TENNESSEE
OKLAHOMA
ARIZONA
ARKANSAS
SOUTH CAROLINA
NEW MEXICO
VA ranks 36th
GEORGIA
MS
ALABAMA
TEXAS
LOUISIANA
FLORIDA
HAWAII
States that are spending 50 or more of CDC
recommendation on tobacco prevention
programs. States that are spending 25 - 49 of
CDC recommendation on tobacco prevention programs.
States that are spending 10 - 24 of CDC
recommendation on tobacco prevention programs.
States that are spending less than 10 of CDC
recommendation on tobacco prevention programs.
November 2008
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History of Tobacco Prevention Fundingin
Virginia(in millions)
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Virginia Tobacco Money for Tobacco Prevention,
FY 2008
310 Million
132 Million Estimated Tobacco Settlement Revenues
178 Million Estimated Tobacco Tax Revenues
103.2 Million
13.6 Million
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Virginias Tobacco Control Spending vs. Tobacco
Industrys Marketing Spending
438.5 Million
13.6 Million
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Virginias Tobacco Control Spending vs.
Tobacco-Related Healthcare Cost
2.08 Billion
13.6 Million
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The Need for FDA Regulation

• Tobacco companies continue to market to kids,
  mislead consumers, and introduce array of new
  products
• The product that kills the most is regulated the
  least. Food, cosmetics, drugs, and even dog food
  are regulated, but not tobacco
• Tobacco companies are free to manipulate the
  product at will without regard to health and
  without disclosing changes
• Health claims are virtually unregulated as
  evidenced by recent spate of reduced risk
  products
• States are currently preempted by FCLA from
  regulating the time, place, and manner of tobacco
  advertising, so they cannot act

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Glamour, Lucky, Vanity Fair, August 2007
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Virginia Slims Purse Packs Introduced October
2008
Virginia Slims Purse Pack Direct Mail November
2008
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Camel Orbs began test marketing in Columbus, OH,
Indianapolis, IN, and Portland, OR in January
2009 Camel Sticks will start test marketing in
Spring 2009. Camel Strips will start test
marketing in Summer 2009.
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Ending the Tobacco ProblemA Blueprint for
the NationInstitute of Medicine, May 2007

• The committee concludes that product regulation
  by the FDA will advance tobacco control efforts
  in the United States and around the world. The
  proposed Tobacco Control legislation embodies
  the principles that should govern the regulation
  of tobacco products in the coming years.

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Presidents Cancer Panel ReportAugust 2007

• The Panel recommends foremost that the
  influence of the tobacco industry particularly
  on Americas children be weakened through
  strict Federal regulation of tobacco products
  sales and marketing.

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Key Components of FDA Regulation

• Regulating the marketing of tobacco products
• Regulating the product itself
• Using a Public Health standard, which takes
  into account not just the impact on the
  individual smoker but on encouraging initiation
  and discouraging cessation

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Why Should I Care?

• If you are working on prevention
• New marketing restrictions and new flexible
  authority to limit marketing that appeals to kids
  or deceives consumers
• Bans flavored cigarettes, which we know are more
  popular with young smokers
• Allows oversight of product changes and health
  claims that encourage initiation
• If you are working on cessation
• Bans terms like light, low, and mild that
  we know have discouraged
• smokers from quitting
• Provides oversight over deceptive claims
• Requires FDA approval of reduced harm products
  with a public health standard, including impact
  on cessation
• If you are working in policy advocacy
• States have expanded power to regulate tobacco
  marketing

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• Using Research for
• Media and Policy Advocacy 

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Research Role

• Understand the Science
• Relate the Science to Policy/program Goals
• Frame the Message for Media Policy Makers
• Disseminate Findings and Implications
• Add the Political Dimension
• Humanize the Research
• Use in Advocacy Efforts

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Using Research

• Serve as THE information resource for media and
  policy makers
• Use secondary and primary research to support
  communications, advocacy
• and outreach efforts
• Secondary Research
• -- Materials Development and Dissemination
  Fact Sheets, etc
• -- Special Reports
• -- Information Resource for Media
• Exposing the Tobacco Industry
• Translation of Research into Media Policy
  Advocacy
• Primary Research
• -- Polling
• -- Air Quality Studies
• -- Compliance Checks

