While who gets the funds to implement media campaigns and outreach is unimportant, the fact of increased Native American tobacco use prevalence indicates that TEPP must use a different strategy. Another issue reservations encountered was the fact that cigarettes cost $1.00 less in tax per pack in 2007 than they cost off-reservation because three out of Arizona’s five tobacco tax increases do not apply on the reservations. The other two tobacco taxes apply because their ballot language included reservations in the tax scheme, while the other three tobacco taxes neglected to include the necessary additional language which would include reservations. While only tribal members were supposed to be able to purchase the reduced tax cigarettes, some Arizona non-native smokers go to reservations to buy reduced-tax cigarettes. There is no concrete data substantiating claims that more than a negligible number of Arizonan smokers buy the reduced-tax cigarettes from reservations, although various billboards around the state advertised cheap cigarettes on reservations. The revenue-generating sale of tobacco for the tribes makes it more difficult for Native American tribes to pass smoke free laws and tobacco tax increases.When the 1994 initiative Proposition 200 coalition was created and the Arizona Hospital and Healthcare Association backed it with significant financial support, the tobacco industry threatened to retaliate against the hospitals. The tobacco industry threatened that if the hospitals backed Proposition 200, the industry would bring to ballot a proposition to regulate the hospitals as utilities.In response, AzHHA president John Rivers initiated Project Rolling Thunder, a plan to pass comprehensive clean indoor air acts locally,outdoor grow table as a way to force the tobacco companies to fight local clean indoor air ordinances in every Arizona city of 10,000 inhabitants or more rather than pursuing regulation of hospitals.
Rivers was never forced to use this tactic because the tobacco industry threat against the hospitals turned out to be a bluff. However, tobacco control groups started working towards the very aim Rivers had devised, although their clean indoor air laws passed one-at-a-time rather than simultaneously. Despite the fact that Rivers initially kept close to the vest the threat leveled by the tobacco industry and Project Rolling Thunder’s smoke free cities strategy, the tobacco industry’s general challenge to Proposition 200 served to galvanize Arizona tobacco control advocates to achieve city-by-city clean indoor air ordinances in a manner Arizona never previously encountered. The local ordinance battles were some of the toughest the tobacco control community in Arizona encountered; even after a local smoke free ordinance passed, tobacco industry front groups would often attempt to amend or repeal voter-approved measures, occasionally for years. Lawsuits and campaigns for exemptions were also frequent, alleging negative economic impact would or did ensue following the passage of clean indoor air ordinances. Arizonans Concerned About Smoking , the grassroots organization founded in 1966 by Betty Carnes, and one of the first nonsmokers’ rights groups in the United States,led the charge in passing most of Arizona’s local smoke free ordinances. The sustained funding of $45,000 a year ACAS receives from an endowment set up by Carnes enabled ACAS to play a major role as an independent organization in achieving Arizona’s tobacco control victories. Led by Dr. Leland Fairbanks and Dr. Donald Morris, ACAS’s single-issue focus on tobacco control made ACAS more dedicated, and often more effective than the national voluntary health associations. By far the most progressive tobacco control organization in Arizona, ACAS often times forged ahead in successfully furthering tobacco control efforts despite the health voluntaries rather than because of them.
The cities discussed below had noticeable effects on tobacco control in Arizona, either because they achieved strong smoke free ordinances, or because the political brouhaha surrounding the passage furthered the course of tobacco control in Arizona by providing public debate leading to denormalizing tobacco. These local ordinances also laid the foundation for the successful effort, through Proposition 201 in 2006, to pass a strong statewide clean indoor air act.The City of Mesa in 1996 enacted by voter initiative the first significant clean indoor air act in Arizona, approved with 55% support.The ballot initiative mounted by Mesa for Clean Air on March 26, 1996, covered indoor areas including all bars, restaurants, pool halls, and hotels.The Mesa Smoking Control Ordinance took effect July 1, 1996, with a hardship exemption for bars making more than 50% of their sales from alcohol that allowed for a separately ventilated smoking area. Before the law even became effective, it was challenged. While the Tobacco Institute funded “no” campaign was unsuccessful in preventing the Mesa Clean Air ordinance from passing, another tobacco industry challenge to the ordinance appeared in October 1996 when the National Smokers Alliance created an organization called Citizens to Repeal Proposition 200 . Led by former Mesa mayoral candidate Kat Gallant, Citizens to Repeal Proposition 200 gathered signatures for the purpose of forcing a special election to recall the ordinance. Citizens to Repeal Proposition 200 claimed large losses to business and sought the tobacco industry’s policy of “accommodation”30 of smokers and nonsmoker rather than laws requiring smoke free environments. Even though the City of Mesa had already granted exemptions to all 13 restaurants that applied for exemptions under the hardship clause in the law, which allowed that restaurants proving more than 15% reduction in sales over four months could apply for a partial and temporary exemption, the opponents wanted to stop the impending inclusion of restaurant bars.
