Traynor M P, Glantz S A
University of California, USA.
J Health Polit Policy Law. 1996 Fall;21(3):543-85. doi: 10.1215/03616878-21-3-543.
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. They organized a long-term effort by conducting essential polling, planning strategies, gaining media exposure, developing a coalition, and running a successful campaign to enact the tax by shifting the venue from legislative to initiative politics. To build the coalition that was needed to pass Proposition 99, public health proponents enlisted the help of medical organizations in exchange for additional revenue to be allocated to medical services. By shifting the venue from the legislature to the general public, advocates capitalized on public concern about tobacco and for youth and took advantage of the tobacco industry's low credibility. The passage of Proposition 99, despite a massive campaign against it by the tobacco industry, represents a milestone in the tobacco control and public health fields. From its passage in 1988 through 1993, tobacco use in California declined by 27 percent, which is three times faster than the United States average. As a result, Proposition 99 has served as a national model for other states and the federal government. Although allocation of tobacco tax revenues specifically to health education and prevention was a primary goal during the development and passage of Proposition 99, when the venue shifted back to the legislature for implementation, medical organizations successfully advocated illegal diversions of Proposition 99 tobacco control and research funds to medical services. Organizations seeking to enact Proposition 99-like tobacco tax increases must be prepared to mount aggressive campaigns to pass the initiative in the face of major tobacco industry opposition and then must continue to work to protect the program after passage by voters.
在本案例研究中，我们描述并分析了加利福尼亚州烟草税倡议提案99号即《1988年烟草税与健康促进法案》的发展历程及通过情况。我们从已发表的报告、公共文件、私人信件、内部备忘录、民意调查数据以及对参与提案99号活动的组织代表的访谈中收集信息。提案99号的通过得益于志愿健康机构、医学组织和环保组织联盟的努力。他们通过开展关键民意调查、制定策略、获得媒体曝光、建立联盟以及开展成功的活动，将立法途径转变为倡议政治途径，从而成功推动了该税收法案的颁布。为建立通过提案99号所需的联盟，公共卫生支持者寻求医学组织的帮助，以换取将额外收入分配给医疗服务。通过将途径从立法机构转向普通公众，倡导者利用了公众对烟草以及对青少年的关注，并利用了烟草行业的低可信度。尽管遭到烟草行业的大规模反对，提案99号的通过仍是烟草控制和公共卫生领域的一个里程碑。从1988年通过到1993年，加利福尼亚州的烟草使用量下降了27%，下降速度是美国平均水平的三倍。因此，提案99号成为了其他州和联邦政府的全国典范。尽管在提案99号的制定和通过过程中，将烟草税收入专门用于健康教育和预防是一个主要目标，但当实施途径转回立法机构时，医学组织成功地主张将提案99号的烟草控制和研究资金非法挪用至医疗服务。寻求颁布类似提案99号的烟草税上调举措的组织，必须准备好在面对烟草行业的重大反对时开展积极的活动以通过该倡议，并且在选民通过后必须继续努力保护该项目。
