14. Doing It
By the fall of 1995, because of the failure of the Legislature to
appropriate the Proposition 99 revenues in accordance with the lawsuits, substantial
amounts of Proposition 99 money had not been spent for anything. The courts stopped the
governor and Legislature from spending the money for medical services, and the governor
and the Legislature refused to spend the money for anti-tobacco education and research.
The Health Education Account was projected to contain $191 million by June 1996, and the
Research Account $82 million. A total of $274 million had been diverted away from
anti-tobacco education and $71 million from research, and these cuts were having an
effect. The prevalence of youth smoking had increased by 20 percent between 1994 and 1995
(from 9.1 percent to 10.9 percent), and adult prevalence was no longer declining. In fact, adult prevalence appeared to be increasing for the
first time since the state began collecting statistics in 1974. Thanks to the governor,
the Legislature, and the medical lobby, the tobacco industry was reversing the damage that
Proposition 99 had done to it.
As they prepared for the 1996 reauthorization fight, tobacco control
advocates had two court decisions on their side. But a favorable court decision had been
of little help to them in 1995 when the Legislature passed SB 493. The governor and
Legislature seemed more angered than chastised by their legal defeats. The challenge to
tobacco control advocates was how to change the outcome of the authorization fight.
The Need for a Change
The lobbyists from the three voluntary health agencies ”American
Cancer Society (ACS), American Lung Association (ALA), and American Heart Association
(AHA) ”organized a series of fall meetings led by AHA to plan a strategy for the
Proposition 99 reauthorization fight. They needed focus, energy, and resources. As Paul
Knepprath, who had joined Tony Najera as a lobbyist for the state ALA in 1995, explained,
What we needed the next go around was not a pure sort of traditional
legislative lobbying campaign but rather a campaign that included other elements that
brought the public pressure from the outside more. ¦There was a consensus that we
needed to do things differently for reauthorization than what we had done in the past.
There was consensus on bringing in new players and new partners, which I'm not sure which
ever came to fruition.  Beyond acknowledging that
something had to be done differently, there was little activity.
This lack of action on the part of the voluntaries was confirmed for the
local lead agencies (LLAs) in a monthly technical assistance telephone call hosted by the
American Nonsmokers' Rights Foundation (ANRF), the educational arm of Americans for
Nonsmokers' Rights (ANR). The service was part of the technical assistance provided by
ANRF under contract to the Tobacco Control Section (TCS). ANRF director Julia Carol used
this forum to let the LLAs know what was happening on reauthorization. Carol attempted to
use an early fall teleconference to bring the LLAs together with the ACS:
ANR's plan was to have nothing whatsoever more to do with any
statewide efforts, we were just doing our work. But I still wanted to look out for the
constituency we serve, so I invited the Cancer Society to come on the line and give an
update on the plans for reauthorization for Prop. 99. ¦I was trying to get these
people to look to the Cancer Society for leadership and not to us and that these people
were very mistrustful and that they needed to know that something was going on and they
needed to be included. They needed to be a part; they're tired of being left out.
They're suspicious of deals being cut in the dark and of people not telling them things.
So really there needed to be a frank conversation with them about what
the plans were and what they could or couldn't do, what the communities could or couldn't
do. So ¦I asked Theresa [Renken, the ACS lobbyist] to give an update and she said,
Well you know, we're going to be forming a coalition and we're going to be talking
about blah and we're going to have a big meeting in the fall and we're going to do this
and that and by November we'll do the other and the Legislature is gone and they'll come
back and blah and blah and blah.
And I said to her, What's our plan in the meantime, right
now? And I meant for influencing the budget language before the budget comes out,
but I didn't say that. What's our plan now? And she said in a very
snotty tone, this is a teleconference with over one hundred people on it,
Well, Julia, if you understood the legislative process you would know that the
Legislature is about to be out of session. So there is nothing that can be done until they
return anyway. ¦
So I said to her, Theresa, it sounds to me like the campaign
is going to be run much the same way as it has been the past, is that correct? And
she said, she paused and said, Well, yes. And I said, I see.
¦well then, if you are going to do things the same way, what makes you think
you are not going to get the same results?  [emphasis
The Sacramento lobbyists who had negotiated the implementing
legislation for Proposition 99 over the years still did not appreciate the need to
actively engage the grassroots or the power of doing so.
Tony Najera, who, with John Miller, had headed the inside
game on behalf of the health organizations since 1989 and the passage of AB 75,
revealed why the inside game was played the way it was: Paul [Knepprath] would
from time to time criticize me and rightfully so because he wanted me to include other
parties. And I would always say, `That's nice to be inclusive and to bring people along.
However, there are times where you have personal relationships and ¦they don't want other
people. They want to be able to confide, quietly tell you what they think.'  Najera was sensitive to his role in the inside game:
I've been accused of giving away the store by people that don't understand this
game. I consider that a false accusation which is very unfounded. 
Steve Scott of the California Journal observed that the behavior
of the voluntary health agencies' lobbyists was typical of the tendency of the lobbyists
in Sacramento to live in their own world:
As somebody who covers the Capitol, I can't be too critical of the way
they [the voluntary health agency lobbyists] approach the Legislature. ¦You tend to
become a product of the system in which you operate and over time I'm sure that these
lobbyists are no different from any other lobbyists. Over time you become inculcated into
the culture and you start to think in incremental terms rather than in bolder terms. But
that's why you have grassroots. ¦Ultimately the lobbyists are employees. And if the
people who employ them don't look beyond what they are telling them, then they are not
doing their members any good service either. So I don't think that the grassroots arms of
the organizations can be exempted from a share of responsibility for allowing the Prop. 99
situation to atrophy the way it did. Because the repository for all wisdom isn't the
lobbyist in Sacramento.
Thanks to Proposition 99, the TCS and ANR leadership, and the LLA
directors, the local tobacco control coalitions were getting stronger and more organized.
They could not understand why the lobbyists in Sacramento were not reaching out to tap
At the same time, things were changing at the AHA in a way that would
lead to a much stronger appreciation of the grassroots. Mary Adams had recently replaced
Dian Kiser as AHA's lobbyist. While Adams had been involved in the early Proposition 99
fights as the ACS lobbyist (as Mary Dunn), she had lived in Europe for several years and
had only returned to Sacramento in November 1994. She was surprised at how far the
Proposition 99 allocations had deviated from the terms of the initiative. In crafting a
legislative strategy for 1996, Adams felt that the voluntary health agencies needed to
open up the process and involve new people, particularly those in the field who had been
fostered by Proposition 99's community-based activity. She also
recognized the need for the tobacco control advocates to be more nonpartisan and
I wanted to have both Democratic and Republican representatives.
Because in the past, we'd just always focused on the Democrats and I felt like that wasn't
going to get us where we needed to go. ¦I started communicating to my organization
after meeting with this group and I hawked the same three points all the way through with
this group that I had drawn together and then with my own organization: that we needed to
have an intensive grassroots effort, ¦that we had to have intensive use of the media to
get the public to focus on the issue, and that we needed to have a contract lobbyist with
Republican ties who would be able to work the issue for us in a successful way. And then I
shored that up with just my strong feeling that this was all going to take place through
the budget, that it was not going to go through the normal legislative track.
Having been absent from the battles in Sacramento over the past few
years, Adams had an easier time recognizing strategic errors that the voluntary health
agencies had made: The strategies that had been used in the past ¦had been
dismal failures. When I left, there was a ton of money coming. When I came back I saw the
whole thing in a real mess. I knew that we had to draw together many more facets, many
more approaches than had been used in the past.  Adams
wanted a more aggressive campaign to defend Proposition 99 that reached well beyond the
Capitol building and was determined to get ANR and its past president, Stanton Glantz, on
But involving Glantz and ANR was not just a matter of adding their names
to a coalition letterhead and proceeding with business as usual. Neither Glantz nor the
ANR leadership had much confidence in pursuing the kind of insider game that had failed
for the last several years. They were committed to action with a strong grassroots
component based on their experience doing battle over Propositions 5, 10, and P and
passing hundreds of local ordinances. They also recognized the central role that the CMA
and other medical interests had played in legitimizing the diversion of money out of the
Health Education and Research Accounts; they viewed neutralizing the CMA as the crucial
first step to restoring Proposition 99. But they doubted that the voluntary health
agencies would have the nerve to confront the CMA, much less the governor or the
ANR had built its reputation as a grassroots organization by being a
confrontational outsider. Even if it could be persuaded to change its focus from local
ordinance fights, its preferred strategy, to a state-level one, it would certainly not
compromise its style in the process. ANR had its own vision of what was needed in the
Proposition 99 fight. According to ANR co-director Robin Hobart,
One thing that we realized was that the only way you were going to see
real reauthorization of Prop. 99 at the full level ”and this was based on our
experience with [Proposition] 188 in some ways ”was that you're going to have to run
it like an election campaign, not like just any old bill. It had to really be a campaign
with all the attendant grassroots strategy and media strategy and inside-the-Capitol
strategy. ¦The other thing that we knew based on how the governor had responded and
the Legislature responded to our lawsuits ”we were successful in court but having
absolutely no effect whatsoever with regards to what the Legislature was prepared to do
”was that it was going to have to be a real gloves-off campaign. People were going to
have to name names. And the California Medical Association was going to have to be forced
to get out of the way.
ANR could envision an effective strategy, but it had no intention of
actually getting involved. Hobart continued, We didn't believe that it ever
was going to happen and so to a certain extent, we decided, `It's really awful, it's
really a shame, but ANR has absolutely no ability to do anything about any of this by
ourselves and we're done.' We gave at the office, the lawsuit was the last thing that we
made a commitment to do to try to save Prop. 99 and after that, we were done. 
Glantz also saw the need for a more confrontational strategy but was
more willing to get involved. In a 1996 interview he said,
And what happened last year [in 1995] was I saw the whole program just
going down the drain. I think the CMA and the Tobacco Institute were coming
in for the kill. ¦The program was in a complete shambles, because local lead
programs had basically been dismantled, because the media campaign was a mess. And the
tobacco companies and the Medical Association had succeeded in turning this into a fight
about money, and a fight about money is not news in Sacramento. And Tony [Najera] and John
[Miller] and the others up there were still pursuing the same old insider strategies where
they'd been screwed every time. Just all the tea leaves were looking bad. ¦I sat
back and I said, Now, ¦am I going to sit here and chronicle the demise of
this program while watching it and have a nice clean paper where I've written about how
the thing went down the drain? ¦I just decided I could not stand to sit and watch
this thing go down the drain because I thought it was just too important.