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Fact Sheets
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Use Your Website
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Briefing Books
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Ed Board Memos Win-Win-Win!
Raising Cigarette Taxes is Good Fiscal Policy,
Good Public Health Policy, and Good Politics
Its a Win-Win-Win Solution for Georgias Fiscal
Challenges
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EDITORIAL There's still time to pass cigarette
tax increase 5 April 2007 Indianapolis Star The
combination of a higher cigarette tax and a
low-income insurance plan is a win-win for
Hoosiers' health. Legislators shouldn't leave
town without it.
EDITORIAL Win, win Tobacco tax hike Too good not
to come true 27 March 2004 Daily
Press (Virginia) It doesn't get much better than
this a recent report confirming that one
specific tax -- a 50-cent-per-pack hike in the
state cigarette tax -- would be a good thing for
the state's coffers, its citizens, its workers,
its businesses and its public health.
Costly cigarettes seen as win, win 9 February
2007 The Oregonian An independent health
economist, Jeffrey Fellows of the Kaiser
Permanente Center for Health Research, said he
thinks the state's projections of how much
smoking would decrease and how much tax revenues
would increase are sound. "Increasing taxes on
cigarettes is one of the most effective ways of
reducing smoking rates," he said.
Proposed fee on cigarettes wins two ways 5
February 2005 Stevens Point Journal (Wisconsin) A
s far as we're concerned, the extra buck a pack
is a win-win proposition. It means more money to
treat smoking-related illnesses and more money to
promote smoking cessation. It means fewer kids
who'll start smoking. Sounds like a bargain.
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Resource for Media -- Fact Sheets
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Editorial The Tobacco TaxThe benefits of a
proposed increase go way beyond funding
children's health insurance. Wednesday, October
17, 2007 A16 TOBACCO USE is the No. 1 cause of
preventable death in the United States, killing
more than 400,000 Americans each year. Half of
all long-term smokers will die early from a
disease caused by tobacco. One answer to this
scourge is imposing higher taxes According to
one recent report, increasing tobacco taxes has
"proven highly effective in reducing tobacco
use." For every 10 percent increase in tobacco
prices, the number of adult smokers drops by 1.5
percent and overall consumption drops 2 percent.
Young smokers are much more responsive to price
increases than adults, so higher tobacco taxes
are particularly effective in preventing youths
from moving beyond experimentation to habitual
smoking. Pregnant women are similarly affected a
10 percent price increase produces a 5 to 7
percent reduction in smoking. . . . The
Campaign for Tobacco-Free Kids estimates that the
61-cents-a pack increase would result in a 9.2
percent decline in youth smoking. Some 1.9
million children alive today would not become
smokers, and 1.2 million adult smokers would
quit. The administration argues that because
tobacco taxes are effective in reducing smoking,
the increase would not produce enough to fund
SCHIP after the first five years. That's true --
but it's an argument for the tax, not against it.
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Special Reports
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The Need for FDA Regulation of Tobacco Products
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Three Key Messages

• Tobacco Companies Still Up to Their Tricks
• The Critical Role of the Product in Marketing
• Need for FDA Oversight
• Therefore Congressional Support Critical

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Media Coverage
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Translating New Research for Media Policy
Advocacy

