Elections would be held in November and all 100 members of the House were up for reelection

Whibley was frustrated as four council members had changed their minds four months after voting the initial passage of the ordinance, comparing it to the failure of the General Assembly to pass smoking restrictions that Virginians overwhelmingly supported: “We dropped the ball like they did.”Soon afterwards, Lorene Alba of the ALA, Hilton Oliver of Virginia GASP, and Katie Pepe of ACS went on the record to question the Council’s reasoning. Hilton Oliver pointed out the fallacy of one of the main rationales in reversing the ordinance, that it would harm business, saying “[f]or every Norfolk resident who goes to a Virginia Beach restaurant to smoke, you’ll get four or five people from Virginia Beach.”After rescinding the ordinance, Norfolk did not consider a local smoking proposal again in light of the pending statewide law. The reversal of the Norfolk city council has parallels with tobacco industry efforts in other states, notably in California. In the late 1980s and early 1990s, several California localities attempted to enact local smoking restrictions. In 1990, the Los Angeles city council considered a total smoking prohibition in all restaurants in the city, a proposal which had been developed internally without prompting by tobacco control groups . The tobacco industry mobilized restaurateurs and smokers rights groups to oppose the legislation, and were successful because the voluntary health organizations were inactive on the issue.Because of a lack of sustained activity by health groups, the ordinance was defeated by the tobacco industry.In contrast, 1990 smoking restrictions in the city and county of Sacramento both succeeded despite significant industry opposition due to the concerted efforts of the ALA, which worked closely with city council members to educate them about the scientific harms of secondhand smoke.While the role of the tobacco industry in influencing the city council in Norfolk was unclear,vertical farm systems the health groups did not take any significant action to counter the claims of harm to restaurants that apparently influenced the council.

While VFHF provided technical support testimony at Norfolk City Council hearings in support of Whibley’s proposal, VFHF felt that Norfolk was hamstrung by the Attorney General’s opinion that Norfolk could not restrict smoking on their own.Cathleen Grzesiek, interviewed in 2010, felt that challenging the Attorney General’s opinion would require a costly lawsuit that VFHF could not afford.Despite the important precedential value of the Norfolk ordinance, VFHF chose to focus instead on state level smoking restrictions. With funding to properly support Norfolk’s innovative strategy by challenging the Attorney General’s opinion in court, public health advocates in Virginia could create a precedent for local action. During the discussions among the Norfolk city council concerning their proposed ordinance, Norfolk became part of an attempt to unite the surrounding Hampton Roads region in pushing for restaurant smoking restrictions. The discussions were headed by two council members, Barclay Winn from Norfolk and Rosemary Wilson from Virginia Beach. The proposal would have brought a unified block of around one million Hampton Roads constituents to bear on the General Assembly.The discussions included the cities of Norfolk, Virginia Beach, Portsmouth, and Chesapeake.All of the Hampton Roads cities except Norfolk determined that in order to introduce stronger restaurant smoking restrictions, they would have to ask the General Assembly to enact a law granting them the power to do so. After Norfolk’s efforts to enact their own separate ordinance fell apart in 2008 all of the cities agreed that asking for permission from the General Assembly was the correct approach. This push led several legislators to introduce bills sought to grant localities the ability to exceed statewide smoking restrictions in restaurants. Despite the regional effort in Hampton Roads, most of the bills did not specifically apply to one region, and would grant preemption restrictions to most or all localities in Virginia . None of the bills survived. There were some important changes in Virginia’s political climate in 2009 that increased the chances that health advocates would be able to enact legislation that year.This election coincided with a rise in Democratic influence in Virginia – Gov. Tim Kaine was elected in 2006 and Virginia supported Democratic Presidential candidate Barack Obama, the first time a Democratic presidential candidate had taken Virginia since 1964. Democrats were gaining influence, especially in suburban Northern Virginia.