Meanwhile, as AHA was trying to recruit ANR and Glantz, ACS was engaged
in its own discussion about reauthorization. According to Don Beerline, a past chair of
the ACS California Division, ACS also recognized the need to do something different:
What the ACS decided early last fall [of 1995] was that we had been
unsuccessful. The advocacy in those previous reauthorization campaigns had primarily been
carried out by our professional lobbyists. The lobbyists in those previous campaigns have
complained somewhat that they didn't feel like they really had the support to do what they
needed to do. And given the past history of that failure, the ACS said, We
need to do something different this time. The debate went on within the ACS, and it
culminated when our board of directors in November of 1995 committed $120,000 for this
campaign plus obligated one individual full time for the first six months of 1996, and
this is not a clerical person. This was a middle manager. So that's a significant
commitment of personnel and funds compared to the last time, the assumption being with
that sort of commitment then we would become, for the first time, the lead agency in this
fight. And in the past, it has been other organizations have been considered the lead
agency. And that is exactly what happened. ¦Lung Association definitely and their
representatives were definitely not happy when ACS took the role of the lead agency in
this and decided that we needed to have a different strategy.
Although everyone had the same goal ”full funding of the Health
Education and Research Accounts ”there were no indications that their plans to
achieve those goals meshed.
The December Meeting
Adams scheduled a December 13, 1995, meeting at AHA in Sacramento in
the hope that it would get the key players together to discuss reauthorization, but she
had some difficulty persuading ANR and Glantz to come. Believing that it was impossible
for a voluntary health agency to take the kind of strong action necessary to rescue
Proposition 99, Glantz told Adams that he would only be willing to attend a meeting after
the AHA did something real.
AHA had its chance to do so when Glantz obtained a copy of a
thirty-second anti-smoking advertisement, Insurance, produced by DHS.
After making the point that tobacco companies owned insurance companies that gave
nonsmoker discounts, the advertisement ended with the question What do the
tobacco guys know that they are not telling us? The administration was sitting on
the advertisement. Glantz suggested that AHA hold a press conference to demand that the
governor put the advertisement on the air. AHA did so, together with ALA and, at the last
minute, ACS. The event got media coverage, and Glantz and ANR agreed to attend the
Adams's meeting brought together lobbyists from the three voluntary
agencies ”Adams from AHA, Knepprath and Najera from ALA, and Renken from ACS ”as
well as John Miller from Senator Diane Watson's office, Carolyn Martin, a volunteer with
ALA and past chair of the Tobacco Education Oversight Committee (TEOC), Carol and Hobart
from ANR, and Glantz. The morning session featured a briefing by the TCS staff on the
substance of the program; TCS left before the afternoon strategy session.
During the afternoon session, Adams announced that AHA had committed
$50,000 for the reauthorization effort, $25,000 of which would go to ANR for a grassroots
campaign and the rest to do other things, such as hiring a Republican lobbyist. ANR
committed $25,000 of its own, ALA committed $10,000, and Glantz wrote a personal check for
$1,000 ”creating a war chest of $86,000. Renken did not mention the fact that ACS had
already committed $120,000 to the Proposition 99 effort. The meeting ended with the health
groups posturing, not with an action plan. Glantz, Carol, and Hobart, who felt that the
pledged money would be enough to mount a substantial campaign, left the meeting
The meeting was a watershed. Rather than resulting in a larger, more
diverse working group, which had been AHA's goal, the meeting eventually resulted in a
divided coalition and two different reauthorization campaigns.
Najera later described his reaction to the meeting:
We had been planning and planning since October and we had one thing
in mind, that was a statewide coalition ”united we stand together. But we go to this
meeting in December and that was the telling ¦thing for me, that Mary was playing both
sides, because ANR and Stan had not been working with us necessarily at the October
meetings. And consequently when we got to the meeting in December, it was very clear that
the Heart Association was not necessarily interested or concerned about working together
with the Coalition. And they frankly were attempting to tell us that this wasn't going to
work. It was for me the telling time when it became clear that they didn't want Cancer and
they were afraid that by contributing the money Cancer would take the leadership in this
thing. And it wasn't going to work because Cancer and the governor were friends.
According to Knepprath, ANR and Glantz were assuming that any ACS
strategy would represent the old school, the old way of doing things,
Sacramento based, lobbying, an inside play of the game. Knepprath went on to say,
Stan and ANR were advocating `we're not doing that this time. We're doing
something different this time,' which is their right and prerogative. ¦They were
definitely thinking fast track, and Stan by this time had been pitching to all of us,
`Let's utilize the [Proposition] 188 format in which it wasn't centralized; you didn't
really have a centralized coalition. Everybody did their own thing and we worked together
and, gee, wasn't that great? So let's do that again.' 
Knepprath was seeking basically the same type of centralized coalition that had operated
in the past, except with ACS in charge.
Adams remembered a lot of tension in the room at the December meeting:
Theresa went out in the hall and was talking to somebody, she had her little
nose out of joint and certainly didn't say that they had any money. ¦But I think
that they had already gotten some money put together as well. But it was clear that Tony
was already starting to feel somewhat threatened. The fact that I had been the one that
convened this meeting with TCS and with the others, that Stan and Julia were there
¦  For Adams, the philosophical differences could have
been accommodated if only the strong personalities had not gotten in the way. This view
underestimated the depth of the philosophical disagreements that existed over the approach
the campaign should take. Adams was unaware of how much money ACS had committed to the
campaign, and the distrust she, ANR, and Glantz felt about ACS in a leadership role was
aggravated by Renken's failure to mention it when all the other organizations were anteing
up their contributions.
If the other organizations had negative reactions to the ANR presence,
it was echoed by ANR's response. ANR had not wanted to be involved in the Proposition 99
reauthorization campaign and had not wanted to go to the AHA meeting. Adams convinced them
to come. Carol said about the meeting,
We didn't want to be involved in a big campaign to save Prop 99.
However, one of ANR's goals is to separate tobacco money from politicians and to highlight
the nefarious connection between the tobacco industry and politicians and their
interference in public policy. To that end, the thought of beating up Pete Wilson a little
every now and then over his connection to Philip Morris in fact appealed to me greatly.
When Pete Wilson appointed Craig Fuller, the former senior vice president of Philip
Morris, as his campaign manager [for Wilson's abortive presidential campaign in 1995], we
had run a radio spot asking if Pete Wilson was running for president or just wanted to be
the next Marlboro Man. ¦And I thought we'd follow it up with a Hall of Shame ad,
which I had in draft form at that meeting and we wanted to run. ¦People were
starting to put money on the table as far as what they were going to do with Prop 99, and
Stan thought it would be great for us to spur them along by saying what we were doing.
Stan and Mary both begged us to be there. ¦Mary decided, and she probably regrets
it now, but Mary decided that in order to win Prop 99 we had to be a major player.
¦ it was awful. The Cancer Society said nothing, Lung said what they
were going to put up, we said what we were going to put up, Heart said what they had to
put up. Cancer stayed silent. Theresa only said one or two things, one of which was,
Well, if you beat up the governor, how do you expect him to sign your bill?
Why would he sign the bill if you beat him up? ¦She said nothing about any money.
The next thing I know, Cynthia [Hallett of the Los Angeles LLA] calls me
from L.A. and tells me that the Cancer Society has announced the week before in a public
forum ¦they had I think it was $110,000 and they were going to run a Save 99 campaign.
Now why the Cancer Society would feel free to discuss this publicly, ¦but would sit there
in a meeting with her so-called partners ”an inside-the-room confidential meeting
”and not say a word about it is beyond me.
ANR did not believe that the coalition was prepared to adopt a
vigorous grassroots strategy, attack the CMA, or take ANR's advice seriously. Hobart
came away from that meeting really firmly convinced ¦this is not going to
At the December meeting Glantz knew about the money that AHA, ALA, and
ANR had available, but he did not know about the ACS plan. He later recalled,
We went into that meeting with $86,000, which I thought, intelligently
spent, was enough money, and I went up there all excited. And what happened was exactly
the opposite of what I was expecting, and I think the basic problem was that if normal
human beings had been at that meeting, as opposed to voluntary health agency lobbyists and
small-minded people, we would have walked out of that meeting excited and with a new
leader in Mary. Because she's the one who pulled it together. She had established a
working relationship with TCS. She had gotten all the key stakeholders in the room and
come up with a significant amount of money.
I would have thought we would have walked out of that meeting with a new
fresh face, with a smart woman with some serious resources: I was there with the sort of
intellectual stuff, Julia was there with the grassroots stuff, Tony was there with all of
his insider stuff, which he's good at, Mary was there. We had Paul Knepprath, who is good
with the media. And I think we had the real makings of a good solid campaign. ¦
I think they were tremendously threatened by her [Mary Adams] and the
Heart Association. ¦This had been their little sandbox for all these years and all
of a sudden, here was a new player. And rather than saying, Oh boy! We've got
somebody else to work with, we can be strong and productive and this and that, they
were instantly threatened. ¦And I think the fact that Theresa did not disclose that
the Cancer Society had this big wad of money at the meeting was just at the very least,
unprofessional, and duplicitous and devious and dishonest and all these other things. And
so we came out of that meeting ¦very depressed and Julia had had it. And I was very
The only person who did not seem discouraged by the meeting was John
Miller. Miller felt that the meeting revealed the divisions between the insiders and
outsiders but that, in the end, having an aggressive outside campaign might be helpful.
Whereas Najera and Knepprath suspected that ANR and Glantz were
threatened by ACS, Glantz was concerned that ALA and ACS were threatened by AHA. Either
way, the questions about leadership and direction, far from being settled by the meeting,
seemed to be exacerbated. Despite their differences in strategies, however, all the
players believed that three things had to happen in 1996 if they were to secure full
funding of the Health Education and Research Accounts. First, the CMA had to drop its
advocacy of the diversions. Second, the sole reliance on the inside game had to end and
the grassroots constituency had to be involved. And, third, the media attention had to be
recaptured with a focus on following the will of the voters instead of a
California's fiscal problems and the CMA's support of diversions had
been the governor's best defenses for diverting the Proposition 99 monies. Scott
emphasized the importance of the CMA to the success of previous diversion efforts, saying,
I don't necessarily believe that you're going to find secret
communiques between the tobacco industry and Steve Thompson [the CMA's chief lobbyist] or
anybody with the California Medical Association. I don't think that there is direct
contact and I don't think there was intentional collaboration. But what you had was a sort
of a symbiosis which was acquiesced to by the Medical Association because it furthered
their goals. As this relates to Prop 99, you had the Medical Association that wanted more
money for direct medical services, specifically CHDP. You had the tobacco industry that
was only too happy to let that happen. The Medical Association in the minds of the
legislators who want to support the tobacco industry becomes their astroturf, their front.
They say, Well, I'm just following the views of the California Medical
Association, which has always been very strong on tobacco issues, co-sponsors of
Proposition 99, co-sponsors of AB 13. Whatever else you want to say about them as a
special interest, you can't impugn their reputation on tobacco. You could, but for a
legislator who is inclined to vote tobacco's way, that gives them convenient cover.
In fact, there was a much more active and direct engagement between
the CMA and the tobacco industry than Scott believed (see chapters 3-5).
