EXECUTIVE SUMMARY - Iowa was a tobacco control leader in the 19th Century. In 1897 the General Assembly completely prohibited the use, sale, and possession of tobacco products in the state. When the law was repealed in 1921, the General Assembly enacted strong measures to prevent tobacco use by minors. In 1921 Iowa passed the first state cigarette excise tax (2 cents). - Tobacco control reemerged in the 1970s, however a coalition of health groups were consistently outmaneuvered by tobacco industry lobbyists. - In 1990 health groups attempted to strengthen Iowa’s Clean Indoor Air Act (passed in 1987), however the tobacco industry, represented primarily by Charles Wasker, co-opted the bill, stripping meaningful tobacco control provisions and using it to include ambiguous language to preempt localities from passing clean indoor air laws, which chilled local clean indoor air action for a decade. - In 1993 the voluntary health organizations founded Tobacco Free Iowa (TFI), a dedicated statewide tobacco control coalition to advocate for tobacco control policy change. In 1995 TFI hired Serge Garrison, a former R.J. Reynolds (RJR) lobbyist, to lobby to repeal clean indoor air preemption. Garrison, who helped draft the preemption clause when working for RJR, questioned whether Iowa’s ambiguously worded clause actually preempted local clean indoor air action. - Iowa, represented by Attorney General Tom Miller (D), was a party in the 1998 Master Settlement Agreement. Miller and the Iowa Attorney General’s Office, have been strong allies to tobacco control in Iowa. - After the MSA, in 2000, Iowa created the Division of Tobacco Use Prevention and Control within the Iowa Department of Public Health to implement a state tobacco control program funded with MSA revenue. - In 2001 the General Assembly passed legislation to securitize the MSA revenue stream to receive an upfront lump sum in lieu of most future MSA payments. Politicians framed MSA securitization as a way to create stable funding for health programs, including tobacco, but the vast majority of the money went to infrastructure projects. - The Health Iowans Tobacco Trust created through securitization to fund tobacco and other health programs was continually raided by the General Assembly from 2001 to 2008, and zeroed out in 2009. - The Iowa Tobacco Division has never been funded at or near the CDC recommended best practices for tobacco control and tobacco control advocates have not mobilized enough political pressure to demand and protect funding for the Tobacco Division. - From 1998 to 2008, $44,577 in campaign contributions were given to Iowa legislative candidates and party committees by five tobacco companies: Altria/Philip Morris, Farner-Bocken (an Iowa-based distributor), Myers-Cox Company (an Iowa-based distributor),R.J. Reynolds, and US Smokeless Tobacco. - Tobacco industry contributions spiked in 2000 when the Iowa General Assembly was considering legislation to create the Iowa Tobacco Division and deciding the use of their MSA payments. Contributions dropped in 2004 after the General Assembly mandated that the Tobacco Division have a youth focus (a pro-industry position) and securitized most of their MSA revenue. In 2004, industry contributions jumped back up (and steadily increased though 2008) concurrent with an increase in the introduction of tobacco control initiatives (which were repeatedly killed until 2007). - The tobacco industry focused contributions on legislative leaders. Rep. Christopher Rants(R-Woodbury) former Iowa House Majority Leader (1999-2003) and Speaker of the House (2003-2006) received the most industry money from 1998-2008 ($7,397). Rants was a key player in killing tobacco tax and local control bills throughout the 2000s. Representative Jamie Van Fossen (R- Scott) who served as the Chair of the House Ways and Means Committee received the second greatest amount ($6,050), followed by Sen. Stewart Iverson, Jr. (R-Wright), Senate Majority Leader from 1997-2006 ($2,220). - From 1998 to 2008, tobacco industry contributions to Republican candidates and the Republican party ($27,947) far outweighed contributions to their Democratic counterparts($15,130). From 1998 to 2007, Republicans controlled both houses (except in 2006 when the Senate was tied). - Republican legislators were significantly more pro-tobacco than Democrats. - Legislators who accepted campaign contributions from the tobacco industry were significantly more pro-tobacco than those who did not, controlling for party. - The tobacco industry maintains a significant lobbying presence, between 2003 and 2008 the tobacco industry reported $667,875 in lobbying expenditures in Iowa. - After an inquiry prompted by Serge Garrison in the late 1990s, Attorney General Tom Miller (D) issued an opinion in November 2000 stating that state law did not preempt local clean indoor air ordinances. - From 1999 to 2003 there was a tide of local clean indoor air action. In March 2002, Ames passed Iowa’s first clean indoor air ordinance. Ames’ ordinance included a tobacco industry inspired “hours” provision that allowed smoking after 8:30pm, advocated for by hospitality interests, making the ordinance weak. Its passage created momentum for other localities to pass clean indoor air measures. - In January 2002, Iowa City passed Iowa’s first 100% smokefree restaurant ordinance. Other localities, aided by the Iowa Attorney General’s Office and TFI, began considering ordinances and enactment of voluntary clean indoor air policies. - Local clean indoor air progress was blocked in 2003, after a group of Ames business owners, funded by Philip Morris, challenged the Ames ordinance in court. In May 2003, the Iowa Supreme Court ruled that the 1990 Clean Indoor Air Act was preemptive. - In 2003, TFI collapsed, leaving Iowa without a functioning tobacco control coalition until 2006. In 2003 some advocates reorganized to create CAFE Iowa and CAFE Iowa CAN, primarily to repeal preemption. - Beginning in 2005, under the direction of Iowa Tobacco Division Director Bonnie Mapes, Iowa advocates reorganized and created a strategic plan. In 2006 the Iowa Tobacco Prevention Alliance was created to assume the role of Iowa’s statewide tobacco control coalition. - The combination Democrats taking control of the legislature in 2007 and the reorganization of tobacco control advocates in 2006 led to substantial tobacco control policy changes. - In 2007 the Iowa General Assembly passed a $1 increase in the cigarette tax, the first increase in 16 years. - In 2008 the General Assembly passed the strong Iowa Smokefree Air Act that extended smokefree environments to 99 percent of Iowa employees and repealed preemption. - Following the 2007 tax increase, adult smoking rates in Iowa fell from 18 to 14% in two years (2006 to 2008). - Youth smoking rates increased from 2004 to 2006 following a substantial cut in allocations to the Tobacco Division in 2002, leading to a substantial decrease in expenditures for Just Eliminate Lies, Iowa’s youth counter-marketing campaign. - Tobacco control advocates must make securing and maintain adequate funding for Iowa’s Tobacco Division a top priority. The CDC recommends that tobacco control programs in Iowa be funded at $36.7 million per year. In FY 2009, the Tobacco Division received only $11.0 million, less than a third of the CDC recommended level. An increase in funding is particularly important because of the increase in youth smoking rates since JEL’s 2002 funding cut. - Given the Tobacco Division’s limited budget and the increasing levels of youth and young adult smoking, the Tobacco Division should focus less on funding individual level cessation services (other than the Quitline, which is a public health intervention) and instead increase its emphasis on media and community-based programs that are more cost effective public health interventions to reduce tobacco use. - Advocates should work to require health insurance to provide cessation services through the medical services budget, not public health. - Advocates need to expand their base beyond major cities to rural areas of Iowa to broaden the base of support for smokefree environments and expand the political base to maintain and expand funding for tobacco control efforts.