California's tobacco tax initiative: the development and passage of Proposition 99.

In this case study, we describe and analyze the development and passage of California's tobacco tax initiative, Proposition 99, the Tobacco Tax and Health Promotion Act of 1988. We gathered information from published reports, public documents, personal correspondence, internal memorandums, polling data, and interviews with representatives from organizations that participated in the Proposition 99 campaign. Proposition 99 passed as a result of the efforts of a coalition of voluntary health agencies, medical organizations, and environmental groups.

Tobacco information in two grade school newsweeklies: a content analysis.

Objectives: This study compared tobacco-related articles from two elementary school publications, Weekly Reader and Scholastic News, published in 1989 through 1994.

Methods: Articles for grades 4 through 6 were evaluated, and the publications were compared with each other. Also, issues of Weekly Reader published after acquisition by K-III, which is owned by the firm that formerly owned RJR Tobacco, were compared with the earlier ones.

Tobacco industry smokers' rights publications: a content analysis.

Objectives: This study was undertaken to identify the content of tobacco industry smokers' rights publications and to analyze their major themes.

Methods: Fifty-eight issues of smokers' rights publications from 1987 to 1992 were selected at random and analyzed. The number of publications per year, number of mentions (sentences) in different thematic categories per year, and number of mentions per category per publication were examined.

Environmental tobacco smoke. The Brown and Williamson documents.

Objective: To examine the tobacco industry's public and private responses to rising concern over the health effects of environmental tobacco smoke (ETS).

Data Sources: Documents from Brown and Williamson Tobacco Corporation (B&W), the British American Tobacco Company (BAT), and other tobacco interests provided by an anonymous source, obtained from Congress, and received from the private papers of a former BAT officer.

Study Selection: All available materials, including confidential reports regarding research and internal memoranda exchanged between tobacco industry lawyers.

Lawyer control of the tobacco industry's external research program. The Brown and Williamson documents.

Objective: To examine the involvement of tobacco industry lawyers in the selection of tobacco industry scientific research projects and to examine how the research was used to influence public policy.

Data Sources: Documents from Brown and Williamson Tobacco Corporation, the British American Tobacco Company (BAT), and other tobacco interests provided by an anonymous source, obtained from Congress, and received from the private papers of a former BAT officer.

Study Selection: All available materials, including confidential reports regarding research and internal memoranda exchanged between tobacco industry lawyers.

Lawyer control of internal scientific research to protect against products liability lawsuits. The Brown and Williamson documents.

Objective: To understand how attorneys for the tobacco industry in general, and Brown and Williamson Tobacco Corporation (B&W) in particular, have responded to the threat of products liability litigation arising from smoking-induced diseases.

Data Sources: Documents from B&W, the British American Tobacco Company (BAT), and other tobacco interests provided by an anonymous source, obtained from Congress, or received from the private papers of a former BAT officer.

Study Selection: All available materials, including confidential reports regarding research and internal memoranda exchanged between tobacco industry lawyers.

Nicotine and addiction. The Brown and Williamson documents.

Objective: To learn how nicotine has been regarded by a major tobacco company.

Data Sources: Documents from Brown and Williamson Tobacco Corporation (B&W), the British American Tobacco Company (BAT), and other tobacco interests provided by an anonymous source, obtained from Congress, and received from the private papers of a former BAT officer.

Study Selection: All available materials, including confidential reports regarding research and internal memoranda exchanged between tobacco industry lawyers.

Looking through a keyhole at the tobacco industry. The Brown and Williamson documents.

Objective: To introduce a series of papers discussing previously undocumented tobacco industry activities regarding strategies to avoid products liability litigation, understand nicotine addiction, and manipulate both internal and external scientific research on the effects of both active and passive smoking.

Data Sources: Documents from Brown and Williamson Tobacco Corporation (B&W), the British American Tobacco Company (BAT), and other tobacco interests provided by an anonymous source, obtained from Congress, and received from the private papers of a former BAT officer.

Study Selection: All available materials, including confidential reports regarding research and internal memoranda exchanged between tobacco industry lawyers.

Left ventricular contractility predicts how the end-diastolic pressure-volume relation shifts during pacing-induced ischemia in dogs.

Background: Two types of ischemia, pacing-induced and coronary occlusion-induced, have different effects on left ventricular diastolic properties. During pacing-induced ischemia, the diastolic pressure-volume relation is said to shift upward, whereas during coronary occlusion, it is said to shift rightward or downward. However, recent studies have shown that the relation can shift in any direction during both types of ischemia.

Contraceptive implant use among inner city teens.

Purposes: This study develops a clinical profile of urban teens who selected Norplant for contraception; determines which variables identify the subjects most likely to be compliant with the method; and determines the most common reasons for early termination of use.

Methods: Demographic and health history data and reasons for termination of use were collected prospectively for 122 inner city teens who received Norplant. Life table analysis and the Mantel-Haenszel procedure were used to investigate differences between Norplant retainers and terminators.

Passive smoking and heart disease. Mechanisms and risk.

OBJECTIVE--Recent clinical, laboratory, and epidemiological evidence that passive smoking causes heart disease was reviewed, with particular emphasis on understanding the underlying physiological and biochemical mechanisms. DATA SOURCES--Publications in the peer-reviewed literature were located via MEDLINE, citation in other relevant articles, and appropriate reports by scientific agencies. Greatest emphasis was given to work published since 1990.

Gadolinium attenuates the upward shift of the left ventricular diastolic pressure-volume relation during pacing-induced ischemia in dogs.