An important leadership change in the CMA helped to shift the CMA away
from its aggressive opposition to the anti-tobacco education and research programs. In
1995 Dr. Jack Lewin was appointed as the new executive vice president, replacing Robert
Elsner. Lewin had headed the public health department in Hawaii prior to his CMA
appointment and was personally sympathetic to tobacco control. When asked about finding
Proposition 99 on his agenda almost immediately, Lewin said,
As I arrived on the scene, I was confronted with allegations from Dr.
Glantz and others, who told me that CMA had been far from a proponent of anti-tobacco
efforts and really had thwarted those efforts by virtue of its collusion with the tobacco
industry and many other nefarious scenarios. I knew from my discussions with the
leadership, the doctors of the association, that nothing could be further from the truth.
And while I was greatly concerned, I knew that there had to be some complex relationship
in the competition for funds or in government relations or in strategies and tactics,
where you have competing agencies in a very awkward state of working against each other
instead of with each other.
At the time, of course, Lewin was not aware of the secret tobacco
industry memos documenting its relationship with the CMA. (These memos were not made
public until 1998 as part of the State of Minnesota's lawsuit against the tobacco
industry.) Lewin recognized that the CMA's history on tobacco control was a problem. He
went on to say,
In the back of the history of CMA, there was clearly a part of the
time when Prop 99 came out, where the person who was in charge of our government relations
at that time was a wheeler-dealer type of very effective political strategist in
Sacramento who was willing to work with whomever he needed to work with to get things
done. Sometimes he would make a trade-off that would frankly not please me or the current
leadership of CMA. But that was just the way things were then.
Like AHA, ANR, and ACS, Lewin believed that people outside the
Sacramento lobbyists' circle needed to get involved in the decision making about
If you talk to the constituencies in those [voluntary health]
agencies, they're victims in my view because the doctors will be happy to get together
with the Cancer, Heart and Lung boards and those constituencies and work on this. You're
stuck at the political level of the agency staff and the government relations people that
themselves have developed long-standing animosities they're not going to let go.
¦So what we decided to do was try to get out of that loop. That meant telling our
government relations people to change the way they were relating to these other groups. If
they couldn't do it, then we had to get some other people to make the relationships
because the relationships were dysfunctional. ¦We're going to have to get through
this whole epic of the past ” you did that to me, you did that to me, why did
you do that to me? Get beyond that and say, Can we get together this
year to go get this money? 
But Lewin could not act unilaterally. There was a strong animosity
within the CMA toward the anti-tobacco education and research programs that had built up
over the years, dating back to at least the Napkin Deal of 1987. Steve Thompson, Willie
Brown's longtime aide, was an especially popular figure within the CMA.
The Governor's Budget
The health groups hoped to avoid another battle in the Legislature.
They had won two court rulings on the illegality of diverting Proposition 99 Health
Education and Research money into medical services. More important, the state's economy
had improved, which meant that the excuse for the diversions ”fiscal necessity
”had evaporated. Indeed, when Governor Wilson released his budget on January 10,
1996, he announced that solid gains in employment and income will continue for
the next two years. 
Rather than proposing expenditures conforming with the two court orders,
however, the governor's 1996-1997 budget was identical to AB 816 and SB 493. (Wilson cited
SB 493 as his rationale, purposely ignoring SB 493's stipulation that, effective July 1,
1996, the allocations of tobacco tax revenues to the Health Education and Research
Accounts would conform to those established in Proposition 99: 20 percent and 5 percent,
respectively.) Wilson proposed spending only $53 million (of the available $191 million)
on anti-tobacco education and $4 million (of the available $82 million) on research. He
proposed diverting $57 million into medical services. Wilson
was still trying to starve the anti-tobacco programs to death.
The three voluntary health agencies issued a press release immediately
after the governor released the budget, saying they were outraged at the
budget proposal and that it reveals his latest attempt to thwart the law and
steal monies earmarked for anti-tobacco education and research programs by the
voter-approved Proposition 99.  The press release
announced that the health agencies refuse to let that happen and are launching
a statewide campaign to invoke public awareness and put pressure on legislators to reject
the Governor's tobacco fund raid.
Changes in the Legislature
Not only would the health groups' change in approach have its effects,
but the fate of the governor's budget in the Legislature would be different this year
because the Legislature had changed too. The Republicans had taken control of the Assembly
in the 1994 elections by one vote, thanks in part to a massive $125,000 contribution that
Philip Morris made to Republican Steve Kuykendall (R-Long Beach) the weekend before the
election, which helped him defeat incumbent Democrat Betty Carnette.
By that time, the tobacco industry had shifted from giving campaign contributions in a
bipartisan manner to favoring the Republicans. During the 1993-1994 election cycle, 45
percent of the contributions went to the Republicans; by 1995-1996 the share had shifted
to 56 percent.
On April 24, 1996, Senators Watson, Hayden, and Petris, three of the
strongest advocates for tobacco control in the Senate, wrote a long memorandum to Senator
Bill Lockyer, the Senate's president pro tem and a senior Democrat in the Legislature. The
subject of the memo was the Democratic Caucus Position on Tobacco Issues,
and the senators argued that it was not only good policy, but good politics for the
Democrats to embrace tobacco control:
Tobacco regulation, a long-standing and contentious political issue,
has assumed even greater prominence in recent months, and gives every indication of
continuing to hold the media and the public's interest. We would like to encourage the
Democratic Caucus to assume a much more aggressive attitude against tobacco. There are
sound policy reasons for such a reassessment of our position, but there are also equally
sound political reasons for such a change.
¦ Control of tobacco is morally the best policy. It is also a popular
issue consistent with Democratic principals [sic], and an issue with every
possibility of becoming an electoral wedge. We believe the benefits to Democrats in terms
of the public good will substantially outweigh the anticipated loss of tobacco support. [emphasis added]
In John Miller's view, the shift in tobacco industry campaign
contributions to the Republicans was the key factor that got the Democrats lining up to
support the Proposition 99 programs. He commented, What moved them as a body
wasn't our rhetoric or the public's interest or the public's wishes clearly expressed and
apparent to everyone. It was the stupid move by the industry in terms of donations. 
The new Republican leadership in the Assembly was clear about its
pro-tobacco sympathies. Curtis Pringle (R-Garden Grove), who became the speaker of the
Assembly on January 5, 1996, accepted $17,250 in tobacco industry campaign contributions
in the election cycle from 1995 through the March 1996 primaries; this amount ballooned to
a total of $105,750 after he became speaker. Pringle
believed that some of the legislative changes [to limit tobacco] swung the
pendulum too far in one direction.  The chair of the
Assembly Health Committee passed to Brett Granlund (R-Yucaipa). In the 1995-1996 period,
he accepted $31,750 in tobacco industry campaign contributions and described himself as
a free-enterprise, no-tax smoker. It doesn't matter if I'm chairing the
Health Committee. Those [anti-smoking] people don't have a right to tell everybody else
how to live.  A Los Angeles Times editorial saw
the Republicans as a Whole New Pack of Buddies for the Cigarette Industry.
The Democrats also had an important leadership change. Willie Brown, the
longtime speaker of the Assembly when it was controlled by the Democrats, left the
Assembly in January 1996 to become mayor of San Francisco. By then, Brown had accepted
$635,472 in campaign contributions, more than any other legislator in the country,
including members of Congress from tobacco-growing states.
Brown had been a powerful presence and used his power as speaker to protect the tobacco
Assembly Member Richard Katz (D-Panorama City) replaced Brown as the
Democratic minority leader. In stark contrast to Brown, Katz was a longtime supporter of
tobacco control and had only taken $5,500 in tobacco industry campaign contributions, none
of them since 1991. Katz specifically rejected the claims
that the Proposition 99 diversions were made because of fiscal necessity: In
terms of the overall budget, it's not a lot of money. ¦I don't know who came up
with it; it was a very very clever strategy that helps big tobacco under the guise of
providing indigent health care. ¦The budget was a convenient issue for them.  As Adams observed, The real hero this year was Richard
Katz. Without a doubt. ¦Since he's the Democratic floor leader, he's got a lot of
loyalty from the other Democratic members on both sides of the house, so that was really
good. ¦it was like they'd all had this conversion, some sort of `Come to Jesus
meeting' must have taken place in the California State Capitol because they were all
saying how wonderful they thought Prop 99 was.  Katz's
ascendancy to the leadership greatly reduced the likelihood that the Assembly could muster
a four-fifths vote to divert Proposition 99 money, regardless of what the Republicans
wanted to do. This fact fundamentally changed the political dynamics surrounding
Proposition 99 in the Legislature.
Meanwhile, the Democrats still controlled the Senate, and a shift in
attitude toward Proposition 99 diversions appeared to be occurring there, too. Senator
Mike Thompson (D-Santa Rosa) chaired the Senate Budget and Fiscal Review Committee, which
meant that his position on Proposition 99 was also important. According to Diane Van Maren
from Thompson's office, Mike made it very clear he was not going to vote for a
redirection to that level and that we thought that we needed to talk about transitioning
some of these programs and using some General Fund monies, in a prudent manner.
¦Mike was very well aware of the increase in adolescent smoking and thought that if we
had the opportunity, we should start using the Health Education monies again and more
fully to mitigate that. 
Another change was the decision of Assembly Member Phil Isenberg
(D-Sacramento) not to be involved in Proposition 99 reauthorization. Isenberg said,
I'm bored with it, I don't want to do it anymore. I've done it three cycles. I've
done enough. I've got other things to do.  Isenberg's
absence meant that the dynamic of the previous authorization efforts would be disrupted,
which was potentially advantageous for the tobacco control advocates.
A final major change in the Legislature, according to Richard Katz, was
the effect of term limits. Katz felt that they helped the Proposition 99 Health Education
and Research Accounts:
One of the things with term limits is you have a whole bunch of
members here who did not vote for that compromise, didn't go through that budget fight. So
they said, How could you do that? Don't you understand, you can't do that now
the courts have ruled? So you lose the historical context that that all took place
in and without saying that's good or bad, they bring a different set of criteria to the
evaluation. I also think that the folks who are elected now are much more anti-smoking
than the group that was here ten years ago.
In January lobbyists from the three voluntary health organizations
”Najera, Knepprath, Adams, and Renken ”met with Katz to sound out his views on
the Health Education and Research Accounts. They proposed several authors for the
Proposition 99 reauthorization bill, but Katz decided to carry the bill to restore
Proposition 99 himself. He also agreed to let individual members vote their conscience on
the bills rather than make this a leadership issue, as it had been in AB 816 and SB 493.
When asked why he decided to carry the bill, he said, I like fights. I like
fighting with people that are arrogant.  He went on to
Someone needed to step out of the chaos and do it. When we sat around
and talked about who was in a position to do it, it made the most sense for me to do it
just because of what I'd done on the issue before. ¦We also saw this as a potential
issue that could be an us versus them. We knew the public was on the
side of the Prop 99s of the world and that Republicans for the most part were much more
beholden to tobacco companies than Democrats, even though Democrats have had their fair
share over the years. I knew that Philip Morris was looking to underwrite a huge piece of
the Republican convention in San Diego. ¦So there were good political reasons for
doing it also.