In response to this threat mobilized by the National Smokers Alliance to force a special election which would have cost the City of Mesa an estimated $100,000, the Mesa City Council weakened the ordinance between July and December 1996 to exempt bars that made more than 50% of their sales from alcohol, rented hotel meeting rooms, banquet rooms, and the outdoor areas of restaurants . Despite the facts that the public had passed the original ordinance and the Council weakened the ordinance, the National Smokers’ Alliance still forced a public vote on the weakened version of the ordinance in March 1998.The Mesa ordinance as it stood in 1998 ended smoking in workplaces, restaurants, and restaurant-bars, and allowed smoking in bars that derive over 50% of their revenue from the sale of alcohol. Mesa’s law, in effect since 1996, inspired many subsequent local clean indoor laws,plant grow table and until Tempe passed its law in 2002, was the strongest smoke free policy in Arizona.In 1985, Tucson had been the first city in Arizona to make workplaces smoke free, although it exempted restaurants and bars. Nonsmokers, Inc., the Tucson group headed by Arizona tobacco control advocate Karen Zielaski that helped win Tucson’s ordinance, and a long-term tobacco control advocacy force in Tucson, dissolved in December 1997.A new group, Tucson Clearing the Air, formed a year later, including many former members of Nonsmokers Inc., to work in the new tobacco control environment in Arizona. Clearing the Air came together primarily through physicians from Tucson including Keith Kaback and Joel Meister, who served leadership roles. Tucson Clearing the Air guided a smoke free workplaces and restaurants ordinance through the Tucson City Council in 1999 and the Pima County Board of Supervisors in 2001. In 1999 Tucson Clearing the Air lead the movement to get the Tucson City Council to pass 4-3 a smoke free ordinance that made all restaurants smoke free. The ordinance, passed in April, went into effect October 1, 1999. By working with the City Council, the group avoided the expense of a ballot campaign. Tucson Clearing the Air did not encounter opposition, though after the council passed the ordinance the Arizona Restaurant and Hospitality Association sought exemptions to extend the hardship clause by a year, instead of the three months given to businesses. Tucson’s ordinance gave restaurants until January 2000 to file for hardship exemptions if they could show with tax receipts that they had sustained a two consecutive months of 15% or greater loss of business compared to the previous year. Few exemptions were granted. The six-month delay sought to give Pima County the opportunity to pass a similar smoke free law bringing the clean indoor air ordinance region-wide. Pima County, however, would not pass an ordinance until 2001. Due in large part to Arizonans Clearing the Air , Pima County adopted a clean air ordinance including restaurants but not bars on October 9, 2001. The ordinance had come before the Pima County Board of Supervisors twice before in the previous two years, as Tucson tobacco control advocates urged Pima County to follow Tucson’s lead. Arizonans Clearing the Air lobbied the Pima County commissioners, and banking on the success of this same measure two years prior in Tucson, Pima County’s largest city, the Supervisors voted 4-1 for smoke free restaurants and workplaces. This ordinance covered unincorporated areas in Pima County, including workplaces and more than 400 restaurants.
Philip Morris consultants exchanged many emails as Pima County’s clean air ordinance was being considered, in which they discussed mounting a signature gathering campaign costing $80,000 to $100,000 to place the Pima County smoke free ordinance on the next year’s ballot.An email sent weeks before the ordinance passed from Philip Morris lobbyist John Mangum to tobacco industry lobbyists and consultants Jack Dillard, Rip Wilson, and Trisha Hart describes how “we have been successful in delaying the proposal for the last 6 months,” even though Mangum did not “think [they] are succeeding in defeating it, despite yeoman efforts on the ground and substantial support and $$$ from PM and the other companies.”Mangum explained the significance of the Pima County effort in a September 19, 2001 email: “Pima County has about 15% of the states [sic] population, with only 4 or 5 cities. If the ban effort is successful here I anticipate the battleground will immediately move to Maricopa County [which includes Phoenix] where 70 to 75 percent of the population resides. We already are under attack in 7 or 8 of the 19 incorporated cities in Maricopa County.”The tobacco industry opposition to the Pima County clean indoor air ordinance largely resulted from this fear: “If we lose Pima County the pressure on local government in the Phoenix area will be enormous.” Although the Pima County smoke free ordinance was viewed as only a moderate gain by tobacco control advocates as it exempted bars, Philip Morris Arizona representative Jack Dillard viewed Pima County as the tipping point for smoke free ordinances in Arizona prior to its passing, and suggested a statewide preemptive ballot initiative rather than attempting to gather 19,000 valid signatures in Pima County to force a vote on the ordinance.Dillard acknowledged the tobacco industry’s defeat: “All we have to offer the public as an alternative to the new [Pima County] ordinance is a continuation of smoke filled hospitality venues.” The success of the Pima County ordinance led the incorporated town of Oro Valley to adopt a similar ordinance later the same year, in November, 2001. A Robert Wood Johnson Foundation Smokeless States Initiative grant from 2001 to 2004 helped Arizona to raise the standard for clean indoor air laws and continue denormalizing tobacco use. The more than $900,000 grant over three years funded the creation of the Arizona Clearing the Air coalition managed by ACS with Andrew Ortiz as the director of the program. This grant required the ACS, AHA, and ALA to provide matching funds, which went to fund the campaign-related expenditures, as the RWJF grant could not be used for direct political lobbying. The voluntary health organizations, along with Andrew Ortiz, coordinated Arizona Clearing the Air, which played a similar role that the RWJF-funded Coalition for Tobacco-Free Arizona had provided in the early 1990s. ACTA participated in passing 11 of the 17 local clean indoor air ordinances in place in Arizona by the end of 2004, providing strategic support and expertise to every local campaign during this period. Part of ACTA’s role involved developing a media campaign through the Riester advertising firm to educate communities on the value of clean indoor air ordinances. Despite ACTA’s organization and technical support on the local level, these local smoke free ordinances were, of course, dependant upon the political will of local city councils and the support of local tobacco control advocates. This meant that in a city like Phoenix, where the City Council was not receptive to considering a clean indoor air ordinance, ACTA’s hands were tied.