• Exposing the Tobacco Industry
• Promoting Policy Change

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The New York Times Editorial Raising Nicotine
Doses, on the Sly Published August 31, 2006
September 2, 2006 Today's editorial Strike back
against tobacco tactics The Indianapolis Star
(IN)  
The Courier-Journal (Louisville, KY) Sunday,
September 3, 2006  Editorial Addicted to
addiction
Our position Indiana legislators should increase
the cigarette tax as way to fight against rising
nicotine levels.
September 3, 2006Florida Today (Melbourne,
FL) Our view Florida should fight tobacco
addictionFlorida should fight tobacco addiction
with more education for youth
Editorial More nicotine for your money St. Louis
Post-Dispatch (MO) Friday, Sept. 1, 2006
Editorial Big Tobacco, Lawless as EverProfiting
by manipulating addictions that kill The
Washington Post
Editorial A killer of a businessTobacco
companies have gradually increased nicotine
levels The TennesseanPublished Tuesday,
09/05/06
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Smoke And Mirrors By Matthew Kirdahy November
1, 2006 Those annoying television commercials
that told parents to talk to their teenagers
about not smoking were especially annoying to the
kids they were meant to help, an upcoming article
in the American Journal of Public Health will
claim--so annoying that they may have encouraged
kids to take up the habit that the
tobacco-company-sponsored spots were supposed to
deter. While the authors of the article do not go
as far as saying the ads were purposely designed
to encourage smoking, they do claim there was no
benefit to them. The article was the work of a
team of nine doctors, including specialists in
psychology, sociology and economics, who studied
the influence on teenagers of anti-smoking ads
paid for by Altria unit Philip Morris and
Carolina Group's Lorillard Tobacco. The research
was funded by the National Cancer Institute, the
national Institute on Drug Abuse and the Robert
Wood Johnson Foundation, which focuses on health
issues all of those groups have an obvious ax to
grind with cigarette makers. Philip Morris and
Lorillard did not return phone calls Tuesday
afternoon seeking comment. The report was
released ahead of its publication by the American
Cancer Society. "We must make sure the tobacco
industry isn't drafting our health care
Study snuffs tobacco company's claims By Greg
Bolt December 16, 2006 A study by an Oregon
State University researcher and his colleagues
suggests that anti-smoking ads paid for by the
tobacco industry and targeted at youth and their
parents not only don't work but might actually
encourage teens to smoke. Brian Flay, a
professor in OSU's department of public health,
was one of nine researchers who studied tobacco
industry ads aimed at preventing youth smoking
and said that at best they don't have any effect.
And he said some, particularly those aimed at
parents, had the opposite effect. It actually
encourages it, especially when kids see those ads
targeted to parents," Flay said. "If they see
those, there's a 12 percent increase in the
likelihood they'll become smokers. That's a
conclusion that is strongly contested by
cigarette maker Philip Morris USA, which says it
not only has spent 1 billion to develop and
disseminate effective advertising aimed at
deterring youth smoking but also has research
that shows that it works. It says the ads are
based on widely accepted research and don't carry
any hidden messages. "There's nothing in our
research that raises the concerns
Manufacturers' anti-smoking ads
ineffective-study By Maggie Fox October 31,
2006 WASHINGTON, Oct 31 (Reuters) - Television
ads that tobacco companies say are designed to
discourage teenagers from smoking do no such
thing, and some may actually encourage youths to
smoke, researchers reported on Tuesday. Their
study of more than 100,000 U.S. teenagers show
the ads may do more harm than good, the
researchers wrote in the American Journal of
Public Health. This study provides more proof
that the tobacco industry is all smoke and
mirrors, said M. Cass Wheeler, Chief Executive
Officer of the American Heart Association. The
tobacco industry is addicted to lying and in
truth wants our kids to become addicted to
