Tobacco tax initiatives to prevent tobacco use: a study of eight statewide campaigns.

This article reviews the history of successful and unsuccessful tobacco tax initiatives in eight states in the U. S. since 1988. It addresses the common origins of these initiatives and proposes several strategies for the success of citizen-based initiative campaigns attempting to raise the tobacco excise tax. It explores the impact of tobacco tax increases on youth and discusses why youth consumption is increasing even in the face of rising tobacco taxes. Only 50% of the states in the U. S. can pass tobacco tax increases using the initiative process; the other states require legislative action. Four states have succeeded in passing citizen-sponsored tobacco tax initiatives, whereas two others have failed at the ballot. Efforts in two other states foundered when insufficient signatures were submitted to gain a spot on the ballot. Surveys in all six states in which initiatives were placed on the ballot revealed similar high levels of voter support, but the clearest factor separating winning from losing campaigns was the availability of sufficient financial resources. Other important campaign elements included strong leadership, broad coalitions, experienced legal and political consultants, access to public opinion research, and advance planning.