Knepprath understood Katz's political motives: We were going
to concede to him as the author of the bill his ability to do what he wanted, but I think
it was at that meeting that we really launched then the effort to do our grassroots stuff
and to really build the campaign around his bill. 
The Coalitions Form
Following the December 1995 meeting, ANR, AHA, and Glantz decided to
move ahead without ALA and ACS, in the hopes that, once things started happening, the two
other organizations would join them. Adams invited Roman Bowser, AHA's executive vice
president, to a meeting to work out how ANR would run a grassroots campaign coordinated
with AHA's lobbying effort. AHA was to help finance this campaign by providing $25,000 to
ANR. Under Bowser's leadership, the AHA had been evolving from an organization that did
not even have a lobbyist before 1988 to one that was willing to engage in a political
fight. When asked about this change, Bowser replied,
I think that if we look back over time ”the origin of Prop 99,
the passage, the lawsuits ”I think you see somewhat of an escalation of our activity
and involvement each step of the way. The more I learned about it, the more interested I
was in it. ¦When the lawsuits started, then we started getting a little bit
concerned. I think that the real turning point for me was [when] Stan Glantz called our
national executive vice-president and left him a voice mail message saying that
we've really got some problems out here with Prop 99 and ¦he passed the
message to me. ¦I knew who he [Glantz] was. I wasn't real thrilled about meeting
him because I'd read some unflattering remarks he made about the Heart Association.
Anyway, I called him back. I asked him if there was anything I could do to help him, what
he wanted, and that was the turning point, that telephone conversation, because he spent
quite a bit of time with me basically educating me on what was really going on behind the
scenes with Prop 99. Also, I did not realize until then that we were in serious danger of
losing the whole thing. ¦[but] I was still bound and determined to have the
American Heart Association stay with the American Cancer Society and the American Lung
When the meeting started, Bowser announced that the ACS had just told
him that it would put $120,000 into an effort to save Proposition 99 on the condition that
ACS run the campaign. ANR and Glantz reacted skeptically, as did Adams. They were
concerned that ACS, as the least combative of the voluntary health agencies, would simply
adopt earlier failed strategies, and Glantz urged Bowser to move ahead with the original
plan to work with ANR. Bowser, although doubtful about ACS, felt that he simply could not
ignore his colleagues at ACS and ALA. The meeting ended without agreement on how to
The next several weeks were devoted to extended discussions among ANR,
AHA, and Glantz on how to deal with ACS. By mid-January, Glantz felt that saving
Proposition 99 was impossible. ACS and ALA were unwilling to
confront the CMA and the governor, and AHA was unwilling to move without them. The
governor had released an unacceptable budget, but the health groups did nothing more than
issue a press release. On Friday afternoon, Glantz told Carol that he was recognizing
reality and giving up. Carol replied that the only reason ANR was involved was because of
pressure from Glantz and that without Glantz, ANR would drop out, too. (She had joked that
she knew Glantz would write the history of Proposition 99 and she did not want ANR blamed
for letting it die.) Glantz called Adams and Bowser as a courtesy. Adams asked Glantz to
keep an open mind over the long Martin Luther King Holiday weekend.
The following Tuesday, Adams called Glantz and Carol and said that AHA
had decided to break with ACS and ALA and asked them to reconsider working with AHA. AHA
intended to confront the CMA and the governor and mount a major campaign to reengage the
public in the future of Proposition 99. Carol was particularly surprised. Following the
December meeting, ANR had decided not to get involved in the Proposition 99
reauthorization fight. Rather than simply saying no to AHA at that time, Carol had laid
down a set of four conditions that AHA would have to accept about the campaign that she
was sure would scare them off:
One, that it'll really be hard hitting. And that means taking on Pete
Wilson and the CMA. Two, that I can find a grassroots coordinator who I really trust,
because otherwise I can't do this. Three, they were going to have to pay us. And, four,
we're not going to be in a coalition with Cancer and Lung, given their position on not
wanting to bash the governor and the CMA. ¦It was clear that they had different
strategies in mind. So they chose us and you could have blown me away. I thought I was off
the hook. ¦So there we were. Stuck running a campaign!
When asked about the change at AHA, Mary Adams said,
We were not going to sit back on our heels and watch yet another year
go by and dismal failure. Cancer and Lung put together this group called ¦ Keep the
Promise to Our Kids, the Coalition to Restore 99. They were going along on a similar
path but in a much less rapid way and a much less contentious way. ¦They were
simply ¦not going to play an in your face game. ¦And my thought
had been from the get-go that we had played nice in the past and it didn't work; that we
had to take the gloves off and play the game differently, period.
AHA committed $50,000 for a grassroots lobbying campaign and hired a
Republican lobbyist. Up until that point, the health voluntaries were closely allied with
the Democratic Party; now the Republicans controlled the Assembly. AHA, ANR, and Glantz
began a paid advertising campaign to publicize the failure of the governor and the
Legislature to follow the will of the voters. They also started to work to force the CMA
to stop supporting the tobacco industry.
Meanwhile ACS, joined by ALA, had been pursuing their nonconfrontational
reauthorization strategy. Beerline explained, We're going to be nonpartisan,
positive, try to take the high road and create win-win situations. ¦Heart decided
that the campaign that we were putting together was not aggressive enough and that they
wanted to have a more aggressive campaign but still remain a member of the coalition. And,
of course, they were talking by then with ANR. And we basically told Heart that they
couldn't have it both ways. ¦And ANR, of course, has their own style, the way they
do things.  Beerline went to on to say that if AHA went
off to work with ANR in ANR's style, then AHA could not be part of the old coalition.
While not willing to be confrontational, ACS was planning to change its
tactics from the past. The organization planned to devote staff to coordinating a
grassroots campaign and to hire a professional public relations firm to help attract media
attention to Proposition 99 and arrange meetings with editorial boards.
The Hall of Shame Advertisement
The core of the ANR/AHA strategy was to bring the issue of Proposition
99 back before the public, with the expectation that an informed and engaged electorate
would force the politicians to implement Proposition 99 the way the voters intended. The
media had come to view Proposition 99 as just one more fight over money in Sacramento. So
the first step in accomplishing this goal was getting the media interested in the issue by
publishing a very strong advertisement in the Sacramento Bee attacking Governor
Wilson and CMA lobbyist Steve Thompson for their roles in the Proposition 99 diversions.
This advertisement, which appeared on January 30, 1996, featured photographs of Governor
Wilson and Steve Thompson as the mock nominees for the Tobacco Industry Hall
of Shame (figure 16).
The advertisement attracted Thompson's attention. Nancy Miller of the
law firm Hyde, Miller & Owen wrote Bowser, objecting that your political
advertisement is personally and professionally damaging to Mr. Thompson. He would like a
retraction of the damaging and inaccurate statements in an ad of equal size placed in the Sacramento
Bee as soon as possible. He is requesting approval of the language of such an ad.
 Steve Thompson followed this letter with one on CMA
letterhead to Bowser that read:
The issue of whether the Child Health [and] Disability Prevention
program should be funded in part with Prop. 99 health education funds goes back to initial
implementation of the initiative. While members of the initial Prop. 99 coalition
disagreed on this issue, a compromise was reached to fund CHDP from health education to
ensure enactment and maintain a common front against the tobacco industry whose major
objective was to eliminate the television advertising program. This initial agreement
occurred two years prior to my joining CMA. As a legislative staff person at the time, I
supported the agreement because the threat to the advertising program was very real.
As tobacco tax revenues declined as a result of the many successful
efforts following the enactment of Proposition 99 ¦indeed, including efforts of the Heart
Association ¦competition for fewer dollars became intense, and what was once considered a
compromise became an illegal raid on the tobacco education account.
Through legal counsel, I requested (in addition to Dr. Lewin's request),
that you apologize for your untrue advertisement. As the attachments indicate, you have no
intention of doing so. In fact, while litigation was never mentioned in Ms. Miller's
letter to you, you threatened to counter sue ( slap-suit ) if I chose to
pursue the issue legally. Outside of fulfilling an enormous emotional need ¦which will
stick in my craw for a long time to come. ¦I don't believe litigation will result
in civilizing this debate. I believe you've done your cause an enormous disservice and
hope you reflect on the value and ethics of your current tactics.
Thompson also defended Governor Wilson, who, in his view,
was also unfairly smeared in your ad. 
Adams was sure that her new offensive was going to get her organization
sued, although Bowser shrugged off the Thompson letter as bluster. Carol and Glantz passed
the threatening letter on to the San Francisco Chronicle and it made news:
Darts, not hearts, are flying this Valentine's Day between the
American Heart Association and organized medicine: The nonprofit group claims that
California doctors have run off with Governor Wilson and the tobacco industry.
The latest spat ”nasty even by Sacramento standards ”began two
weeks ago when the California office of the American Heart Association signed a newspaper
advertisement nominating Wilson and the California Medical Association
lobbyist Steve Thompson to the Tobacco Industry Hall of Fame. ¦ Wilson
was not amused by the ad. And Thompson ”one of the most prominent figures in the
state capital ”had his personal lawyer fire off a demand for a retraction.
Dr. Jack Lewin, executive director of the California Medical
Association, called the name-calling unconscionable and
slanderous in a letter to the heart association and threatened legal action if
more advertisements appear.
The heart association will print no retraction, said Mary
Adams, chief lobbyist for the California charity.
Adams said that the association will forge ahead with a publicity
campaign that challenges doctors' roles in the battle over anti-smoking programs.
This is a diversion from the American Heart Association's way of doing business, but
that just underscores the importance we attach to this, said Adams.
It's time to get this issue out in the open. 
The media was finally paying attention to Proposition 99 again.
The fact that AHA had allied itself with the radicals
at ANR also interested the media. Steve Scott of the California Journal observed,
The Heart Association's participation was crucial to the credibility
of those ads. ANR is a wonderful organization. They do a lot of good stuff but they are
viewed by the Sacramento press, which winds up covering this, as kind of the radicals.
They're the ones who are beating the drums. When the Heart Association came on, then all
of a sudden you had this group that is perceived as centrist, one of the
moderates. So one of the moderates had gone over to the other side and all of a sudden you
had a situation where the voluntaries couldn't claim unanimity. Lung and Cancer couldn't
say, Oh well, ANR ”they're just out there on the fringes. 
Thompson also apparently mobilized support from other medical groups.
The California chapter of the American College of Emergency Physicians, the California
Association of Obstetricians and Gynecologists, the California Society of Plastic
Surgeons, and the California Society of Anesthesiologists all responded to the
Hall of Shame advertisement by writing an open letter to the California
senators and Assembly members to lampoon the same hit list of projects
that they had lampooned in 1994 during the hearings on AB 816. The letter from the
specialist groups made it sound as though the same old fight about money was about to
CMA lobbyist Elizabeth McNeil was unhappy with the advertisement, not
only because it attacked the CMA but also because she felt it would make Wilson more
The first ad was pretty devastating as far as moving anything
politically, and we thought that shut the door completely to doing anything. ¦I
think that turned off a lot of people, not only in the Capitol but around here. I think it
was a very stupid move politically. I think it hurt his kids, hurt his family, and he's
been someone who has always fought for kids' programs and health programs. ¦But it
just dug the governor in. The governor called up Steve and said, Forget it,
I'm not going to compromise on this and all conversations are off, basically. 
