This appropriation added to an already levied $500,000 a year transfer from the Health Research Account through FY2013. Proposition 303 payed for this $5.5 million per year appropriation from the Health Research Account by allocating five percent of the 60 cent tobacco tax increase to the Health Research Account, effectively more than offsetting the fund transfer. Yet, while the Legislature got their appropriation money either way, standing to gain even more if Prop. 303 passed , had Proposition 303 lost, the $5 million-a-year appropriation would have come from the Health Education Account that funds TEPP instead of from the Health Research Account. The text of Chapter 320 of HB 2711 read: “if a Tobacco Tax referendum submitted to the voters on November 5, 2002passes, the appropriations to the DCRC [Disease Control Research Commission, now ABRC] for allocation to a biotechnology non-profit foundation [TGen] will come from the Health Research Fund instead of the Health Education Account”as per the original allocation . Filing with the Arizona Secretary of State on June 13, 2002, John Rivers, CEO of the AzHHA, chaired the campaign organization to pass Proposition 303, termed “Arizona for Healthy Futures.” The campaign used the same name as the campaign to pass Proposition 200 that created TEPP, as it again joined the AzHHA with the AHA, ALA, and ACS. Bill Pfeifer, CEO of the ALA Southwest Division served as treasurer for the campaign. Formal ballot arguments supporting Proposition 303 appeared from Governor Hull, former U.S. Surgeon General C. Everett Koop, former Arizona Attorney General Grant Woods,cannabis grow tables and a long list of health professionals. Governor Hull’s statement in the ballot information packet said, “Without these additional tobacco tax dollars, the State will be forced to use additional General Fund revenues, necessitating reductions in or elimination of other services or programs.”
Proposition 303 had almost universal support and attracted support from pro-business interests, including the Tucson Metropolitan Chamber of Commerce, which had opposed the tobacco tax increase in 1994.21, 107 While the tobacco companies did not actively oppose Proposition 303 once it was placed on the ballot, groups allied with the tobacco industry, including the Cato Institute and the Arizona Tax Research Association wrote opinion editorials warning that a tobacco tax increase would bring cigarette smuggling and that forcing smokers to pay for others’ healthcare constituted an unfair burden.According to RJ Reynolds spokesperson David Howard , RJ Reynolds planned “nothing proactive,” explaining that opposing Proposition 303 was “just not the best use of [RJ Reynolds’] resources” at the time.Not a single argument “against” Proposition 303 was filed with the Secretary of State for the ballot information pamphlet.The health voluntaries’ fundraising strategy to campaign for Proposition 303 focused on donors that had an interest in protecting the TEPP monies because they had been contractors for TEPP in the past. In a 2006 interview, Madonna noted that the Coalition “looked at where was the TEPP advertising dollar being spent… [we] got $100,000 from the Suns and Diamondbacks,” teams that for years had received TEPP advertising contracts and understood that in contributing to the Coalition’s campaign, they were investing in their own future contracts with TEPP .Additionally, because of the popular and political support for the measure, Viacom and other media companies donated billboards and air play . The Health Research Account to fund tobacco disease-related research was created in 1994 by Proposition 200 which allocated 5% of the 40 cent cigarette pack tax increase revenues for “research on preventing and treating tobacco-related diseases and addiction” through grants to Arizona researchers.In 1995, the Legislature designated the Arizona Biomedical Research Commission * to administer the Health Research Account. The Legislature created the ABRC in 1984 to fund and solicit biomedical research proposals to “protect the public health and safety by funding research into the causes, treatments, and cures of disease,” with no reference to tobacco.ABRC grants have typically lasted three years and serve as a bridge for junior researchers to apply and be awarded federal research grants.The ABRC is an independent commission of nine governor-appointed and Senate confirmed members representing the general public, medical, and scientific research communities .
Until 1997 the ABRC was funded from the General Fund through the interest and penalties paid on delinquent income taxes and occasionally also received money from the state lottery funds.By FY1997, however, tobacco tax revenue represented 100% of the funds the Commission administered for new contracts.During the implementation of Proposition 200 by the Legislature, Representative Carol Springer took advantage of the Health Research Account funding to phase-out General Fund spending on the ABRC.HB 2108, created for this purpose, established a separate account for the ABRC for its regular contracts, explicitly barring the ABRC from using the Health Research Account funds for the ABRC’s previous category of research.By FY1996 only continuing non-tobacco related contracts from previous years received general fund money, and by FY1997 the only funds the ABRC had at its disposal were earmarked for tobacco-related research from the Health Research Account.Thus, Proposition 200 revived the ABRC by giving it a new mission and transformed its task from supporting biomedical research in general to managing the Health Research Account grants for tobacco-related disease research.The ABRC did not welcome the Health Research Account’s statutory requirement that all grants given from its funds be tobacco disease-related. The ABRC’s Executive Director Dawn Schroeder and Deputy Director James Matthews saw assigning the ABRC responsibility for administering the Health Research Account as a malicious act by Senate Appropriations Chair Carol Springer.In a 2007 interview Matthews said, “It was a personal thing, she didn’t like the Commission. Her mission in life was to get rid of the Commission. So along comes the first of those tobacco tax initiatives, and she says ‘so you can take money from the initiative, but you can only spend it on tobacco.’ She didn’t want to spend state generated general funds for the Commission. She said, ‘if you can collect it from tobacco, fine.’”The Commission viewed the Health Research Account as a burden rather than an opportunity. The tobacco-related “constraint” for funding research was cited as one of the major impediments facing the ABRC in an 1998 Auditor General Report Sunset Review of the ABRC.The Report, commissioned by the Joint Legislative Budget Committee in a standard decennial automatic agency review, concurred with ABRC executive staff’s perceptions that because the “Commission’s statutory mission is not limited to supporting tobacco-related research,”commercial grow tables the “Commission and its researchers have been heavily impacted by its switch from general medical research to a more narrow focus on tobacco-related issues.” [emphasis added]As a consequence, the ABRC begrudgingly restricted its requests for proposals between FY1997 and FY2001 to tobacco-related research.
