Carter also refused to go along with the majority position of the VTSF Board to fight the governor’s proposal, saying that as an appointee of the governor, he answered to Gilmore and not the foundation.In a 2009 interview, Danish felt that Gilmore was not specifically seeking to remove funding from VTSF to impede VTSF’s mission, but rather that Gilmore was attempting to mitigate a budget crisis.However, Gilmore had close ties to the tobacco industry, having received a considerable amount of campaign contributions from the tobacco industry for his gubernatorial campaign.For example, in 1997 the Tobacco Institute conducted at least one major fundraiser for his campaign.The governor’s proposed changes to the budget, embodied in HB 2432 and SB 1180, included language that VTSF funds “may be used for health care purposes,” opening the fund to being tapped to cover health expenses not associated with tobacco use and potentially substantially reducing the amount of MSA money to fund tobacco control efforts.Two members of VTSF Board of Directors, Del. John O’Bannon and Sen. Emmet Hanger sponsored the bills to allow such diversion of funds. HB 2432 advanced into the Senate in February, where it was stricken from the calendar by a vote of 39-0 on the 24. After being introduced, SB 1180 was referred to the Senate Finance Committee on February 1, where it died without any further action. The Senate Finance Committee rejected the bill because it would have converted the securitized funds into general revenue, which the committee feared could lead to a deficit the next year.Supporters of the governor’s proposal, like Del. Phillip Hamilton viewed the proposal as a way to spend more money on healthcare without having to raise a new revenue stream. As noted above, much was made of the fact that VTSF had not spent their allotment yet. A spokesperson for the governor, Lila White,cannabis drying rack ideas described the proposal as “an effort to spend the money in a productive way for medical purposes.”ACS, ALA, and AHA rallied to VTSF’s defense with a newspaper and radio advertising campaign.
The campaign targeted HB 2432 and SB 1180, saying that they would dilute tobacco control efforts and divert funds to assist Gilmore politically in the wake of a budget crisis.The media campaign was successful; it drew the ire of Gilmore, who characterized the campaign as “deceptive” and “offensive.”In light of the governor’s criticism that VTSF had not spent their allotted funds, VTSF’s chairperson was put on the defensive. Danish argued that the members of the Board had been confused about whether VTSF would operate as a state-controlled or independent entity and their ability to award funding. VTSF had decided to thoroughly research all funding proposals before implementing them, causing the delay.Danish also acknowledged that “it’s evident that we have not let the Commonwealth know that we are doing anything.”It was eventually determined that VTSF had the ability to distribute funds out of its operating fund, but that the governor and legislature through the budget process could control the amount of money that VTSF has access to.In 2009, SB 1112, introduced by Sen. Ralph Northam , sought to change the name and mission of VTSF. The bill passed and was signed by Gov. Kaine in March 2009. SB 1112 changed the name of VTSF to the Virginia Foundation for Healthy Youth and allowed some of the Virginia Tobacco Settlement Fund monies to be used to prevent childhood obesity. No changes were made to the governance of the organization. This action had the effect splitting the VFHY into two divisions: the VTSF division, which maintained its original function, and the Virginia Youth Obesity Prevention division , which would “assist in financing efforts to reduce childhood obesity through such means as educational and awareness programs, implementing evidence-based practices, and assisting schools and communities with policies and programs.”Both divisions were to be funded out of the same pool of MSA money, the Virginia Tobacco Settlement Fund , potentially reducing the available funding for tobacco control activities. The funds were to be used “primarily” for tobacco prevention among youth, but it was up to VFHY’s discretion how much would be dedicated to VTSF and how much to VYOP. In addition, funds used for the VFHY that were not derived from the MSA Fund and instead were derived from other sources, such as grants and private funding, and would be used for obesity at the VFHY’s discretion. Therefore, there was a chance that VTSF funding could be significantly reduced due to the funding distribution structure, down to as little as 51% of their original.