The AHA and ANR shrugged off these criticisms. They purposely had
designed the ad to get people's attention, believing that it was better than being
ignored. Isenberg thought the 1996 advertising campaign had value, and he also confirmed
that it enraged Thompson: Thompson was beside himself. God, he was so mad. My
wife took ¦the one with Steve in it. She altered it a little bit and said, `Steve
Thompson, drug dealer' [laughter]. Anyway, Steve didn't think that was very funny. Well,
it's like everything else in politics, it escalates the battle. It certainly irritated
Wilson, agitated the California Medical Association. Did it have some impact? Might have
had some impact, together with the second lawsuit. 
The Wellness Grant
In March the California Wellness Foundation, which had financed the
voter education campaign about Proposition 188, gave the ANR/AHA media strategy a huge
shot in the arm: a $250,000 grant to run a series of advertisements on the status of the
Proposition 99 Health Education and Research programs and their importance. The campaign
was not designed to lobby for any particular piece of legislation, but rather to educate
and involve the public in the debate over the future of Proposition 99.
The Hall of Shame ad had attracted the attention of Herb Gunther,
director of the Public Media Center in San Francisco, which had run the nonpartisan
advertising campaign on Proposition 188 with a grant from the Wellness Foundation a year
earlier (see chapter 11). Gunther had been interested in helping restore the integrity of
Proposition 99 but had not met any credible players with whom to work. The fact that the
AHA had adopted such an aggressive approach impressed Gunther, and he arranged a meeting
between Glantz and Wellness Foundation president Gary Yates to discuss Proposition 99.
Glantz later described the meeting in an interview:
Gary basically said, I know what you want. You want some
money to run ads about Prop 99 and I had thought it over and decided not to do it. I
had pitched the idea to him at the meeting after an adequate amount of wine, and my whole
idea of engaging the public. They had just come off this victory in [Proposition] 188 and
really shown a whole new way foundations could play a positive role in public health. I
basically said we wanted to do something like the 188 campaign and that the Heart
Association was showing some guts. And it turns out that Wellness had been kind of
watching. Tobacco isn't one of their priority areas, but they'd been watching Prop 99,
wanting to do something to help and not seeing any place to put the money, because they
looked at it as the same old same-olds, making the same old mistakes.
And they had noticed the [Hall of Shame] ad, too. And they had seen the
article about the threats from the CMA, too, and were impressed by that. And were
impressed that the Heart Association was willing to do it. ANR had a very good reputation
with them for some other projects they'd been involved with.
And in the end Yates said, Okay, I'm interested in doing
this. And he looked at Gunther and he said, How much money is this going
to take? And Herb said, A hundred thousand dollars. And then Yates
looked at me. I mean, that was more money than I had thought we had needed at the
beginning. And then Yates looked at me and he says, You know, you don't take
on the CMA and the governor and lose. How much do you need to win? Can you win for a
hundred thousand dollars? And I said, I'm pretty sure. And he
said, I don't want to be pretty sure. I want to be sure. How much do you need
to be sure? And I thought for a minute, took a deep breath, and said, A
quarter of a million dollars. And he looked at me and he said, this was about
nine-thirty on a Thursday night, and he says, I want a grant on my desk by
five o'clock Tuesday morning for $250,000. I want ANR Foundation to be the fiscal agent.
And you work it out with them and Heart and the Public Media Center. So we had one
hysterical weekend of putting together this proposal.
The resulting grant to ANRF paid for a series of advertisements to be
developed by the Public Media Center in concert with Glantz, ANR, and AHA. The ads were to
appear in major California newspapers and discuss issues surrounding Proposition 99. In
addition, there were funds for public opinion polling and grassroots education. Gunther
knew the hard-hitting advertisements would be out of character for the voluntary health
agencies: Our side invariably thinks the only way you win is by being nice,
and the voluntaries are into that. I mean certainly around tobacco issues, it's been
about, `Oh, you know, I hope my back isn't hurting the heel of your shoe, Governor. We
really appreciate your standing on us in this way. Let us know what else we can do to make
you even more comfortable.' And that's the approach the voluntaries have had. 
Carol invited ACS and ALA to a meeting at the Public Media Center to
discuss the strategy and encourage their participation. Beerline, however, had very little
interest in Gunther's approach:
At the ad agency that was going to run their campaign, we had a major
meeting. And all the players were there and we spent a lot of time talking about our
differences on how we wanted to run the campaign and basically what we agreed upon at that
point in time [was] that there was no way that we could come together on this. So ANR and
Heart would wage their campaign, we would wage ours, we would keep each other informed.
They felt very comfortable about the type of campaign that they had in mind and we dubbed
it the black hat. ¦We said, Okay, but we're not going to do
it and we can see that this might present some political problems in Sacramento and we're
going to have to distance ourselves from you. ¦But there was just no other way that
we could reconcile it because of the extreme difference in the way that we were planning
to run our campaigns.
While ACS and ALA tried to work within the existing power structure
(which included the CMA), AHA, ANRF, Glantz, and Gunther started trying to change it.
Their first goal was neutralizing the CMA.
The CMA House of Delegates Meeting
AHA and ANRF believed that the CMA's pro-tobacco position originated
with its political leadership and did not enjoy particularly broad support among its
physician members. To force the issue, they ran a full-page ad in the California edition
of the New York Times on February 29, 1996, during the CMA's annual House of
Delegates meeting. The advertisement was an open letter signed by former
surgeon general C. Everett Koop and other physicians and scientists telling the CMA,
It is time to change (figure 17). The advertisement helped stimulate a
major floor fight over CMA's position on Proposition 99. Roger Kennedy, a physician from
Santa Clara County who also served as chair of his local tobacco control coalition, was
involved in the floor fight and later recalled, It really became clear that we
were not going to win based on the resolution, which was a very definite statement that
the CMA should change its position ¦but I think that we got what we could. In retrospect,
I'm sorry I didn't push harder. ¦I think that going down to flaming defeat in the
face of the public may have accomplished more in the long run. ¦There's no question
that the leadership of the CMA was not going to take a firm position that they would
absolutely oppose any reallocation of funds.  ALA was
working through its own doctors who were CMA members to get a resolution supporting full
funding. According to Najera, We took this to the public to make it a public
debate at the House of Delegates. We literally organized a public debate for what I would
say was the first time on the floor of the board, of the House of Delegates for CMA.
The eventual CMA resolution was less than the public health advocates
wanted. On March 3, 1996, the CMA House of Delegates voted to support full funding of
Proposition 99's Health Education and Research programs if the governor and Legislature
were willing to fund the challenged programs from the state General
Fund. If the governor and Legislature refused to use the
General Fund, the CMA would continue to accept Proposition 99 funds for these programs,
despite the court rulings. The CMA refused to withdraw its friend of the court briefs in
support of the governor's position on AB 816 and SB 493. But in April 1996 the CMA did
release a statement announcing its opposition to the governor's proposed budget concerning
the use of the Health Education and Research Accounts to fund medical services. Lewin saw the House of Delegates vote as representing a
fairly dramatic change:
I think that the change was because I'm a new leader and I was able to
go directly to the doctors in the CMA and ask them what they wanted, what they believed
in. And it was very clear that they were quite willing to support education and research
as well as indigent health care and that they hadn't been asked the question in that way,
that they didn't think you should undermine education for indigent health care. But they
didn't think you should cut indigent health care to enhance education. Their strategy was
that all of these things were too important and that the state had enough resources to do
all three of these things and do them well.
The CMA joined the ACS/ALA's Coalition to Restore Proposition 99, a
decision that had the effect of isolating the governor. According to CMA lobbyist
Elizabeth McNeil, the CMA action not only isolated the governor but also
showed them [the administration] and all these other groups, we're going work for
something else and that isolated them, which made it difficult for them. In some ways made
it more difficult for us to bring them around because they were a little upset with us
about that.  The CMA's changed position made it less
likely that the governor and tobacco industry could use medical necessity as the excuse
for gutting the Proposition 99 Health Education and Research programs.
The Philip Morris Memo
One of Wilson's major responses to the criticism that he was
pro-tobacco had always been that he took no direct campaign contributions from the tobacco
industry. This claim ignored the fact that the tobacco industry was a major source of
money for the California Republican Party ”$165,727 in the 1995-1996 election cycle ”and that Wilson was the political leader of California
Republicans. In any event, Wilson's defense hit a major snag when ANR obtained a March 4,
1990, internal memo between two Philip Morris lobbyists in Washington reassuring company
executives that Wilson's act of returning some campaign contributions from the company did
not mean that he was anti-tobacco. The Philip Morris lobbyists reported:
Wilson is only sending about 16K of the 100K he collected. This 16K
only includes checks he received either from a tobacco company or anyone working for a
tobacco company, i.e., Hamish Maxwell [CEO and chairman of the Philip Morris Executive
Committee], Mrs. Ehud [wife of Ehud Houminer, CEO of Philip Morris USA], Bill Murray
[former president of Philip Morris].
Apparently, he has also done this with other controversial
industries such as lumber, chemicals, and others. The decision to do this was
Wilson's alone, and in response to a wave of negative campaigning in California that not
only attacks the candidates, but those who give to them as well.
You will be pleased to know that Pete called Hamish to explain that
he was doing this to protect Hamish as well as himself. You will also be pleased to know
that Pete is still pro-tobacco. 
Wilson first saw the memo when he was being interviewed on camera by
correspondent Peter Jennings for an ABC news special on tobacco. Wilson did not
immediately say the memo was a lie, which limited what his staff could say later. (To the
disappointment of many California tobacco control advocates, the exchange was not included
in the final broadcast.) The memo, and the fact that the $84,000 retained by Wilson came
from a variety of advertising agencies, law firms, and others who worked for the tobacco
industry, received wide media coverage.[34-37]
ANRF and AHA also featured the memo in their first full-page
advertisement attacking Wilson for diverting Proposition 99 anti-tobacco money into
medical services, which ran on April 16 in the New York Times, and later in the Sacramento
Bee and Los Angeles Times (figure 18). The advertisement reprinted the original
memo and asked the question Is this why Governor Pete Wilson is gutting
Proposition 99 anti-tobacco education and research programs? The ad also posed this
question: It's time to ask the Governor who he really works for: The people of
California or the tobacco companies.
The tension between the ANRF/AHA and the ACS/ALA's Coalition to Restore
Prop 99 was growing because the Coalition kept pressuring ANRF and AHA to tone down the
attacks on Wilson. On April 29, after the advertisement featuring the Philip Morris memo
ran, Coalition co-chairs Beerline and Martin wrote to the presidents of ANR and AHA
calling on them to work to restore Proposition 99 in a more positive way
utilizing its media campaign to inform and educate the public on the real issues regarding
the restoration of Prop. 99 funds.  ACS and ALA still
hoped that the Legislature and the governor could be convinced to support the program with
a plethora of data and new information that will prove convincing and
effective in restoring these important funds. 
