New UCSF state report now available: Tobacco Policymaking in Illinois, 1965-2014: Gaining Ground in a Short Time

Randy Uang, Richard Barnes, and I have just completed your state report on Illinois, Tobacco Policymaking in Illinois, 1965-2014: Gaining Ground in a Short Time, which can be downloaded for free here.
 
Here is the Executive Summary:
 
Health and Budgetary Costs of Tobacco Use in Illinois
 

• Tobacco-induced diseases cost $785 million in state Medicaid expenditures in 2005; over1 percent of the state budget in the 2010s went to treating the health effects of tobacco.

Tobacco Industry Influence

• Tobacco industry campaign contributions to elected officials in Illinois between 1995 and2012 totaled at least $4.9 million.
• In every two-year election cycle between 1995-1996 and 2011-2012 the tobacco industrygave campaign contributions to most (58% to 88%) state legislators.
• Spikes in contributions occurred around the 2002 state cigarette tax increase, the January2008 effective date of the Smoke Free Illinois Act, and the 2012 increase in state taxesfor cigarettes and other tobacco products.
• On a per capita basis, the tobacco industry made campaign expenditures in Illinois at a rate four times that of neighboring Indiana.
• Tobacco industry allies from the 1950s through 1990s included the heads of major statehospitality associations.
• In the 2000s, the heads of the Illinois Restaurant Association and Illinois Licensed Beverage Association changed, and these organizations stopped backing tobacco industrypolicy positions.

State Tobacco Control Organization

• The Illinois Coalition Against Tobacco originated from precursor health advocate groups starting in 1965, and had its strongest funding from 1994 to 2004 under a series of grants from the Robert Wood Johnson Foundation’s SmokeLess States program.Clean Indoor Air and the Smoke Free Illinois Act
• Between 1977 and 1989, 21 municipalities passed smoking restrictions.
• From 1983 through 1988 the tobacco industry blocked state clean indoor air legislation.In 1989, the Tobacco Institute won legislation that preempted local governments fromregulating smoking, freezing local activity.
• After a 16-year-long campaign by health advocates, the Illinois General Assemblyrestored local authority in 2005 for municipalities, and in 2006 for counties.
• Local ordinances between 2005 and 2007 came from the efforts of local smokefree coalitions with assistance from the members of the Illinois  Coalition Against Tobacco,which encouraged local activity to build pressure for a statewide law.
• The Smoke Free Illinois Act passed in 2007 and went into effect in 2008, requiringsmokefree indoor workplaces, restaurants, bars, casinos, and private clubs.
• The Smoke Free Illinois Act included casinos because its Senate sponsor and an additional key supporter were in positions of legislative leadership and took a stand against amendments that might weaken the law.
• As part of a jurisdictional battle between the legislature and Governor Rod Blagojevich, the Illinois General Assembly’s Joint Committee on Administrative Rules blocked implementing rules for the Smoke Free Illinois Act in 2008. As of May 2014, the implementing rules had not been issued.
• Between 2007 and 2012, health advocates blocked a series of legislative attempts to add exceptions to the Smoke Free Illinois Act, especially for casinos.

Tobacco Taxes, Youth Smoking Prevention, and State Tobacco Control Programs

• Between 1970 and 1993, cities and counties with “home rule” status could enact new cigarette taxes.
• The tobacco industry won legislation in 1993 to remove local power to establish new local cigarette taxes, leaving only a handful that already had local cigarette taxes to maintain or change existing local cigarette tax rates.
• Chicago’s cigarette tax of $1.18, as of 2014, combined with Cook County’s $3 tax and Illinois’ state cigarette tax, gave Chicago the highest combined state and local cigarette taxes in the United States.
• Chicago banned the sale of bidis in 1999; Illinois banned bidi sales in 2000.
• In 2013, Chicago prohibited the sale of menthol cigarettes within 500 feet of schools.
• In 2014, Chicago required tobacco retailer licenses to sell electronic cigarettes and added requiring electronic cigarettes in Chicago’s existing smokefree ordinance.
• Funding for tobacco control programs reached over $46 million in the 2001-2002 fiscal year but was reduced to $11 million in fiscal year 2002-2003, and remained at similar levels through the early 2010s.

Conclusions and Recommendations

• Tobacco policymaking in Illinois shifted from a period of persistent wins by tobaccoindustry interests from the 1960s to 1980s, to increasing progress on clean indoor air and tobacco taxes from the 1990s onwards.
• Major factors in the success of public health advocates were giving priority to tobacco control and becoming more assertive over the decades from the 1960s to 2010s.
• Outside funding from the Robert Wood Johnson Foundation contributed to building the capacity of the Illinois Coalition Against Tobacco, showing the ability of national organizations to shape the conditions under which tobacco policymaking takes place.
• The case of Illinois confirms that the tobacco industry works to thwart smokefree laws by courting the restaurant and casino industries, using third-party business associations, creating front groups, and fighting smokefree laws after passage.
• Health groups at the state level must have dedicated staff working to tobacco control, including lobbyists at the state capitol during the legislative session.
• Health advocates should make the widespread campaign contributions of the tobacco industry in Illinois more of an issue.
• For policy issues with inaction at the state level, including for menthol cigarettes and electronic cigarettes, advocates and local health departments must push at the local level, replicating the local-to-state strategy that proved successful for smokefree laws.
• State health advocates should continue to press for increased appropriations for the state tobacco control program.
• The state tobacco control program should broaden the scope of advertising to discuss issues of tobacco beyond promoting the Illinois Tobacco Quitline.

The full report is availabe for free here.  All our state reports are available here.