Tobacco Settlement Fund allotment and 0% of non-MSA private and public funding sources, with the rest being distributed to the VYOP. SB 1112 was supported by the Secretary Health and Human Resources, Marilyn B. Tavenner, and by its sponsors, Northam and Del. John O’Bannon III , who were both members of the VTSF board of trustees as well as both being physicians.Tavenner made statements to the press indicating that childhood obesity was an issue that she wanted to take seriously in order to stem a potential type 2 diabetes epidemic.Northam and others argued that the change would not interfere with the VTSF’s original and primary purpose of youth smoking prevention, but would add obesity to the mission of the organization. Marty Kilgore, the executive director of VTSF , said stated to the press, “We don’t want to water down in any way our tobacco-use prevention initiative. This is just going to be an extension of what we do.”Amy Barkley of the Campaign for Tobacco-Free Kids stated in a 2009 interview that while youth programs are not usually effective for achieving tobacco control goals, VTSF had been “really effective … their smoking rates have come down.”However, problems with the new arrangement abounded. VTSF was already underfunded and had limited staffing, and now the organization would be forced by the legislature to take on an additional policy issue, without securing new funding or new staff for VFHY.We were unable to identify any specific actions of the health groups to actually oppose the legislation. Additionally, the national advocacy groups and the three voluntary health organizations found it difficult to protest the move, as obesity was part of their health policy focus as well, and they were reluctant to be seen as opposing obesity control measures when they were trying to ensure adequate funding for the tobacco control part of their mission.VFHF did not take a position on SB 1112. The ALA opposed the measure while AHA and ACS supported it, so the VFHF leadership decided to keep the coalition out of the issue. The ALA took the position that, if SB 1112 passed, it hoped that VYOP would only use funds that were newly raised from independent, non-MSA public and private sources for any obesity program. David DeBiasi, in his capacity as director of advocacy for the ALA, said to the press, “We don’t want to see any tobacco-prevention dollars diverted from their intended use.”ALA and other health groups opposing the measure pushed for a cap of $100,000 of MSA derived funds intended for obesity programs,vegetable farming equipment but were unsuccessful in amending the legislation to incorporate the cap.Tobacco control efforts in Virginia have been difficult from the beginning due to the well-funded and politically powerful tobacco industry’s lobbying efforts in a tobacco-growing state where Philip Morris is headquartered.Despite this situation, Virginians have demonstrated through consistent polling for more than 20 years that they support strong and comprehensive clean indoor air legislation and higher cigarette excise taxes. This public support for tobacco control has grown with demographic changes in the state, especially the growth of the Washington DC suburban areas in Northern Virginia. These new residents to Virginia are generally not concerned with preserving Virginia’s “tobacco heritage.” Virginia is also becoming less rural and more urban overall, tending to increase the support for tobacco control measures. Over time, these demographic shifts, coupled with growing support for tobacco control among established Virginia residents, have put pressure on legislators who oppose tobacco control.
Ironically, the public health advocates who have repeatedly produced evidence of broad public support have generally not been able to translate that support into advocacy successes. Instead, they have allowed the tobacco industry to dominate Virginia’s tobacco control debate, and have been willing to compromise for more than 20 years, resulting in many strong proposals for tobacco control dying or becoming weak, industry-favorable laws. Such compromises have resulted in Virginia being mired in the past while other states, including tobacco-growing Southern states with similarly strong tobacco industry lobbying efforts, have moved forward to enact stronger clean indoor air laws or larger cigarette excise tax increases. Despite the good intentions of advocates, “half a loaf” has proven to be considerably worse than “no loaf at all,” and Virginia’s tobacco control advocates must accept the fact that opposing weak measures while holding out for strong, comprehensive ones could have prevented the sort of stagnation that has afflicted Virginia. Virginia has had some notable successes and near successes in recent years. In 2004, the Virginians for a Healthy Future coalition used favorable polling data to show that Virginians supported a sizeable cigarette tax increase. The campaign included TV, radio, and print advertising. The coalition also met with legislators to educate them on the issue, recruited a strong legislative ally , and mobilized grassroots elements of many VFHF member organizations. The result was a 30 cent tax increase that generated $310 million in revenue to be dedicated to offsetting healthcare costs, and saving approximately 12,000 Virginians from tobacco-related deaths. The broad scope of VFHF’s campaign strategy for the cigarette tax increase could be replicated to lead to successes on other tobacco control issues. Advocates in Virginia should rethink their lobbying strategy, which is predominantly focused on the state legislature. The strength of the tobacco industry in the statehouse is significant, as it is in many states throughout the nation. However, advocates can defeat the industry by prioritizing local action, and strengthening and then using their grassroots capability when a fight in the state legislature cannot be avoided. The example of VFHF’s campaign to influence the Speaker of the House, William Howell, in his home district of Fredericksburg in 2009 is illustrative. This campaign was very successful in bringing constituent pressure to bear on the Speaker through phone banking and a paid media campaign. These efforts not only attracted the Speaker’s notice but caused him to change his position dramatically on the issue of restaurant smoking. The ultimate result was unfavorable primarily because the pressure was not applied broadly enough to more key legislators. The degree to which the limited campaign against Howell impacted Virginia speaks to the potential for success if such district campaigns are expanded to target more key politicians. The voluntary health organizations need to provide the resources necessary for Virginia advocates to conduct additional targeted campaigns. Virginia’s advocates also need to do a better job of maintaining cohesion in the face of a strong and unified tobacco lobby. In 1990, during consideration of the bills that would become the Virginia Indoor Clean Air Act , GASP supported a comprehensive measure without preemption, while the Tri-Agency Council backed a weaker, preemptive bill. The divisions among the advocates were exploited by the tobacco industry, whose solidarity and influence allowed them to effectively dictate the terms of what would eventually become the VICAA. Likewise, in 2009, the statewide tobacco control coalition, VFHF, disintegrated over the issue of supporting Governor Kaine’s weak restaurant smoking restriction proposal. The coalition’s inability to hold its members to their deal-breakers agreement, which problematically was never signed by coalition members, made it easier to pass a weak bill. Advocates should use this opportunity to rebuild the coalition using a strong deal breakers agreement as the foundation. Virginia had a brief but promising history of local tobacco control efforts prior to the enactment of the VICAA in 1990, which preempted further local clean indoor air ordinances. Prior to 1990, 16 localities had enacted some sort of local smoking restriction ordinance, and more were considering them.