They distributed their letter to the governor, the Legislature, and the
media. According to Martin, they felt that they had to write the letter to
everybody to say that they had nothing to do with the advertisements:
Basically we said, We share the same goal, there's no
doubt about that, but your tactics and our tactics are not the same. We will pursue a
positive campaign and we are notifying everybody that we have nothing whatsoever to do
with those ads. And we hand-delivered that to the governor's office and we made a
lot of phone calls saying, Look, we don't have any control over the ads,
there's nothing we can do about them. This is being done by these two groups and these two
groups alone, period. We're out of this. And actually we finally did get that
message across. I think that if we had not separated ourselves from those ads, we would
have been dead politically at the Capitol.
Carol found the letter highly offensive: The tone was very
patronizing, the whole `we're glad you share our goals.' Not `we're glad we have the same
goals,' not `we recognize that your goals are the same as ours.' `We're glad you share our
goals. You're welcome to share our goals.' We're welcome to join their coalition. We're
welcome to sit at their table. Of course, we're not really welcome. 
The whole point of the ANRF/AHA campaign was to avoid sitting at tables.
The Governor's May Revision
Meanwhile, as the disagreements among the parties in the field were
playing out, competing bills were being introduced in the Legislature on how to implement
Proposition 99. The Senate Health Committee considered two bills on April 17, the day
after the media stories broke about the memo calling Wilson pro-tobacco,
and both were passed out of committee, including one sponsored by Senator Diane
Watson (D-Los Angeles) requiring full funding. The Assembly Health Committee passed a
full-funding bill sponsored by Assembly Member Katz on April 23 by a 12-1 vote. (After the
hearing, several other members signed on to the bill, resulting in a 15-1 vote in favor of
the bill.) McNeil believed press coverage of the issue the day before in the Los
Angeles Times played an important role in convincing the chair to let the bill out of
committee. The Times reported that the chair of the Assembly Health Committee, Bret
Granlund (R-Yucaipa), who had been quoted as saying, I'm a free enterprise,
no-tax smoker, had taken at least $44,500 in tobacco industry campaign
contributions. According to McNeil,
There was heavy-duty, behind-the-scenes lobbying with the CMA and the
chairman of that committee to get that bill moved out. Ten minutes before the bill was
heard, I was out in the hallway with the Assemblymen Katz and Brett Granlund, the chair.
¦he was getting some bad press in the L.A. Times at the time, which really
helped. And I just said, Well, look, this is going to go through the budget
process and you're going to look terrible for not allowing this issue to move through the
process and holding it up, and it's got a long ways to go and you're going to be
criticized and seen as pro-tobacco, and there's no reason to do that. ¦So he agreed
to let it out of committee. He had to signal that to the rest of his caucus to get it out
because otherwise that bill was not going to come out.
Under such scrutiny, the Assembly Health Committee was unwilling to
vote publicly against Proposition 99's Health Education and Research programs. The bill
later, however, stalled in the Assembly Appropriations Committee and died without a vote.
The Assembly Appropriations Committee passed the governor's proposal
contained in his May revision of the budget. (The May revision is considered the
governor's real budget because it is adjusted to reflect new economic
data.) In the May revision, Wilson proposed releasing $147 million in reserve Proposition
99 funds, including $33 million in the Health Education Account and $41 million in the
Research Account, with the rest for medical services. The funds were available due to
higher-than-expected revenues (because tobacco use was no longer falling, partially as a
result of cuts in the anti-tobacco program) and underspending in several Proposition 99
medical programs, including ones illegally funded out of the Health Education Account. The
additional $74 million in spending on Health Education and Research was to be a one-time
expenditure. The governor was still not willing to allocate all of the Proposition 99
money as specified in the initiative. All of the new monies were to target youth, which
was justified by the release of data showing that in 1995 adult smoking prevalence had
dropped from 17.3 percent to 16.7 percent while youth smoking prevalence had risen again,
this time from 10.9 percent to 11.9 percent.
Reaction to the Governor's New Budget
The reaction to the governor's proposal was mixed. AHA and ANRF
responded with a new full-page advertisement headlined The tobacco industry
knows that the best way to get kids hooked on cigarettes is to say they're for `Adults
Only.' Why is Pete Wilson using tax dollars to help them? The advertisement took
issue with the governor's plan to focus on youth and argued that strategies that focused
only on youth played into the tobacco industry's efforts to hook young smokers. The
tobacco industry, according to internal memos, tries to attract young smokers by
presenting the cigarette as one of the initiations into the adult world
and as part of the illicit pleasure category of products and services.  Smoking is linked to the illicit pleasure category through alcohol
consumption and sex.
Not surprisingly, the Coalition to Restore Prop 99 took a more measured
approach: We are encouraged the Governor has recognized the importance of
funding tobacco education, prevention, and research and believe he has taken a critical
first step. However, we have very serious concerns about his proposed programmatic changes
which may not be consistent with Proposition 99.  In a
separate memo to ALA directors and staff, Caitlin Kirk, director of communications at ALA,
and Najera commented that although the proposal is a positive step, we have
serious concerns and many questions about the details. We are quite concerned about the
overall effectiveness of a tobacco control program that would require all funds to be
spent on youth-focused education and research projects. 
Our coalition was very unified against the revise. We put out a
reject the revise fact sheet to the Legislature and flogged that around. And I
think that helped CMA maybe soften its position on that. ¦I think their posture on
it was Let's be more positive about it and try to work out our
differences. We were saying, Uh-uh, this is bad on its face. Go back to
square one. We were able to, I think, through our combined efforts to convince
[Senator Mike] Thompson and the budget committee that there needed to be a different
approach to using the supplemental funds.
While differing in how aggressive they were willing to be, the
AHA/ANRF and ACS/ALA camps were converging on their policy goals. The CMA, while a member
of the ACS/ALA coalition, was also acting independently and had probably helped negotiate
the governor's position in the May budget revision. The CMA was
not waiting for the Coalition as a group to act before going to the governor.
The objections of the health groups were getting the media's attention.
On June 3 the San Francisco Chronicle carried as its lead editorial
Smelling the Smoke of Governor's Plan, which criticized the governor's May
Governor Wilson recently proposed a compromise that would shift $147
million of previously diverted Prop. 99 funds to tobacco education programs, but that
would still fall short of the 20-percent level approved by voters. The Governor's plan
also limits the education spending to programs aimed at teenagers, instead of a broader
approach. Also, his proposal is a one-year deal, leaving tobacco education funding
vulnerable to vagaries of future budget conditions. ¦The Katz and Watson bills
reassert the state's long-term commitment to fight smoking. California voters delivered
the mandate ”and the money ”eight years ago. This effort must not be undermined
by Wilson and other friends of tobacco in Sacramento.
On that same day, TEROC met and DHS director Kim BelshÃ© came to the
meeting to defend the governor's proposal. Jennie Cook, chair of TEROC, along with other
committee members, echoed the public health groups' concern about focusing so exclusively
on youth. The program, according to Cook, worked best when it included youth, communities,
and adults all together. According to BelshÃ©, the decision on how to spend the dollars
was based on smoking rates. For the previous two years there had been an increase in the
rates of smoking for youth. But what also emerged at the meeting was that for the second
half of 1995 adult rates were also increasing. For the first six months of 1995, the
percentage of adults that smoked was 15.5 percent but in the second six months this figure
went up to 17.9 percent. Reporting the overall figure of 16.7 percent for the year
disguised the uptick in adult smoking. Several major newspapers
reported on the apparent effort to disguise the upturn in the adult smoking rate, creating
more bad publicity for the administration.
In the Capitol, Senate Budget and Fiscal Review Committee staffer Diane
Van Maren was working with Senator Mike Thompson to develop their own budget proposal:
I did multiple renditions of various options with the intent of doing
a two-thirds vote because that's what Senator Thompson wanted, maintaining indigent health
care as best we could, providing an increase particularly for the media campaign, which
Mike thinks is particularly excellent. And there has been very good analysis of that to
show that it is excellent. To provide an increase to the competitive grants area locally
and then also provide good funding to the schools. From a political context of course the
governor did not want to provide much funding to the schools because Oh,
that's Delaine Eastin, and that's a Democrat and that's the Superintendent of Schools,
so he didn't want to do that. ¦A lot of it came from the concern that came
forth regarding the increase in adolescent smoking. We need to know more about what the
schools are doing and we provided additional funding, $2 million, to do an evaluation in
that area this year, but at the same time we also felt that it was important to provide
the schools with more funding for a couple of reasons. One, they have a captive audience
obviously. Two, because of the increase in adolescent smoking and chewing tobacco and
related tobacco products, that was where we needed to get a firmer message across that
smoking isn't cool no matter what the movies show and all the rest of it.
¦ And then restoring the Research Account. And we also went along with
the governor on his $5 million for the rural health grants, and we also went along with
the governor on the $2 million for the evaluation of school program, and we also
¦provided General Fund monies to backfill for indigent health care.
The state constitution requires a two-thirds vote in both houses of
the Legislature to pass a budget bill. By deciding that the Proposition 99 revenues would
be appropriated with a two-thirds bill rather than one that required a
four-fifths vote, Thompson was signaling that there would not be any new diversion of
Proposition 99 money.
On June 5 the Budget Conference Committee, comprising members of both
houses, began meeting to complete the state budget, including decisions on what would
happen with the Proposition 99 funding. The Senate was working with Senator Thompson's
proposal, and the Assembly was presenting the governor's revised budget. On June 10 the San
Francisco Examiner ran as its lead editorial A Plan Goes Up in Smoke: The
Governor and Legislators Must Restore Mandated Funding to Prop. 99 Anti-Smoking Programs
Aimed at Youthful Addiction. The editorial encouraged the Legislature to give the
Health Education and Research Accounts full funding. On June 12
the Budget Conference Committee agreed, on a 6-0 vote, that Proposition 99 reauthorization
would be drafted as a two-thirds bill, which meant that the initiative's funding
percentages would not be violated for the first time since the voters passed Proposition
The health groups were making progress.
Attempted Restrictions on the Media Campaign
Full funding of the Health Education and Research Accounts was only
one problem that tobacco control advocates faced. As illustrated by the Governor's May
budget revision, tobacco control now had to deal with efforts by the tobacco industry's
political allies to withhold money from effective programs and instead fund ineffective
ones. The governor had already tried to focus the campaign on youth. Now Speaker Curt
Pringle (R-Garden Grove) proposed that the media campaign be prohibited from attacking the
tobacco industry and limited to publicizing the health effects of smoking. He wanted the
advertisements to be based solely on the health implications of tobacco use
and on the health implications of refraining from tobacco use. 
Echoing tobacco industry rhetoric, he argued that taxpayer dollars should not be used to
attack a legal industry.