tobacco. If they were serious about reducing
smoking rates, they would stop spending 15
billion a year to promote their deadly products.
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When Dont Smoke Means Do Editorial November
27, 2006 Philip Morris has adopted the role of
good citizen these days. Its Web site brims with
information on the dangers of smoking, and it has
mounted a campaign of television spots that urge
parents, oh so earnestly, to warn their children
against smoking. That follows an earlier 100
million campaign warning young people to Think.
Dont Smoke, analogous to the just say no
admonitions against drugs. All this seems to
fly against the economic interests of the
company, which presumably depends on a continuing
crop of new smokers to replace those who drop out
or die from their habit. But in practice, it
turns out, these industry-run campaigns are
notably ineffective and possibly even a sham. New
research shows that the ads aimed at youths had
no discernible effect in discouraging smoking and
that the ads currently aimed at parents may be
counterproductive. () Philip Morris says it
has spent more than 1 billion on its youth
smoking prevention programs since 1998 and that
it devised its current advertising campaign on
the advice of experts who deem parental influence
extremely important. But the company has done
only the skimpiest research on how the campaign
is working. It cites June 2006 data indicating
that 37 percent of parents with children age 10
to 17 were both aware of its ads and spoke to
their children about not smoking. How the
children reacted has not been explored. And
somehow the company forgot to tell the parents,
as role models, to stop smoking
themselves. Philip Morris, the industrys
biggest and most influential company, is renowned
for its marketing savvy. If it really wanted to
prevent youth smoking and cut off new recruits
to its death-dealing products it could surely
mount a more effective campaign to do so.
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Evidence
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Press Releases
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Print Coverage
USA Today - April 24, 2001
New York Times - May 1, 2001
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Promoting Your Program and Its Success
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Human stories put a face on the program and
the toll of tobacco
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For immediate release October 21, 2004
(04-)  
Contacts Tim Church, Communications
Office 360-236-4077
Number of adult smokers in Washington takes a
healthy drop   12 percent decline means 115,000
fewer smokers since four years ago   OLYMPIA ?
The Washington State Department of Health
announced today a 12 percent drop in the number
of smokers in the state since the launch of the
Tobacco Prevention and Control Program. That
translates into about 115,000 fewer smokers
statewide since the program began. We have
successfully reduced smoking rates in Washington,
so people can live longer, healthier lives, Gov.
Gary Locke said. Everyone benefits from
Washingtons Tobacco Prevention and Control
Program not only those who have quit using
tobacco, but those who wont start and all of us
who have to pay for tobacco-related healthcare
costs. Washingtons general adult smoking rate
has dropped from 22.4 percent in 1999 to 19.7
percent in 2003. The states rate is now lower
than the national median (22 percent), and
Washington is now one of only 10 states with an
adult smoking rate lower than 20 percent. With
fewer adults smoking, about 38,000 early
tobacco-related deaths will ultimately be
prevented. Our anti-tobacco efforts save
thousands of lives every year, said Secretary of
Health Mary Selecky. Quitting smoking also saves
the people of our state a lot of money. This drop
in smoking will result in about 1.4 billion
saved in future medical costs, and that number
with go even higher with continued success. Gov.
Locke launched the states Tobacco Prevention and
Control program in 2000 to reduce tobacco use in
the state. The program currently is funded by the
settlement of a lawsuit with tobacco companies,
federal grants and cigarette taxes.
 
