States' voters speak, and smoking is out

Public health entities go head-to-head with tobacco companies on ballot initiatives and emerge mostly victorious.

By Susan J. Landers, amednews staff. Nov. 27, 2006.

Washington -- The Nov. 7 approval of six anti-smoking state ballot initiatives provided a boost for a range of public health activities. Some states now will have smoke-free workplaces and others more funds for cessation efforts.

In the past, only two or three such measures had appeared on state ballots in a given election. All told, there were eight this year. But two, one in California and the other in Missouri, were defeated.

Links
See related content
Region: States

The victories were hailed by those intent on cutting the number of smokers nationwide. "Health advocates are running out of patience and are going to the ballot more and more if necessary," said AMA President-elect Ron Davis, MD, who went to Columbus, Ohio, to lend the Association's support to the SmokeFree Ohio initiative and to Arizona for similar activities.

Measures prohibiting smoking in workplaces and restaurants are intended to protect people from secondhand smoke, a well-recognized health hazard. Funds, often from increased tobacco taxes, will be used primarily to pay for more cessation programs.

The need to support smokers in the effort to stop became more apparent with the recent Centers for Disease Control and Prevention study showing that adult quit rates have stalled after years of progress. Also in the Nov. 7 Morbidity and Mortality Weekly Report, the CDC reported significant variation among residents of 14 states studied in the proportion of adults protected by smoke-free workplace policies and the proportion of adults who protect themselves and families from secondhand smoke in their homes.

Arizona, at nearly 83%, and Nevada, at 79%, had the highest percentage of people who reported to the CDC that smoking is not allowed inside their homes. Voters in both states also passed ballot initiatives calling for broad smoke-free laws.

A CDC report says adult efforts to stop smoking have stalled after years of progress.

Arizona's measure makes all workplaces, restaurants and bars off-limits for tobacco use. Nevada's initiative prohibits smoking in restaurants, grocery stores, shopping malls, other retail establishments and bars that serve food. Nevada communities will be allowed to pass stronger laws.

Both state initiatives had to overcome well-funded ballot measures supported by tobacco companies and other groups that would have allowed smoking in many more venues.

Ohio voters, who approved an initiative that bans smoking in all workplaces, rejected a ballot measure sponsored by the R.J. Reynolds Tobacco Co. that would have amended the state constitution and overturned smoke-free laws in 21 Ohio cities. Voters deserve praise for providing a "great public health benefit for everyone in Ohio," said Thomas Houston, MD, director of the Nicotine Dependence Program at OhioHealth's McConnell Heart Health Center in Columbus. "Ohio has set a good example for the rest of the nation."

Public health advocates were proud of going head-to-head with tobacco company-sponsored measures in several states and coming out winners. "Big tobacco flexed its muscles and outspent advocates but still lost this crucial fight in Arizona, Ohio, South Dakota, Florida and Nevada," said M. Cass Wheeler, CEO of the American Heart Assn., in a statement.

Among other initiatives decided:

Arizona passed a measure to increase cigarette taxes by 80 cents per pack and to raise the tax on other tobacco products. The revenue is to be used for early childhood development programs.
Florida voters now require the state Legislature to annually fund a comprehensive tobacco education and prevention program using tobacco settlement money.
South Dakota voted to increase the cigarette tax by $1 per pack and raise the tax on other tobacco products. This increase would produce about $40 million a year to fund tobacco prevention and cessation programs and provide property tax relief, education enhancements and health care.
California voters rejected a measure to boost cigarette taxes by $2.60 per pack and use the revenue to fund tobacco prevention and cessation programs and other health programs.
Missouri voters rejected an initiative to increase cigarette taxes by 80 cents per pack with the revenue to fund smoking-cessation programs.