The Commission did not engage in any outreach to identify promising young investigators who could be interested in tobacco and – probably as a result – felt that the proposals decreased in quality because fewer of their grantees had moved on to federal grants than when the Commission offered unrestricted RFPs.In February 1999, when Arizona first began debating where MSA money would be allocated, the ABRC attempted to secure funding for unrestricted research through the Legislature. SB 1095 and HB 2490 , Lou-Ann Preble , and Herschella Horton would have continuously appropriated $2 million a year from the MSA payments for supporting unrestricted projects.The ABRC pushed both bills in hopes of obtaining funds to fulfill its original charter without modifying or attenuating the Health Research Account’s tobacco specific RFPs. SB 1095 addressed the ABRC’s concerns that the “transition to tobacco tax revenues has restricted the type of research the Commission may support” and cited the “Auditor General performance audit [which] contained a finding that researchers and the Commission have been heavily impacted by the funding shift.”Because these attempts to create a new unrestricted funding source failed, as did an effort in 2000 to provide the ABRC unrestricted funding from the sale of special license plates,ABRC gave up looking for new sources of funding and began exploring how they could relax the restriction that Proposition 200 funds be limited to tobacco-related research.The 2001 aim of ABRC commission members and executive staff was to shift the organization’s focus to translational research, defined as taking research from the lab and “translating” it into consumer products, particularly drugs. TGen, created in 2002, was seen as a good mechanism to accomplish this goal. The ABRC took a positive view of HB 2711 to shift $5 million per year for 5 years to TGen by transferring money from the Health Research Account, seeing it as a strategic partnership with TGen.While this $5 million a year transferred from the Health Research Fund to TGen was poised to sunset FY2007, clamors for an extension of this appropriation from the business community as well as ABRC’s own interest in keeping TGen afloat resulted in ABRC committing continued funding from the Heath Research Account to TGen, $5 million a year for an additional five years.A December 14, 2006 Arizona Republic editorial entitled “A quick ROI [Return on Investment] for Arizona” espoused preserving the tobacco tax Health Research Fund $5 million-a-year appropriation to TGen because despite it being “a relatively small share of TGen’s budget, it is crucial base support. …In order to keep the momentum going, Arizona needs to continue supporting TGen.”When ABRC’s funding of TGen expired June 30, 2007, ABRC unilaterally extended its funding through FY2012.ABRC continued to spend on TGen the money originally intended for tobacco related research. While the restriction that the Health Research Account funds had to go to tobacco-related research had already been lifted, the little remaining funds that did go to tobacco-disease related proposals diminished as the Health Research Account received additional diversions. Further erosion of funds available for tobacco research from the Health Research Account occurred in 2002 when the Legislature passed SB 1270, which took $500,000 a year for 10 years from the Health Research Account for TGen, provided that TGen contribute matching funds from private donors.The health voluntary organizations and tobacco control advocates at the time and subsequently largely ignored the Legislative diversions – and the ABRC’s – that completely stripped the Health Research Account of its original purpose. As of 2006, the ABRC typically received around 140 proposals requesting funding a year, with on average only 10 of these proposals per year specifically addressing tobacco.51 proposals were actually funded in 2006, with only four directly relating to tobacco receiving funding.Unless legislation or vigorous advocacy alters its course, the Health Research Account has lost its raison d’être of funding quality tobacco-related research. While tobacco control advocates could not reenact the Health Research Account under Proposition, the additional funding the ABRC received from Proposition 303 could have been specified for tobacco control research. Tobacco disease related research is an important element of tobacco control that Arizona’s advocates and government need to address by taking advantage of opportunities to either voter-protect the Health Research Account or create a new and secure funding source for tobacco related research.The Arizona Department of Health Services Tobacco Education and Prevention Program , created after Proposition 200 passed in 1994, is the organization that coordinates Arizona’s tobacco education, prevention, and cessation campaigns. TEPP’s history is best viewed in four periods, each influencing programming differently. From FY1995-FY1997 TEPP had restricted programming but rapid development; from FY1998-FY2001 TEPP developed a robust tobacco control program; from FY2002- FY2003 TEPP experienced program breakdown, with a weak media component, and; from FY2004-FY2007 TEPP, propelled by an emerging smoke free state climate, modernized its program to keep up with Arizona’s increasingly smoke free norms. As noted in our previous report, TEPP suffered initial setbacks that constrained the areas of tobacco control it could address.In 1995, ADHS Director Jack Dillenberg limited TEPP’s target programming population to pre-adolescents, adolescents, and pregnant women and their partners.This program maticlimitation went against the consensus that comprehensive tobacco prevention media programming is most effective when it targets a broad audience, exposes the tobacco industry, highlights the dangers of addiction, and relates the harms of secondhand smoke.This restriction slowed down TEPP’s programmatic development in secondhand smoke, prevention for older adolescents and young adults, disparate populations, cessation, youth access, and smokeless tobacco.