UC TOBACCO FELLOWS

Delve into the comprehensive journey of tobacco control measures in California led by Dr. Stanton A. Glantz, PhD. Explore the pivotal moments from the nonsmokers' rights movement to the profound effects on industry sales and public health outcomes.

• Tobacco control
• Public health
• California
• Stanton Glantz
• Anti-smoking

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1. Stanton A. Glantz, PhD UC TOBACCO FELLOWS

2. Early years Nonsmokers rights movement Propositions 5 and 10 in 1978 and 1980 Local ordinance strategy

3. Proposition 99 (1988) 25 cent tobacco tax 5 cents for tobacco control 2 cents for research Tobacco control program Focuses on social norm change Directly confronts industry

4. Per capita cigarette consumption Per Capita Cigarette Consumption (Packs/Year) United States - California California 140 120 100 80 Prop 99 60 Tax increase 40 1979 1984 1989 Year 1994

5. Age Adjusted Heart Disease Mortality 200 United States - California California Age-Adjusted Heart Disease Mortality 180 (deaths/100,000) 160 140 Prop 99 120 Tax increase 100 1979 1984 1989 1994 Year

6. Effect on Mortality 175 Age-Adjusted Heart Disease Mortality (deaths/100,000 Resident Population) 155 59,000 fewer deaths (9%) 135 115 1,500 unnecessary deaths 95 1979 1984 1989 1994 Year

7. Effect on Industry Sales Per Capita Cigarette Consumption 115 95 (Packs/Year) 2.9 billion packs not smoked ($4 billion) 75 55 1 billion extra packs ($1.4 billion) 35 1979 1984 1989 1994 Year

8. Lung cancer incidence in SFO California 73 71 Age adjusted incidence (cases/100,000/year) 69 67 65 14% reduction 63 61 Anti-tobacco program 59 57 55 1975 1980 1985 1990 1995 2000 In the first 10 years in SFO: 6% cases (2036 cases in SFO) Statewide: 11,000 cases in 10 years

9. Annual Health Care Savings Attributable to Historical CA Tobacco Control Expenditures 20 Annual savings in CA personal health care expenditures, billions of 2004$ 15 10 5 0 1990 1992 1994 1996 1998 2000 2002 2004 Year

10. But it was fading Inflation Industry dominates legislature Two failed initiatives Prop 29 in 2006 Prop 86 in 2012

11. Litigation against industry Mississippi, Florida, Texas Minnesota Tobacco documents Then other states Washington and MSA $246 billion Little for tobacco control More documents American Legacy Foundation

12. RICO case Same law used to prosecute organized crime No money Broke up industry Restricted denials Banned light and mild Even more documents They are racketeers

13. FCTC 2003 Global health treaty 180 parties Followed by more Smokefree laws Health warning labels Taxes But fading

14. FSPTCA/FDA 2009 Granted FDA authority over cigarettes and smokeless tobacco Banned characterizing flavors Except menthol Banned light and mild Allowed deeming other tobacco products Finally happened in May 2016

15. FDA actions Not much Warning labels thrown out Underestimated effect Consumer surplus ( lost pleasure ) Report but no action on menthol Funding research Strong educational campaigns No meaningful product regulation Now: Comprehensive nicotine strategy Embraces industry s harm reduction frame

16. Smokefree Movies Movies are biggest reason kids smoke Halfway to fixing the problem

17. Important 2016 California Legislation E-cigarettes in clean indoor air law Close loopholes in clean indoor air law Tobacco 21 Increase tobacco license fee to cover costs Local legislation on menthol and flavored tobacco products Because of failure of national FDA

18. Back to the Future Proposition 56 in 2016 $2 tax increase Includes e-cigs and other products A smokefree society is within reach Price increase Reinvigorate tobacco control program