Reflecting another common tobacco industry strategy for reducing the
effectiveness of anti-smoking advertising, Pringle wanted the ads to focus on children
between the ages of six and fourteen, a strategy, Adams said, that dooms the
entire campaign to fail.  These restrictions would have
forced DHS to stop using effective messages that had changed the social environment and
helped reduce smoking in favor of ones that public health professionals had long known to
be ineffective. Pringle also wanted $5 million set aside for
Senators Thompson and Lockyer and Assembly Member Katz were strongly
opposed to media account restrictions, although they were willing to include the cessation
language as a compromise with Speaker Pringle in order to protect the media campaign. Though it was not realized at the time, this $5 million was money
currently appropriated for the media campaign that the governor had not spent and which
would have been carried over to the next year in the media account. Thus, the cessation
compromise was effectively a cut in the media campaign.
In addition, following the lead of his predecessor, Willie Brown,
Speaker Pringle also tried to insert language in the authorization for the Research
Account that would block it from funding research of a partisan political
nature.  (ANRF and AHA protested this incursion of
politics into the Research Account debate by running an advertisement, which included
side-by-side photos of Pringle and Brown, who despised each other.) According to Katz,
Pringle and the governor were very, very serious about attacking Stan
[Glantz] and the research, writing into Prop 99 or the budget that the ads couldn't attack
the tobacco companies. 
Pringle was widely criticized for his stance. The editorial in the Sacramento
Bee on June 28 was representative: Tobacco industry executives plainly
don't enjoy turning on the television and seeing ads telling Californians that the
industry profits at the expense of their health. They don't like it when researchers
unmask their marketing and political strategies. It's not hard to understand why they want
the Legislature to undermine those elements of Proposition 99. What's harder to explain,
and impossible to justify, is the speaker's willingness to do their work.  Pringle's language putting limits on what the media account could
be used for was eventually dropped.
The Research Account
Significant changes also occurred in 1996 in the way the Research
Account was to be spent. Up to that time, the University of California had been left wide
discretion in selecting which research projects to fund using the peer review process. On
one side, the public health advocates had been critical of the University of California
for not focusing the research effort more directly on tobacco in the form of applied
research. On the other side, the governor and Pringle were trying to impose more political
control on the content of the research program. In the May budget Governor Wilson had
proposed that TEROC be required to hold hearings and approve projects for funding. Since
the majority of TEROC's members are appointed by the governor, this would increase his
control over the program.
The public health groups vigorously objected to giving TEROC control
over individual research projects, as well as to Pringle's language designed to stop
partisan political research, as infringements on academic freedom.
Rather than demanding that the Pringle language be dropped, however, the university
attempted to finesse the point. The university convinced the governor to agree to a
procedure whereby TEROC would hold a hearing and make recommendations to the Department of
Finance on the university's expenditure plan, which was a general plan
for how the money was to be spent, rather than act on specific projects. The university
argued that it had to submit expenditure plans to the Department of Finance anyway, so
this was not a significant change. As in prior years, the university was reluctant to make
any waves regarding Proposition 99 if it meant offending the governor.
Public health advocates were furious with the university for proposing
this compromise because they thought it might be possible to get rid of the language
altogether. According to Martin, The budget people were trying to work a deal
without understanding the issues. I was just floored. ¦I read this and I said to
Cathrine [Castoreno, the UC lobbyist], `Don't they know these people aren't their
friends?' So we were shocked, because I don't believe that was necessary. ¦UC
should never have caved in on that. 
On July 1 the University of California's vice president for health
affairs, Cornelius Hopper, attempted to clarify the university's interpretation of the
language. A research program expenditure plan, he wrote, was understood
to be a general expenditure plan identifying the range of targeted research
areas. As we have made clear to all parties, we do not intend to submit for review each
grant proposal we wish to fund.  The letter went on to
say that the university interprets the phrase, `research or other activities
of a partisan political nature,' to mean activities pertinent to political parties. As a
matter of policy, the University of California does not engage in such activities and the
TRDRP [Tobacco Related Disease Research Program, which administers the Research Account]
would not fund research that does so. The letter specifically affirmed that research
related to public policies for tobacco control would be funded and that the university had
no control over the uses to which its research was put by others.
Hopper also phoned Glantz and assured him that the university did not consider his work to
be of a partisan political nature and that he would be free to compete
for funding from the Research Account. (Glantz, whose research was by then supported by
the National Cancer Institute and the American Cancer Society, did not apply for funding
from the Research Account that year.)According to Castoreno, the university was trying to
accommodate the political process while holding firm on the issue of academic freedom:
We put out a letter to clarify our understanding of the language which very
specifically is to share an overall plan about the areas we're intending to fund and how
much money we're prepared to contribute to each of those areas, but definitely not to
allow any external party to second-guess the actual projects we fund. And within that, we
plan to fund public policy research.  Both the
Legislature and the Wilson administration consented to Hopper's interpretation of the
While the public battle had been over the imposition of political
control over the research program, the big change in the final budget language actually
represented an important victory for the public health groups regarding the priorities for
the research program. The relevant passage read as follows:
Of the funds appropriated by this item, $60,422,000 is to be allocated
for research regarding tobacco use, with an emphasis on youth and young adults,
including, but not limited to, the effects of active and passive smoking, primary
prevention of tobacco use, nicotine addiction and its treatment, effects of second hand
smoke and public health issues surrounding tobacco use. These funds may not be used to
support research or other activities of a partisan political nature, and shall be
allocated primarily for applied research. In addition, prior to its use of this
$60,422,000, the university shall submit a research program expenditure plan to the
Department of Finance for approval. The Tobacco Education [and] Research Oversight
Committee shall conduct public hearings on the proposed expenditure plan and make
recommendations to the Director of Finance regarding approval of the plan.
The university was directed to develop a program of research with much
more direct relevance to tobacco. While Pringle's language remained, it had no practical
effect. TEROC held its hearing and approved the expenditure plan later that year, as did
the Department of Finance. The university was free to use the peer review process to
select specific projects for funding, and the new program had a stronger tobacco focus.
The following year, the requirement for the TEROC hearing and the Department of Finance's
approval of the expenditure plan was dropped.
The Final Budget Negotiation
At a June 19 meeting of the Budget Conference Committee, chaired by
Senator Mike Thompson, a spending plan for Proposition 99 was passed that allocated the
full 20 percent to the Health Education Account and 5 percent to the Research Account. Of
the $131 million allocated to Health Education, $5 million was to go to support cessation
programs, $25 million to the media program, $43 million to schools, $31 million to
competitive grants, and $27 million to LLAs. The Research Account was given $60 million.
On June 20 ANRF and AHA released the results of the public opinion poll
they had commissioned from the Field Institute to determine the extent of public support
for Proposition 99. The results indicated overwhelming support among both Democrats and
Republicans for Proposition 99 as it was passed by the voters ”80.1 percent of voters
supported the Proposition 99 revenue allocations. In addition, 55.3 percent of voters said
they would be less likely to vote for a candidate who took campaign contributions from the
tobacco industry, and 56.4 percent thought that the industry had a great deal
of influence over those who accepted industry money.
On July 8 the Assembly and Senate approved the budget, which included
the Proposition 99 programs. A related bill, AB 3487, authorized the programs by
permanently removing the sunset provision and leaving the program appropriations to be
determined through the yearly budget process. The governor signed the budget on July 15.
The only downside of the final decision was that the funds were
appropriated for only one year. Program authorization alone, however, became a moot issue
with the removal of the sunset language. Miller was unhappy to have Proposition 99 in the
budget bill because, ironically, this made it more susceptible to back-room deals out of
the public eye:
¦ decisions in the budget aren't made like in a public hearing and
you don't get to testify. Nobody does. It's done by the pols in the back room, and that's
where they're going to assign the money. ¦And I think for a year or two we're stuck
with that. One of the reasons they didn't extend us for more than a year is because they
want it in the budget. And I think that CMA wants it there as well as Mike Thompson and
others, because that puts it under their control. It takes it away from Diane Watson and
Tom Hayden, Richard Katz. ¦The commitment to [Proposition] 99 is real thin in the
Legislature still, despite everything we've done.
McNeil, however, saw having the program in the budget as the only real
alternative: That was our preference to do this in the budget, because we
thought that was the only way we were going to get the governor to go along. ¦if
you had it in the budget, it's part of a bigger deal and there are lots of other issues
and the governor doesn't have to put his signature on a Prop 99 bill. ¦It's not a
single Prop 99 bill where he has to say, `I caved in.' 
In any event, the 1996-1997 budget marked the first time that the Legislature had passed a
bill consistent with Proposition 99. The Health Education Account received its full 20
percent of revenues and the Research Account its full 5 percent. There were no
unacceptable restrictions on the expenditure of Health Education Account funds, and the
Research Account expenditures were refocused in ways that the public health groups had
In the end, Wilson acquiesced to full funding of the Health Education
and Research Accounts. Isenberg described Wilson's personal style in these terms:
He may be a Marine and Marines may be trained for assault, but Pete Wilson when mad
digs his foxhole deeper and never budges. He's a very stubborn guy. 
When asked why Wilson eventually shifted his stance on Proposition 99 funding in 1996,
Isenberg replied, Because everybody badgered him. The administration badgered
him. `You're losing the lawsuit, stop this.' ¦And you know, after a while, even Pete
Wilson wears down when his advisors come [to him with] `You're not winning this fight, now
let's get out of here.' It's only whatever it is, $20 million, $30 million, $40
In addition, the tobacco industry itself had become more of an issue and
the industry's partisan support for the Republicans had turned into a liability. The
Philip Morris memo identifying Wilson as pro-tobacco also made it more
difficult for Wilson to defend his actions as good public policy. As Miller explained,
The industry left him in a bad spot politically by shifting their donations
so dramatically to the Republicans. It did two things. One, it alienated the Democrats
and, two, it provided some convincing evidence to the press that there was indeed some
substance to our claim that the diversion wasn't about a budget shortfall. It was about
stopping [Proposition] 99. And the third one is related to that and that was the discovery
of the Philip Morris memo regarding Wilson and his being a friend. ¦What it did for
the reporters was give credibility to our argument.  The
governor also had to face the reality that there would be no four-fifths vote in 1996, so
he could not even attempt to alter the percentages of tax revenues going to the different
accounts. In short, for Wilson, there was little good news coming from the Legislature on
Proposition 99. With the public watching, with no Democratic support, and with no
recession to provide cover, he was left with little choice but to support the full-funding
effort. The only other cover he had had ”the CMA ”had also switched sides. By
returning to the public arena and taking a principled position of demanding that the will
of the voters be respected, the public health advocates had succeeded.
Engaging the Media
Public opinion both influences and is influenced by events, but public
opinion is activated only when those events are reported in the mass media; even then, the
way opinion leans is often dependent on how events are interpreted in the media. Thus, it was essential that the media perceive Proposition 99 as an
important issue and frame the issue as following the will of the voter.
