Effective Responses to the Tobacco Industry's Legal Challenges to Local Tobacco Control Efforts: An Empirical Study

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Project Summary:

The Tobacco Control Resource Center (TCRC) will study and assess responses that have been used by local governments to ward off legal challenges and threats by the tobacco industry to their tobacco control efforts. In particular we want to find (in ten states) contests between public health officials, municipal legislative bodies, and citizens at large on one side and the tobacco industry and its surrogates on the other. If carefully selected these ten case studies should shed light on techniques of innovative or especially effective local tobacco control strategies and on the patterns of challenge by the tobacco industry. In the process of conducting these studies, too, we expect to discover whether there are links between what works well on the local level and events in the national and international conflict between tobacco interests and public health advocates. As we planned, during first six months of this project we have been exploring the environment in which local tobacco control takes place. First, we have been monitoring national and international events likely to have impacts on the thinking of local decision makers; second, we have been developing a typology of state-local relations with respect to tobacco control, from varieties of pre-emptive State legislation and home rule arrangements to the helping resources at the State level, such as public agencies, private charities and individual advocates; third, we have been studying a small sample of well-documented municipal contests in one state to develop a sense of how factors germane to the locality [such as demographics, economic base, and behavior of other municipalities in the same state] affect where successful local activities take place and where conspicuous inactivity or successfully blocked activity occurs; and fourth, we have been exploring the structure of strictly legal aspects of tobacco control and its impact on municipal activity. 1. At the national and international level we found a greater turbulence than we had anticipated. The FDA regulation, its exemptible pre-emption, and the effort to establish a national settlement of the conflict lead a long list of events that in themselves made significant changes in local tobacco control. Perhaps more important is the extent to which tobacco control swept the public media as a general issue. Watching these national events, we have become aware as well of what we experience as major changes in the ways information is generated, communicated and used by individuals. In particular, participants in local, state and national conflict over the proper regulation of the sale and use of tobacco products have now had nearly instant access to information about events in other places and at other levels of organization. 2. Our investigation of State-level tobacco control efforts and contests suggests that, in addition to the extensive variation in local and state legal relationships, there is a very wide and important variation in levels of support for local tobacco control from state government agencies, chapters of national public health organizations, and volunteer advocates. In states in which there is state leadership and advocacy for local tobacco control activities, it is at times difficult to distinguish state activities from sub-state regional efforts and local activities. Thus understanding local tobacco control contests requires an equally deep analysis of regional and statewide contests. 3. Our study of local contests has reconfirmed some of our initial assumptions and leads us to rethink others. Our secondary observations, for example, suggest that local ordinances and regulations in some places are very strong in comparison with state measures. Likewise, our initial assumption that local support for enforcement of tobacco control regulations is critical for successful tobacco control appears to be well founded. Many of our assumptions about local autonomy, however, may have been exaggerated. The contests we have tentatively observed reveal a lot more connection to outside events and actors than expected. On the other hand, there may be a significant difference in this effect among municipalities with widely differing demographics. For example, it may well prove to be true that education, occupation and income characteristics of the people of a municipality may predict whether or not it is accessible to outside influence. While it is not yet at all clear what strategies may be most effective, efficient or equitable for controlling the sale and use of tobacco products at the local level, we have established a few tentative ideas to test against well-selected and in-depth case studies: 1. Local tobacco control efforts appear to be capable of producing levels of restriction on tobacco sale and use greater than can be accomplished at higher levels of government. While pre-emption and other constitutional hindrances weaken the power of localities to control tobacco, people appear to be more willing to impose local regulations [and to be involved enough to carry out the measure] than they are to organize for state-level regulations. 2. Ideas in tobacco control circles travel very swiftly and the rate of communication is accelerating. In 1995, it took six months for the BBC to find an innovative tobacco control law restricting outdoor smoking; in 1997, Italian television broadcast board of health hearings on a ordinance prohibiting sale of tobacco that is pending action six months hence. Internet communication probably moves even more rapidly than does satellite broadcasting, though how to measure that communication is problematic. 3. Much of what takes place at the municipal level appears to be a resultant of the efforts of state and national organizers; nonetheless, there continue to be local activists who by choice or chance are operating outside the major networks of support. The exact nature of the influence of higher-level organizations on municipal tobacco control is as yet unclear and needs to be explored in greater depth. It may well be the case that, aside from occasional efforts of isolated advocates of public health measures regarding tobacco, most opportunities for strategic activity toward local tobacco control may exist at the state or national level. 4. National events -- in particular the activity directed at a national "settlement" of the question of tobacco control -- have the potential of permanently distorting local tobacco control, even if no settlement is reached. Local actors are caught in a national process of construction of the "tobacco problem" that may render them irrelevant or powerless to affect their own courses of strategy. If this were to be true, it would have implications for the whole notion of decentralized governance as well as for the future relationships between governments and multinational corporations.