Background: The mechanism of the reversible upward shift of the left ventricular diastolic pressure-volume relation during demand ischemia is controversial. To assess the possibility that cation influx through stretch-activation channels may contribute to the upward shift, we asked whether gadolinium, a blocker of the stretch-activated channels, attenuates the upward shift of the diastolic pressure-volume relation during pacing-induced ischemia in 5 dogs.

Methods And Results: To produce pacing-induced ischemia, we constricted the left anterior descending and circumflex coronary arteries to reduce their flows by approximately 30% and paced the left atrium at 150 to 180 beats per minute for 3 minutes.

Tobacco industry campaign contributions are affecting tobacco control policymaking in California.

Objective: To test the hypothesis that tobacco industry campaign contributions are influencing the behavior of members of the California legislature.

Design: Multivariate simultaneous-equations regression was used to analyze data on campaign contributions from the tobacco industry to members of the California legislature in 1991 and 1992, members' tobacco control policy positions, and members' personal characteristics.

Data Sources: The following sources were analyzed: campaign contributions from disclosure statements filed with the California Fair Political Practices Commission; constituent attitudes on tobacco control from the California Tobacco Survey; legislators' personal characteristics, from a survey of key informants conducted by the California Journal; and the tobacco policy score, a survey of key informants working on tobacco issues in the state legislature.

Publication bias and public health policy on environmental tobacco smoke.

Objective: To examine the tobacco industry's claim that publication bias against negative studies invalidates the risk assessment of environmental tobacco smoke (ETS) conducted by the US Environmental Protection Agency and other reviews of the health effects of ETS.

Design: Determination of the number of published original research articles that tested the hypothesis that ETS exposure is associated with adverse health effects and that reported statistically significant ("positive") or nonsignificant ("negative") results; the number of articles that concluded that ETS is a health risk; and unpublished studies on the effects of ETS on health.

Participants: Articles identified by a computerized search of the medical literature supplemented with material obtained from the tobacco industry and hand searching.

Inappropriate and appropriate selection of 'peers' in grant review.

Objective: To assess the members of the California Tobacco Related Diseases Research Program Behavioral and Public Health Research on Tobacco Study Section and those of the Agency for Health Care Policy and Research (AHCPR) Dissemination Study Section as "peers" to review tobacco policy research. Both study sections reviewed a similar grant application on tobacco policy research written by one of us (S.A.

The effect of ordinances requiring smoke-free restaurants on restaurant sales.

Objectives: The effect on restaurant revenues of local ordinances requiring smoke-free restaurants is an important consideration for restauranteurs themselves and the cities that depend on sales tax revenues to provide services.

Methods: Data were obtained from the California State Board of Equalization and Colorado State Department of Revenue on taxable restaurant sales from 1986 (1982 for Aspen) through 1993 for all 15 cities where ordinances were in force, as well as for 15 similar control communities without smoke-free ordinances during this period. These data were analyzed using multiple regression, including time and a dummy variable for whether an ordinance was in force.

Popular films do not reflect current tobacco use.

This study examined trends in tobacco use in a random sample of 2 of the 20 top-grossing US films each year from 1960 through 1990 (62 films). The overall rate of tobacco use did not change. Films continue to portray smokers as successful, attractive White males.

Metoprolol does not attenuate atherosclerosis in lipid-fed rabbits exposed to environmental tobacco smoke.

Background: We previously demonstrated that exposure to environmental tobacco smoke (ETS) increases the development of atherosclerosis in lipid-fed rabbits. Clinical studies have suggested a protective effect of beta-blockers in smokers. Accordingly, we evaluated the effects of metoprolol in this animal model to see whether this beta-blocker would block the atherogenic effects of ETS.

Influence of filling on left ventricular diastolic pressure-volume curve during pacing ischemia in dogs.

The reversible upward shift of the diastolic pressure-volume curve that occurs during pacing-induced ischemia has not been fully explained by increases in passive chamber stiffness or reductions in relaxation rate. We measured the fully relaxed pressure-volume relation defined by both filling and nonfilling beats and the isovolumic relaxation time constant in nonfilling beats before and during demand ischemia using our in situ left ventricular volume clamping technique in 10 dogs. Pacing-induced ischemia shifted the diastolic pressure-volume curves in filling beats upward compared with the end-diastolic pressure-volume relation of the normally perfused heart.

Exposure to environmental tobacco smoke increases myocardial infarct size in rats.

Background: Exposure to environmental tobacco smoke (ETS) has been epidemiologically linked to death from ischemic heart disease in nonsmokers. In this study, we evaluated the influence of 3 days, 3 weeks, and 6 weeks of ETS exposure on myocardial infarct size in a rat ischemia/reperfusion model.

Methods And Results: Sprague-Dawley rats exposed to ETS (four Marlboro cigarettes per 15 minutes, 6 hours per day, 5 days per week) for 3 days (n = 24), 3 weeks (n = 21), or 6 weeks (n = 12) and control rats (n = 24, n = 21, and n = 12, respectively) were subjected to 35 minutes of left coronary artery occlusion and 2 hours of reperfusion.

The tobacco industry, state politics, and tobacco education in California.

Objectives: Proposition 99 added 25 cents to the California state cigarette tax and mandated that 20% of the new revenues be spent on tobacco education and prevention programs. This paper examines the implementation of these programs and the tobacco industry's response to Proposition 99.

Methods: Political expenditure data for twelve tobacco firms and associations were gathered from California's Fair Political Practices Commission and secretary of state's Political Reform Division.