The media had not paid significant attention to the Proposition 99
programs between the 1989 passage of AB 75 and 1994. Scott of the California Journal
had assumed that although programmatic initiatives were disputed, the money was going into
the voter-approved categories:
I have to say that it wasn't until the Lung Association and the Cancer
Society suddenly started complaining about the diversions that I started noticing it at
all, and more people started noticing it. Because the assumption had always been, and I'm
guilty of this as much as anyone, but a lot of times what we look at as journalists to
sort of guide us in determining what's a real issue and what's not a real issue is the
attitude of the constituent groups. ¦They were never thrilled about them [the
diversions], but they never raised them as an issue. I mean they never raised them as an
issue to the level that they were seeking media on it. So the assumption was that if
nobody's making any noise about this, then it's just not that big a deal.
Scott differentiates between raising an issue and raising it
to the level they were seeking media on it. One of the by-products of running
only an insider campaign is that the press is unlikely to be informed about the problems
and issues. Without the press, it is harder to rally the kind of public opinion required
to influence policy.
Some of the media coverage of Proposition 99 was in news reports, and
some of it was paid for by the principals. The key players credited the increased media
interest in the Proposition 99 funding effort with being important, although they differed
over why it occurred. ACS and ALA saw their public relations firm as key, while ANR and
AHA saw their advertising campaign as important; others thought that tobacco had just
become a hotter media story generally because President Bill Clinton was making tobacco an
issue in national politics. It was, in fact, a combination of all these factors.
ACS and ALA had hired the public relations firm Sturges, Zegas, and
Metzger. Bobbie Metzger, who was married to Willie Brown's former chief of staff, carried
weight with both the Legislature and the press. According to Beerline,
Probably one of the better decisions that we made was to hire this
organization. They're extremely well connected politically in Sacramento. They have an
excellent reputation, and they have access to the media that staggered me. ¦They
basically took over the media part of this campaign from that point on, from April through
July. And we had press conferences, press briefings. They set us up with all of our
editorial board visits, numerous radio, TV interviews. ¦After the word got out that
we had hired Metzger, [people commented,] Well, the Coalition must be serious
this time if they hired Metzger et al. So apparently they didn't think much of the
prior efforts, that we were just going symbolically through the motions, but by having
Metzger on board, apparently that sent an entirely different message to the legislators.
The Metzger firm arranged for Martin and Beerline to have meetings
with all the major editorial boards.
Isenberg, when asked about the media attention, attributed it mainly to
advertising and the successful framing of the issue: They advertised. They
have learned the issue, which for them Prop 99 is just another way of saying campaign
contributions. Tobacco campaign contributions. It becomes an opportunity to write the
story; it's a fight. You can always get a good quote, call Stanley [Stanton Glantz] for a
quote, call up whoever you want for a quote. Wilson's people are always outraged. And so
it's a good fight, it's a constant fight, and the press media loves fights. That's how
they explain issues.  Julia Carol agreed:
The first thing that got their attention was the break between the
coalitions, and that actually helped get media attention. It said something is happening
differently. The Heart Association breaking with Cancer and Lung caused a big uproar. That
first ad that we sent out, the reverberations have not yet stopped from that ad on many
levels. ¦That ad shocked the pants off of everybody. ¦And then the Philip
Morris memo and our subsequent ad campaign. The fact that ABC was working on the story
generates interest within the media. You know everybody wants to beat them to the punch.
¦There's peer pressure in journalism as to who is reporting on what. I also think
the voluntaries [principally ACS and ALA] did a good job of getting editorials written.
They did do editorial board visits and you know they were a part, particularly Lung, was a
part of the grassroots sort of getting attention in the field. I think the troops were
more mobilized because they were more excited because something was happening for a
change. ¦I mean everyone needed to be woken up. One big giant wakeup.
Opinions about the series of ANRF/AHA advertisements varied from those
that found them counterproductive to those that deemed them to have had a considerable
positive effect on the effort to stop the diversions. Scott thought they had a
tremendous effect. He went on to say,
Even though they [ACS and ALA] distanced themselves
from it, it provided ammunition for the voluntaries who were working within the system to
really force the issue. ¦I think that even though they felt as though they were
sort of being subtly attacked and that they had been trying to work this deal out with the
Medical Association, they felt as though it undermined them. They didn't want to piss the
Medical Association off, but on some level I think they felt as though, Well,
you'd better deal with us because you don't know what those lunatics are going to do.
¦So it gave them clout with the Medical Association that they might not have
otherwise had. On a broader perspective, I think it put the Medical Association's
Sacramento lobbyists on the hot seat because the whole, I mean, one of those ads was,
Why is the California Medical Association supporting Pete Wilson? Why is the
California Medical Association supporting something that the tobacco industry supports?
Scott continued to discuss the effect of the advertising campaign on
All of a sudden Pete Wilson, if he sticks to the hard line on the
tobacco tax diversions, ¦in the political context, you can't say that it's anything but
doing the tobacco industry's bidding. Wilson, if he still aspires to any kind of life
beyond the governorship, he can't allow that to be a rap against him because it's pretty
clear that's an issue that is playing well with the electorate. So I just don't think
there's any question but those ads had an impact. Again, one of the ways you measure that
impact is how mad the people who were targeted got about them and they got mad. Wilson was
breathing fire about them.
On the other hand, a number of key players felt that the ads had been
ineffective and perhaps even counterproductive. Among them was Lewin, who commented,
Their strategy this year was embarrassing Governor Wilson. Originally they
thought by embarrassing the CMA, they could change the CMA. That was clearly one of their
strategies. I would assume they think they won on that one. And they had nothing, it had
nothing to do with that. If anything, that strengthened the resolve within CMA to do
nothing.  Martin also thought that the ads had a negative
I think it had a very negative effect at the Capitol because one of
the things you avoid is blaming one person for everything bad that's ever happened. It is
a smash-in-your-face kind of ad campaign that I think is very counterproductive. The other
problem we had was that people read the ad and because they knew the Lung Association and
Cancer Society's position on Prop 99, they thought we had written and paid for the ad too.
They didn't read the sponsors' names. So we got many negative calls, both Lung and Cancer
got lots of calls, What are you doing, why are you doing this? ¦This
is not the way the game is played at the Capitol. [emphasis
Of course, that was the point of the ads. ANRF and AHA wanted to
change the way the game was played.
The End of the Diversions
The battle in 1996 was the last time that the governor or the
Legislature tried to divert Proposition 99 money from the Health Education and Research
Accounts into medical services. The 1997, 1998, and 1999 appropriations followed
Proposition 99 and proceeded with little controversy (figure 19). This hands-off attitude
is particularly interesting, given that the Court of Appeal eventually ruled in 1996 that
SB 493, which expressly amended Proposition 99, might be legal and sent the issue back to
the trial court for an evidentiary hearing. The Court of Appeal ruled that AB 816 was
illegal because money from the Health Education and Research Accounts could not be used to
fund medical services. In SB 493 the Legislature moved money out of the Health Education
and Research Accounts into the medical service accounts and then appropriated the money.
The Court of Appeal said that the plaintiffs had not put evidence into the record that
demonstrated that this diversion of funds was inconsistent with the purposes
of Proposition 99. This decision left the door open for further attempts at
diversion, but the Legislature did not try.
Figure 19. Tobacco tax revenue allocations, 1987-1998. The vigorous
campaign mounted by health groups restored funding for the Proposition 99 anti-tobacco
education and research programs starting with the 1996-1997 fiscal year.
The issue on SB 493 was that no evidence had been entered at
the trial court level regarding the effects of the diversions on the Health Education and
Research programs. If the existence of the programs had been jeopardized by the cuts, then
the amendments were not consistent with the purposes of the initiative. On the other hand,
if the programs were continuing to operate successfully, then the court was unsure that
the diversions were, in fact, inconsistent with the purposes of the initiative. The Court
of Appeal had no factual basis on which to make that decision. The voluntary health
agencies and ANR appealed the SB 493 decision to the California Supreme Court, but the
Supreme Court did not take the case, leaving the advocates with the decision whether to
return to the trial court to introduce new evidence.
In the meantime, the $43 million that was being contested in court (see
chapter 13) sat in reserve within the Health Education and Research Accounts. (The
governor had spent the contested funds from AB 816 on anti-tobacco education and research
after he lost the appeal, as well as about $22 million of the contested funds from SB
493.) In 1998, Glantz suggested to Van Maren that the Legislature simply appropriate this
money for anti-tobacco education and research; in exchange, the health groups would drop
their lawsuits. Senator Thompson and the Legislature agreed, and these funds were
appropriated, which would have ended this litigation and provided more money for
anti-tobacco education and research. Rather than concur with this resolution, however,
Wilson used his line-item veto to scuttle the deal because Lee Sanders had refused to drop
the SAYNO lawsuit over the AB 75 and AB 99 diversions.
Several factors contributed to the success of the health groups in
1996. While differing in tone and style, they all expanded the scope of the conflict
beyond the Legislature and governor to include the general public. They also returned to
the principled position of respecting the will of the voters rather than simply treating
Proposition 99 as a fight over money. As a result, the media paid much closer attention to
the Proposition 99 allocations than they had in the past.
Other things had changed. The California Medical Association was no
longer pushing for diversions. The state's fiscal picture had improved. Repeated lawsuits
had found the diversions illegal. The governor was linked to the tobacco industry in a
year when such linkage was particularly embarrassing. The tobacco industry was an
increasingly less desirable ally. The Legislature had changed from a Democratic body,
heavily controlled by Willie Brown, a very strong ally of the tobacco industry, to one in
which the Assembly was Republican and the Senate was Democratic. At the same time, the
tobacco industry became increasingly partisan in its campaign contributions, which reduced
the allegiance that Democrats felt toward the industry. The extent of the industry's clout
in California policy making had changed dramatically since 1978 when Peter Hanauer and
Paul Loveday launched Proposition 5.
For tobacco control advocates trying to defend citizen initiatives in
legislatures, the challenge is to exercise vigilance and to use their greatest source of
power ”public opinion. When asked what tobacco control advocates did differently in
1996, Isenberg said, They just screamed bloody murder. You know, the old oil,
squeaky wheel analogy is not a bad one in all of this. 
Even with full funding, however, the tobacco education programs had to
be implemented by public agencies, so the governor and his appointees were still in charge
of most of the Health Education Account. After all, in its first analysis of how to reduce
the effectiveness of the Proposition 99 media campaign back in April 1990, the Tobacco
Institute had identified influencing the administration as a way to neutralize the
program. Thanks to the leadership of Ken Kizer (director of DHS
in the Deukmejian administration) and Governor Deukmejian's willingness to take a
hands-off position regarding the Proposition 99 programs, the industry had at first been
unable to apply this strategy. But times and people changed, and the Wilson administration
had already demonstrated a willingness to impose political restrictions on the scope and
content of the anti-tobacco program. With full funding of the Health Education Account in
hand, tobacco control advocates could turn their attention to program implementation.
It is possible to spend a large amount of money on an ineffective
campaign, and the Wilson administration did precisely that.
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