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Primary Research

• Air Quality Studies
• Compliance Checks
• Polling
• Media
• Advocacy
• Strategy

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What are we monitoring?

• The SidePak records the levels of respirable
  suspended particles in the air that contribute to
  particle pollution.

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Polling A Strategic Tool For Tobacco Control
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Why We Conduct Opinion Research

• To generate earned media
• To demonstrate public support to decision
  makers/policy makers
• To develop a research-based message strategy for
  a specific issue or campaign

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Case Study Earned Media

• Conduct polls to show public support for tobacco
  control policy
• Release the poll publicly and actively pitch to
  the press
• Weave polling into other public communications

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Would you favor or oppose a state law in New
Hampshire that would prohibit smoking in all
indoor workplaces, including offices, restaurants
and bars?
New Hampshire Voters Favor A Statewide Smoke-Free
Workplace Law
Total Favor 79
Total Oppose 18
New Hampshire Survey of registered voters
January 2006
Darker shading equals stronger intensity
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Poll finds majority favors N.H. smoking ban in
restaurants, bars March 6, 2006 CONCORD, N.H.
-- A majority of New Hampshire residents believe
workers should be protected from secondhand smoke
and support a ban on smoking in all workplaces,
including restaurants and bars, according to a
survey released Monday. The University of New
Hampshire Survey Center poll of 402 registered
voters between Jan. 20 and Jan. 26 was conducted
for Clean Air Works, a coalition of health groups
in favor of a smoking ban. It has an error margin
of plus or minus 4.9 percentage points. A House
committee last month endorsed a bill prohibiting
smoking in all restaurants and cocktail lounges
in the state a full House vote is scheduled for
Thursday. The poll said New Hampshire residents
support a workplace smoking ban by a margin of
more than four to one. It reported 79 percent
favored a ban 18 percent did not. Eighty-eight
percent of Democrats and 72 percent of
Republicans polled supported a ban 80 percent of
undeclared voters also supported a smoking ban,
the survey said. A strong majority of people
polled -- 84 percent -- said they were concerned
about the health effects of secondhand smoke.
Eighty-seven percent said workers should be
protected from secondhand smoke. Of smokers
polled, 58 percent said they believed the right
of people to breathe clean air in restaurants and
bars outweighed their right to smoke in those
places.
More than 20 media hits on the poll in the weeks
before the vote
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75 of New Yorkers Support The Citys Smoke-Free
Law The Law is Even More Popular Than a Variety
of New York Institutions
Voter Support for the Smoke-Free Workplace Law
Favorable Rating
New York Yankees
New York Knicks
David Letterman
Coney Island Hot Dog
A deli cornbeef sandwich
Krispy Kreme donuts
Donald Trump
George Steinbrenner
New York City Survey of registered voters - March
2004
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March 28, 2004 Smoke ban a hit - even outpolls
Yanks Lisa L. ColangeloNew York Daily
News What do New Yorkers like more than the
Yankees or a Coney Island hot dog? The smoking
ban. Or at least that's the conclusion of a poll
of 500 registered voters for the Campaign for
Tobacco-Free Kids. According to the poll, 61 of
people strongly support the ban on smoking in
workplaces, including bars, restaurants and
offices. That's up from 55 in a similar poll
conducted in August. Another 14 said they
"somewhat" support the ban. "Those are amazing
numbers," said Josh Isay, a spokesman for the
campaign. "People should know that contrary to
some press reports, this law is very popular ...
it's a vocal minority that opposes the law." By
comparison, 46 of respondents reported a "very
favorable" view of the New York Yankees, and 39
were big fans of Coney Island hot dogs. And 70
of people said the rights of customers to be in a
smoke-free restaurant or bar is more important
than the right to smoke. Bob Zuckerman of the
New York Nightlife Association questioned the
validity of the results. "When you group bars
and restaurants together, you get a much
different result than if you just ask about
bars," he said. "We continue to hear from members
and even nonmembers that the smoking ban has hurt
business and curtailed the bar business." About
80 of the women surveyed support the ban while
only 19 opposed it. Meanwhile, 70 of men
supported the ban and 29 opposed it. The poll
had a margin of error of 4.5.
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Demonstrate Public Support

• Conduct polls to show public support for tobacco
  control policy
• Show that support among those that matter to
  politicians
• Use a pollster that politicians listen to
• Use the results in one-on-one meetings with key
  decision makers

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Case Study Nebraska Tax (2002)

• Prevailing political wisdom No Republican
  Governor had ever raised the tobacco tax and been
  re-elected.
• Republican Governor consistently opposed efforts
  to increase the tobacco tax
• State grappling with a 100 million budget
  deficit
• The Coalition brought the Republican pollster to
  Nebraska for a full day of meetings, including a
  briefing with the Governor before the press
  conference

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Would you favor or oppose a 50-cent per pack
increase in the state tobacco tax, with part of
the revenue dedicated to a program to reduce
tobacco use, particularly among kids, and another
part of the revenue used to address the states
budget shortfall?
Nebraska Support for a 50-cent Tobacco Tax
Increase Remains Strong Across Party Lines
Total numbers are rounded
Nebraska Statewide survey of registered voters -
January 2002
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Case Study Nebraska Tax (2002)

• Three weeks later, the Governor proposed a
  50-cent increase in the states tobacco tax.
• The legislature ultimately passed a 30-cent
  increase, nearly doubling the existing tax.
• In November, the Governor was re-elected with 69
  percent of the vote.

