Case Studies
Tobacco Excise Tax Constitutional Amendment Referendum
Campaign in Colorado
Planning
Was a needs
assessment completed?
No
Approach Used
Science-based best practices, including The Guide to
Community Preventive Services, identify increasing the
price of tobacco products as a highly effective strategy
to reduce both youth and adult tobacco use prevalence
and consumption. Since 1986, Colorado's cigarette excise
tax was $0.20. An unsuccessful effort to increase the
tax by $0.50 had been made during 1994. Following
several years of budget reductions, during fiscal year
(FY) 2003 the legislature cut the MSA-funded
appropriation to STEPP by 40%, and under funded or left
unfunded other essential health-related programs. In
response to these program cuts and to the 16 years of
level tobacco excise taxes, CTEPA, during 2002,
conducted an in-depth appraisal of tobacco use
prevalence and what the "funding landscape" for tobacco
prevention and treatment looked like in future years.
Given the current climate and expected future trends,
CTEPA was determined to broaden and strengthen its
membership to advocate more effectively for public
policies to reduce tobacco use in Colorado and to ensure
adequate funding for a comprehensive tobacco prevention
and treatment program. CTEPA applied to the Robert Wood
Johnson Foundation (RWJF), SmokeLess States Program for
a Special Opportunity grant to assist its efforts. The
application served as a de facto needs assessment.
Planning Models Used
No one
specific model was used. Rather, the campaign plan was
developed by people who were aware of and had received
specific training in several planning models.
Planning Notes
The
Colorado constitution has unique requirements for
raising and appropriating revenues, including a
Taxpayers Bill of Rights that strictly controls spending
on state programs. Before the current initiative, the
last attempt to increase tobacco excise taxes occurred 8
years earlier during the 1994 general election. Due to
insufficient planning, few partners from outside the
traditional tobacco control advocacy community, and
millions of dollars spent by the tobacco industry on a
campaign opposing the tax increase, the effort to raise
the cigarette excise tax by $0.50 not only failed by a
39%-61% margin but also left tobacco control advocates
dispirited, disheartened, and distrustful of each other
for several years.
During 1998, 4 years after the defeat, and coinciding
with the signing of the MSA, CTEPA began a focused
rebuilding effort. During 1999–2002, the Colorado
legislature provided limited MSA revenues to the
Colorado Department of Public Health STEPP to fund a
tobacco use prevention and control program. Unresolved
negative feelings among legislators toward the tobacco
control community, however, remained from the 1994
campaign. The more active that tobacco control advocates
were in raising grassroots support for increased STEPP
funding, the less financial support the program received
from the legislature. No champions for tobacco control
were in the state legislature; in fact, Philip Morris
considered Colorado a “friendly” venue. Although the
chief medical officer of the Colorado Department of
Public Health supported tobacco prevention and treatment
efforts, other leadership had little expertise in
tobacco issues. Funding for tobacco prevention and
control in STEPP was cut 40% (from $12.7 million in FY
2002 to $7.6 million in FY 2003), and then cut in half
to $3.8 million during FY 2004. The tobacco control
community’s positive experience of working together
advocating for MSA funding for STEPP for a comprehensive
tobacco prevention and control program at the
CDC-recommended minimum level, coupled with the adverse
conditions in which advocates found themselves,
strengthened the tobacco control community’s resolve to
rebuild the tobacco control movement in Colorado.
During 1994–2002 period, some attempts were made to test
the waters for public support for increasing tobacco
excise taxes, but those efforts came to a dead end. By
fall 2002, CTEPA was ready to assess the feasibility of
a campaign to pass a constitutional amendment to
increase tobacco excise taxes. CTEPA leadership,
however, recognized that the residual dislike for
tobacco control issues in general, and tobacco control
advocates in particular, needed to be addressed before
embarking on a statewide campaign. CTEPA applied for and
was awarded in December 2002 a $100,000 Special
Opportunity grant from the RWJF SmokeLess States Program
to continue efforts to expand and strengthen the
coalition. Broadening the tobacco control base and
enlarging the tobacco control constituency to include
groups interested in health care issues was essential
for rebuilding the momentum for tobacco prevention and
treatment issues as well as for the coalition’s survival
as a respected leader in the state’s tobacco control
community.
With the RWJF SmokeLess States Program Special
Opportunity grant in hand, CTEPA used unrestricted
dollars to initiate the “title setting” process required
to put a constitutional amendment on Colorado’s ballot.
