The Public Health Undermined: The Tobacco Industry's Legacy in Missouri in the 1990's
- Author(s): Givel, Michael S., Ph.D.;
- Glantz, Stanton A., Ph.D.
- et al.
The tobacco industry is a major political force in Missouri through lobbying, direct campaign contributions, indirect contributions to the two major political parties and legislative political caucuses, gifts and honoraria, and entertainment events. The tobacco industry has a centralized political organization in Missouri that promotes and defends its political and market interests at the local and state levels of government. Although the tobacco lobby has operated in the open in some political campaigns, it has often operated quietly behind the scenes, frequently working with various allied organizations on state and local political campaigns.
* Total tobacco industry contributions in the 1991-1992 election cycle more than doubled when compared to the 1989-1990 election cycle. Since the 1991-1992 election cycle, tobacco industry contributions have declined with contributions in the 1993-1994 election cycle being nearly half of what they were in 1991-1992. In the 1995-1996 election cycle, tobacco industry contributions were a little greater than what they were in the 1991-1992 election cycle. In the 1997-1998 election cycle, tobacco industry contributions dropped to about what they were in 1991-1992.
From the 1989-1990 to the 1993-1994 electoral cycles, more direct contributions went to the Democratic Party than the Republican Party. That trend reversed in the 1995-1996 and 1997-1998 election cycles when the Republican Party received more than the Democratic Party. * Due to a political deal between the tobacco lobby and former Missouri House Speaker Bob Griffin in 1993, Missouri's tobacco excise tax rate has remained at 17 cents per pack with local governments being preempted from enacting new tobacco taxes. Missouri's tobacco excise tax rate is the ninth lowest in the country with only heavy tobacco growing states like Tennessee, Kentucky, South Carolina, North Carolina, and Virginia being lower. Higher tobacco excise taxes would significantly reduce tobacco use for all age groups in Missouri, particularly for children and poor people.
The impact of Missouri's state clean indoor air law enacted in 1992 has been very weak. Responsibility of who was to enforce the law at the local level has remained unclear. The state has not engaged in significant enforcement.
The state clean indoor air law did not preempt stricter local clean indoor air ordinances. Nevertheless, the local ordinances that did pass were weak by national standards.
Since 1993, the Missouri Department of Mental Health, Division of Alcohol and Drug Abuse has administered the Community 2000 program, a general substance abuse program that includes some tobacco control prevention efforts. The tobacco control efforts under this program have been weak due to a lack of financial and other resources. The program has not been administered in a comprehensive, effective and singular manner, and tobacco control efforts have had to compete with various other substance abuse efforts.
Since 1993, the Missouri Department of Health administered the National Cancer Institute funded antitobacco and educational American Stop Smoking Intervention Study (ASSIST) program (and its current CDC predecessor the Comprehensive State-based Tobacco Use Prevention and Control Program). Due to a lack of energetic leadership in the Department of Health to support statewide anti-tobacco educational efforts and a failure by the Department of Health to encourage legally permissible energetic local anti-tobacco education activities, the program is currently not as effective as it might be.
In 1994, the tobacco lobby in Missouri considered the Missouri Department of Mental Health to be an industry ally that would assist the industry in various political efforts. In 1996, Governor Mel Carnahan named the Missouri Department of Mental Health, Division of Alcohol and Drug Abuse to administer the federal Synar program, which required that states annually reduce the percentage of outlets likely to sell tobacco products to minors to below 20%. Administration of the Synar program occurred under the provisions of a weak 1992 state youth access law that contained very low fines for violations, voluntary enforcement by law enforcement agencies, and no licensing provisions of tobacco vendors, which made it difficult to determine which outlets sold tobacco products.
The percentage of outlets that sold tobacco products to minors dropped from 40% in 1996 to 29% in 1997. In 1998, the percentage of outlets that sold tobacco products increased to 33%. The Division of Alcohol and Drug Abuse argued that extraordinary circumstances had cause this rise including changes in sampling methodology and some law enforcement agencies placing a higher priority on enforcement efforts related to methamphetamine. On September 17, 1997, the United States Department of Health and Human Services found Missouri out of compliance with Synar enforcement and called for a fine of $9.6 million on the basis that changes in sampling methodologies and placing more emphasis on methamphetamine enforcement was the Division of Alcohol and Drug Abuse's own choice.
In the 2000 Legislative Session, the Missouri legislature allocated $1.2 million for Synar enforcement efforts to settle the complaint against it by the federal government. At the same time, the legislature also added an amendment to its appropriations bill prohibiting minors from engaging in Synar enforcement efforts. Governor Carnahan did not line item veto this provision. This amendment seriously undermined Missouri's ability to conduct Synar enforcement because the sale of tobacco to (undercover) individuals over 18 (who looked younger than 18) carried no penalty for outlets that sold these tobacco products.
Despite the fact that 20% of the annual deaths in Missouri are caused by tobacco use, the Missouri legislature failed to enact legislation to spend Master Settlement Agreement funds for tobacco control in the 2000 Legislative Session. The primary reasons for the legislation's defeat was intense opposition by some Democrats and Republicans to any tobacco control program and the House sponsors of the bill lost control of the legislative process in the middle of the Session.
Even if the Master Settlement Agreement bill had passed in the 2000 Legislative Session, its future effectiveness was in doubt because the bill called for the historically pro-tobacco Department of Mental Health to administer the program and a Senate provision allowed tobacco control funds to be diverted to other substance abuse programs.
Organized health groups and advocates in Missouri are currently weak due to reorganization and a lack of resources. The health groups are also taking a strictly insider lobbying approach to tobacco control advocacy, not wanting to hold specific politicians publicly accountable for their pro-tobacco and anti-public health actions with outsider actions such as litigation or newspaper advertisements. Until this approach changes and the health groups are willing to increase resources to tobacco control activities, health advocates are highly unlikely to alter the current pro-tobacco orientation of the state legislature.
Health advocates could successfully advance tobacco control efforts in Missouri by conducting a vigorous campaign to enact local tobacco control ordinances.