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Develop a Research Based Strategy For an Issue or
Campaign

• Research goes beyond whether people support or
  oppose the policy
• Takes a close look at what drives those opinions
• Shapes your message
• Promotes message discipline

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Strong Support for Smoke-Free Laws
Would you favor or oppose a law in your state or
community that would prohibit smoking in most
indoor public places, including all workplaces,
public buildings, offices, restaurants and bars?
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59 strong favor
19 strong oppose
The Mellman Group, Inc. / The Robert Wood Johnson
Foundation January 2006
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Most of the Compelling Messages Focus On The
Right To Breathe Clean Air In Public Places Out
of 29 messages in favor of smoke-free laws, 4
messages featuring the right to breathe clean air
made it into the top tier of arguments
Select top tier reasons to support smoke-free
law ranked by very convincing
Everyone has the right to breathe clean air in
public places and at work
Although many people are not exposed to SHS for
long periods of time, it is still a right of
non-smokers to breathe clean air where they shop,
work and eat
Although many people are not exposed to SHS for
long periods of time, even small amount is
hazardous. It is right of non-smokers to breathe
clean air where they shop/work/eat
Smokers have the choice to smoke, but when they
smoke around others, smokers take away the right
to breathe clean air from non-smokers
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Messages Focusing on Health Round Out the Top
Tier of Arguments Messages on specific health
effects, the support of health groups and the
chemicals in secondhand smoke are very convincing
to voters
Select top tier reasons to support smoke-free
law ranked by very convincing
People shouldn't have to sacrifice their health
just to earn a paycheck
Secondhand smoke kills
Even if smoke-free laws save just a few lives,
they are worth it
. . . SHS is a proven cause of serious health
problems. Exposure to SHS increases the risk of
heart disease, lung cancer and resp. disease -
even in non-smokers
AHA/ALA/ACS all support smoke-free policies
because they protect people from secondhand smoke
This law will protect everyone from the dangers
of SHS, which contains 4,000 chemicals, including
more than 60 cancer-causing substances like
formaldehyde, arsenic and lead
The Mellman Group, Inc. / The Robert Wood Johnson
Foundation January 2006
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The Right To Breathe Clean Air Is The Most
Effective Rebuttal To The Lost Business Argument
Which of the following statements do you agree
with more
Smoke-free laws are bad for business, and when
these laws have been passed, some bars and
restaurants have suffered a significant loss in
business, causing businesses to close and people
to lose their jobs.
Everybody has the right to breathe clean air in
public places. We need to protect the health of
customers and employees even if the business of
some restaurants and bars may be affected.
We can protect public health without hurting
business. Evidence from communities across the
country shows that smoke-free laws do not have a
negative impact on business.  In fact, studies
have shown that some places have seen a slight
positive impact.
We can protect public health without hurting
business. There are a lot more non-smokers than
smokers, and businesses will see an increase in
the long run because more non-smokers will choose
to go out.
41
33
25
(darker shadingstronger intensity)
87
Message Research Strategic Conclusions

• There is strong support for laws prohibiting
  smoking in public places and workplaces
• The most effective way to generate support for
  smoke-free laws is to communicate the right to
  breathe clean air
• Communicate health effects (cancer, heart
  disease, etc) and harmful chemicals in secondhand
  smoke
• Validate with support of health groups
• The key is to stay on our turf (the health
  argument) the economic argument is more
  effective as a rebuttal for key audiences such as
  policy makers

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90
Success !!!!!!!!!
91
Youth Smoking Prevalence in Virginia
Source Virginia Youth Tobacco Survey
92
Adult Smoking Prevalence in Virginia
Source BRFSS
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Challenges Ahead

• Keeping tobacco on the radar screen
• Keeping funders interested and active
• More of what we are doing IT WORKS
• More program funding for community-based norm
  change. What do you do after smoke-free. States
  and locals need training and guidance
• Populations left behind

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So, We Must

• Continue to Build the Science
• Act on the Best Science
• USE the Science for Advocacy
• Stay ACTIVE to Keep Focus on the Problem, the
  Solutions, and the Successes

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You Are the Key

• Continue and intensify your efforts especially
  at the community level
• Use every opportunity to educate about the
  ongoing problem of tobacco use
• Educate your communities about policies that make
  a difference
• Educate your policy makers about what we are
  accomplishing and the need to do more

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Danny McGoldrickVice President, Research
Campaign for Tobacco-Free Kids (202)
296-5469 dmcgoldrick_at_tobaccofreekids.org www.tobac
cofreekids.org