CTEPA submitted language to the Title Board to increase
tobacco excise taxes and to dedicate the revenues to
health-related programs. Concurrently, CTEPA began
working with health care advocates to develop a proposal
to earmark revenues raised by the tax increases for
health care programs and for tobacco prevention and
treatment. The decision to begin the title process
during 2003 was strategic—in effect, a rehearsal for
2004. CTEPA sought to determine whether and how the
tobacco industry and its allies would challenge the
amendment’s language. Philip Morris, RJ Reynolds, and
Brown & Williamson challenged whether the language of
the title was clear and accurate and whether the
initiative addressed a single subject as
constitutionally mandated. The Title Board approved the
amendment language, the tobacco companies appealed, and
in the spring of 2003, the Colorado Supreme Court ruled
in favor of CTEPA. With the knowledge that the amendment
language met constitutional standards, CTEPA withdrew
the amendment for voter consideration during 2003.
During late spring 2003, CTEPA hired a public relations
firm with close and trusted ties to both tobacco control
organizations and health care organizations in order to
improve their strained relations and identify potential
new partners. While this work was ongoing, CTEPA
contracted with a facilitator in July 2003 specifically
to bring to the table the state’s top health care and
tobacco control leaders to discuss joining forces to
increase tobacco excise taxes and dedicate revenues to
health-related programs. This group emerged as the
Steering Committee for CHC, the new coalition of tobacco
control and health care advocates. The group agreed to
support a campaign to increase tobacco excise taxes that
focused on the science-based Guide to Community
Preventive Services, which recommends that
increasing the price of tobacco products is a highly
effective strategy to prevent youth from smoking and to
promote quitting among current smokers. The Steering
Committee continued its discussion on how much to
propose raising the tobacco excise taxes and on how to
allocate the revenues from excise tax increases. A poll
was conducted that summer showing strong public support
for increasing tobacco excise taxes.
Throughout the summer and fall of 2003, the Steering
Committee worked to determine (1) how much to increase
the taxes; (2) how to earmark the revenues raised by the
increased taxes; and (3) whether to collect signatures
to place the amendment directly on the ballot or seek a
legislative vote to place it on the ballot. Ongoing
discussions were held among CHC and the Steering
Committee on whether to establish a new foundation to
administer the tobacco education and cessation program
that would be funded with the revenues generated by the
tobacco excise tax increases or to designate STEPP as
the administrator. Although there was strong support for
STEPP’s efforts and effectiveness during the past
decade, some key leaders expressed concern about the
Colorado Department of Public Health’s commitment to
tobacco prevention and control, and argued that a
foundation could more effectively administer an enhanced
tobacco education and cessation program. During October
2003 several CTEPA members participated in CDC-sponsored
training on sustaining state tobacco prevention and
control programs. At that time, the participating CTEPA
members expressed their commitment to (1) oppose further
cuts in MSA funding for STEPP; (2) oppose legislative
efforts to securitize future MSA payments; (3) work with
CHC to further refine the elements for inclusion in a
constitutional amendment to increase tobacco excise
taxes, including earmarking revenue generated by the
increased taxes to STEPP for a comprehensive tobacco
prevention and control program funded at the
CDC-recommended minimum ($24 million) or higher with the
remaining funds allocated to health-related programs;
and (4) prevent the legislature from placing any other
tobacco excise tax initiative on the November 2004
ballot. Following the CDC-sponsored training, the group
met with the CHC Steering Committee, which endorsed
designating STEPP as the program administrator for
Colorado’s tobacco prevention and control efforts.
The Steering Committee evolved into the Executive
Committee of the campaign. By early winter, CHC reached
a consensus (1) to increase the cigarette excise tax by
$0.64, from $0.20 to $0.84; (2) to double the excise tax
on other tobacco products from 20% to 40% of the
wholesale price; and (3) to earmark the revenues raised
by the tax increases for tobacco prevention and
treatment and other health-related programs, i.e., 46%
for expanded health coverage for low-income children and
adults, 19% to boost primary care, 16% for tobacco
education and cessation, 16% for preventing and treating
cancer and heart and lung diseases, and 3% to bolster
the Old Age Pension Fund and compensate counties for
lower sales tax revenues from tobacco.
Page last modified 07/25/2007
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