Cigarette Excise Taxes in Context: Cautionary Lessons from the U.S. Experience.

Cigarette excise taxes are an important tool in the World Health Organization Framework Convention on Tobacco Control strategy for reducing global tobacco consumption. However, contemporary tobacco control efforts also coincide with the proliferation of neoliberal economic programs calling for the withdrawal of state activity from the economy to facilitate trade. In this environment, cigarette excise taxes may be seen less as an instrument of tobacco control than a feature of an economic program that is punitive to lower-income people. This article reviews collaboration between progressive organizations in the United States and the tobacco industry in the 1980s and 1990s, documenting potential sources of unanticipated resistance to excise taxes and highlighting the tobacco industry's capacity to engage in policy issues through third-party surrogates. It is important for those implementing cigarette excise tax increases to distance tobacco control objectives from larger economic policy measures and for tobacco control advocates to build alliances with organizations working for economic fairness in order to address mutual concerns.

Manufacturing credibility: the National Energy Management Institute and the Tobacco Institute's strategy for indoor air quality.

OBJECTIVES: We studied tobacco industry efforts during the 1980s and 1990s to promote the National Energy Management Institute (NEMI), a nonprofit organization, as an authority on indoor air quality as part of the industry's strategy to oppose smoke-free worksite policies. METHODS: We analyzed tobacco industry documents, conducted literature searches in Lexis-Nexis for background and historical literature, and reviewed relevant public health and policy literature. RESULTS: The tobacco industry provided more than US $6 million to NEMI to establish it as an authority on indoor air quality and to work with it to undermine support for smoke-free air policies by promoting ventilation as a solution to indoor air quality problems. Tobacco industry support for NEMI was not publicly disclosed. CONCLUSIONS: NEMI was a valuable ally for the tobacco industry through NEMI's ties to organized labor, its technical background, and its status as a third-party actor. NEMI also helped the industry to portray ventilation to improve overall indoor air quality and smoke-free worksites as an either-or choice; in fact, both can improve worker health.

Union women, the tobacco industry, and excise taxes: a lesson in unintended consequences.

Between 1987 and 1997, the tobacco industry used the issue of cigarette excise tax increases to create a political partnership with the Coalition of Labor Union Women (CLUW), a group representing female trade unionists in the U.S. This paper documents how the industry created this relationship and the lessons tobacco-control advocates can learn from the industry's example, in order to mitigate possible unintended consequences of advocating excise tax increases. In 1998, under the terms of the Master Settlement Agreement, the tobacco industry began making documents produced in litigation available publicly. Currently, approximately 50 million pages are available online, including substantial documentation of the industry-CLUW relationship. For this study, a comprehensive search of these documents was conducted. The tobacco industry encouraged CLUW's opposition to excise tax increases by emphasizing the economic regressivity of these taxes, discussing excise taxes generically to deflect attention from cigarettes, and encouraging opposition to earmarking cigarette taxes to pay for specific programs. In addition, CLUW received at least $221,500 in financial support between 1987 and 1997 and in-kind support for its conferences, membership materials, and other services. Excise tax increases, if pursued without considering the impacts they may have on low-SES populations, may have unintended consequences. In this case, such proposals may have helped to create a relationship between CLUW and the tobacco industry. Because excise taxes are endorsed in the Framework Convention on Tobacco Control, tobacco-control advocates must understand how to build relationships with low-SES populations and mitigate potential alliances with the tobacco industry.

Building alliances in unlikely places: progressive allies and the Tobacco Institute's coalition strategy on cigarette excise taxes.

The tobacco industry often utilizes third parties to advance its policy agenda. One such utilization occurred when the industry identified organized labor and progressive groups as potential allies whose advocacy could undermine public support for excise tax increases. To attract such collaboration, the industry framed the issue as one of tax fairness, creating a labor management committee to provide distance from tobacco companies and furthering progressive allies' interests through financial and logistical support. Internal industry documents indicate that this strategic use of ideas, institutions, and interests facilitated the recruitment of leading progressive organizations as allies. By placing excise taxes within a strategic policy nexus that promotes mutual public interest goals, public health advocates may use a similar strategy in forging their own excise tax coalitions.

A decade of work on organized labor and tobacco control: reflections on research and coalition building in the United States.

Labor unions can and should make strong allies in tobacco control efforts. Through much of the 1980s and 1990s, however, the organized labor and tobacco control communities rarely formed coalitions to achieve mutual gains. Recently, labor unions and tobacco control organizations have begun to work together on smoking cessation programs, smoke-free worksite policies, and increased insurance coverage for cessation treatments. This paper explores the historic and present-day intersections among organized labor and tobacco control advocates. We summarize research in this area and report on our recent programmatic efforts to promote collaboration between the labor and tobacco control communities. We discuss lessons learned with the aims of promoting deeper understanding among tobacco control and labor advocates of how each views tobacco control issues, and most importantly, stimulating further collaboration toward mutual gains in protecting workers' health.

How the health belief model helps the tobacco industry: individuals, choice, and "information".

OBJECTIVE: To analyse trial and deposition testimony of tobacco industry executives to determine how they use the concepts of "information" and "choice" and consider how these concepts are related to theoretical models of health behaviour change. METHODS: We coded and analysed transcripts of trial and deposition testimony of 14 high-level executives representing six companies plus the Tobacco Institute. We conducted an interpretive analysis of industry executives' characterisation of the industry's role as information provider and the agency of tobacco consumers in making "choices". RESULTS: Tobacco industry executives deployed the concept of "information" as a mechanism that shifted to consumers full moral responsibility for the harms caused by tobacco products. The industry's role was characterised as that of impartial supplier of value-free "information", without regard to its quality, accuracy and truthfulness. Tobacco industry legal defences rely on assumptions congruent with and supported by individual rational choice theories, particularly those that emphasise individual, autonomous decision-makers. CONCLUSIONS: Tobacco control advocates and health educators must challenge the industry's preferred framing, pointing out that "information" is not value-free. Multi-level, multi-sectoral interventions are critical to tobacco use prevention. Over-reliance on individual and interpersonal rational choice models may have the effect of validating the industry's model of smoking and cessation behaviour, absolving it of responsibility and rendering invisible the "choices" the industry has made and continues to make in promoting the most deadly consumer product ever made.

Political coalitions and working women: how the tobacco industry built a relationship with the Coalition of Labor Union Women.

OBJECTIVES: To assess how the tobacco industry established a political relationship with the Coalition of Labor Union Women (CLUW) and to learn from this example how tobacco control advocates can work more effectively with organisations with which working class women are affiliated. METHODS: The study reviewed tobacco industry documents to determine Tobacco Institute strategy, using the CLUW News and other published material to corroborate our findings. RESULTS: The Tobacco Institute was effective at framing excise tax and smokefree worksite issues in a way that facilitated CLUW's support of industry positions on these issues. The Tobacco Institute was also willing to reciprocate by providing financial and other kinds of support to CLUW. CONCLUSIONS: While tobacco control missed an opportunity to partner with CLUW on smokefree worksites and excise taxes in the 1980s and 1990s, tobacco control can also use issue framing and reciprocity to form coalitions with organisations representing the interests of working women.

Political coalitions for mutual advantage: the case of the Tobacco Institute's Labor Management Committee.

In 1984, the tobacco workers' union and the Tobacco Institute, which represents US tobacco companies, formed a labor management committee (LMC). The institute relied on LMC unions to resist smoke-free worksite rules. In a review of the internal tobacco industry documents now publicly available, we found that the LMC succeeded for 2 primary reasons. First, the LMC furthered members' interests, allowing them to overcome institutional barriers to policy success. Second, the LMC used an "institutions, ideas, and interests" strategy to encourage non-LMC unions to oppose smoke-free worksite rules. While public health advocates missed an opportunity to partner with unions on the issue of smoke-free worksites during the era studied, they can use a similar strategy to form coalitions with unions.

Smoke-free airlines and the role of organized labor: a case study.

Labor unions play an important role in debates about smoke-free worksites. We investigated the role of flight attendants and their unions in creating smoke-free air travel. We used case study methodology to search tobacco industry documents and labor union periodicals and to interview key informants (i.e., people identified as having first-hand information and experience in the campaign to make airlines smoke free). We then compared findings across these data sources. Tobacco industry strategies against the establishment of smoke-free worksites failed in the case of airlines, largely because of the efforts of flight attendants and their unions. Other factors contributed to the failure but likely would have been insufficient to derail industry efforts without strong stands by the flight attendants. This case illustrates the potential for successful partnerships between unions and tobacco control policy advocates when developing smoke-free worksite policies.

Labor and the tobacco institute's labor management committee in new york state: the rise and fall of a political coalition.

In 1984 the Tobacco Institute and the Bakery, Confectionary and Tobacco Workers Union formed a Labor Management Committee. From the mid-1980s to the mid-1990s, this LMC worked to elicit labor support in New York by framing issues in terms that made them salient to unions: tobacco excise taxes as regressive taxation, workplace smoking restrictions as an intrusion into collective bargaining. By the late 1990s, however, most of labor in New York had shifted to support for anti-tobacco policies. The reasons for this shift include the growing size and influence of public-sector unions, and their generally favorable stances on tobacco control issues; the policy-making autonomy of the unions; the growing body of scientific knowledge concerning the dangers of tobacco use; and the rise in public awareness of such dangers. Nevertheless, for two decades, the LMC contributed to mutual suspicion between labor and tobacco control advocates that prevented collaboration between them.

R.J. Reynolds' targeting of African Americans: 1988-2000.

OBJECTIVES: The purpose of this study was to describe RJ Reynolds (RJR) Tobacco Company's strategy for targeting African Americans, as revealed in tobacco industry documents and magazine advertisements. METHODS: The authors searched industry documents to determine RJR's strategies and analyzed magazine advertising during 2 periods: the time of the launch of the company's Uptown cigarette (1989-1990) and a decade later (1999-2000). RESULTS: RJR's efforts to target the African American market segment existed before and after Uptown, and the company's strategy was largely implemented via other RJR brands. Advertisements featured mentholated cigarettes, fantasy/escape, expensive objects, and nightlife. CONCLUSIONS: To help all populations become tobacco-free, tobacco control practitioners must understand and counter tobacco industry strategies.