Finally, House Speaker William Howell felt that his seat in his Fredericksburg district was vulnerable because it was becoming less conservative. Some House Republicans, most of all Howell, felt that they needed to project a different image. It is likely that this was a significant source of pressure upon Howell, and coupled with the VFHF campaign discussed below, caused him to shift his position on tobacco control legislation. In addition, the party in power after the election would be able to control redistricting in their chamber. Because the Democrats controlled the Senate, it was a political imperative for Republicans in the House to retain control.210 In addition, during the 2009 session some important changes were made to the composition of the House General Laws committee, namely that Del. Chris Jones replaced Terrie Suit who had retired, as the chairperson of the committee. The VFHF coalition, who had been repeatedly disappointed by the HGL’s consistent propensity to kill tobacco control legislation, felt hopeful that Jones would influence the committee to approach such legislation in a different light.Jones had openly supported clean indoor air legislation and also had stated his desire that clean indoor air bills be heard in the full committee.Prior to beginning the 2009 legislative session, VFHF decided to target Speaker Howell’s Fredericksburg district with pressure from their grassroots elements to force him to stop assigning legislation to the hostile ABC/Gaming subcommittee of the House General Laws Committee and allow it such bills to be heard in the full committee.They intended to capitalize on Howell’s vulnerability before the 2009 elections in a district that was becoming less conservative. VFHF hired a district organizer, Adam Bray, whose background was in community organizing around worker justice issues, to identify and mobilize constituents in and around the Fredericksburg district with phone banking and grassroots action. During the American Cancer Society’s Great American Smoke out in November 2008, Bray and VFHF took out a large ad in the Fredericksburg Free Lance–Star urging readers to call Howell and ask him to “make Virginia smoke free” . The campaign was successful in pressuring Howell, who reportedly referenced Bray’s campaign in a legislative caucus,industrial rack systems saying something to the effect of, “[if] they’re going to do this to me, what else could they do?”Howell sought out Gov. Kaine and they ultimately agreed in principle to a “compromise” restaurant smoking bill that allowed for smoking rooms and ventilation. Howell changed his position on clean indoor air bills directly because of the Fredericksburg grassroots campaign. Had VFHF been able to implement this tactic on a larger scale, it might have lead to a stronger restaurant smoking bill. VFHF was unable to do this because in 2009 they could only afford to hire a single district organizer;using their limited funds, they targeted the legislator who would have the greatest impact for the money spent.

Despite the antipathy of the Virginia Restaurant Association , many restaurant owners supported the idea of comprehensive clean indoor air legislation covering restaurants. The largest restaurant organization to start supporting restaurant smoking restrictions was the Virginia Beach Restaurant Association . One of the more active restaurateurs in Virginia supporting restaurant smoking restrictions was Matt Falvey, a Virginia Beach restaurant and owner of several restaurants including Hot Tuna and Shore break and former president of the VBRA. Falvey had made his three restaurants smoke free in 2007. In a 2009 interview, Falvey explained that he supported smoking restrictions in restaurants for several reasons. First, it was a public relations move; noting vocal public support for restaurant smoking restrictions, Falvey felt it would help VBRA members to support rather than oppose further restrictions.He also was unhappy that workers in some workplaces in Virginia were protected from secondhand smoke and that restaurant and bar workers were not. He felt that voluntary restaurant smoking restrictions were ineffective. In addition, Falvey knew that restaurant associations generally resisted any additional regulation and that libertarian attitudes about individual business rights were prevalent among Virginia restaurateurs. Without guidance from a group like the VBRA, Falvey felt that restaurateurs would have a “knee-jerk reaction” and fight further regulation of smoking in restaurants.As a member of VHTA, Falvey’s advocacy for smoke-free restaurants led the VHTA to stop opposing clean indoor air legislation for one year, during the 2003 session. After VHTA returned to active opposition in 2005, Falvey and other VHTA members resigned and took their concerns to the VBRA.236 The VBRA embraced the tobacco control position and approached Sen. Bell to support SB 1161.Bell put the VBRA members in touch with the VFHF, and the VBRA joined the VFHF coalition in 2007.Falvey lobbied for VBRA members to support VFHF efforts by arguing that, despite the traditional opposition of restaurateurs to any government regulation, that smoking was “the one area that is a major health concern that [the government] had chosen not to regulate us,” which was unfair to restaurant workers and patrons.Falvey also argued that restaurants did not share a common interest in fighting this particular regulation with the tobacco industry, because the tobacco industry was using restaurants to be “the face of anti-tobacco legislation. They’re kind of standing back.”Falvey also had some early contact with VFHF, but particularly with Keenan Caldwell, the ACS co-chair of VFHF, who worked with Falvey and others. However, Falvey was more supportive of local incremental progress than were the voluntary health organization advocates, which was a source of disagreement.HB 1703 was offered by Del. John Cosgrove on January 14, 2009 and was similar to a bill he had filed in 2007. Instead of the VICAA requirement of reasonable smoking in government owned or operated buildings, smoking was prohibited. Restaurants with 50 more seats constructed prior to July 1, 2010, were still required to have a no-smoking area “sufficient to meet customer demand.” Restaurants constructed after July 1, 2010, would be required to confine smoking to a structurally separate, ventilated smoking room. Additionally, there was a provision that required employee consent before a worker would be required to work in a smoking area. HB 1703 was not a strong tobacco control bill. The employees and patrons of all restaurants existing before July 1, 2010, were not protected. Restaurants built after that date would allow smoking in ventilated smoking rooms, an ineffective protection against the harms of secondhand smoke.The bill would have done little to protect the health of Virginians. Cosgrove had been traditionally hostile to tobacco control legislation, but credited his choice to sponsor HB 1703 to constituent pressure, pointing to VFHF-sponsored polling data that showed a large margin of support for such legislation.270 Introducing a bill like HB 1703 that gives the appearance of strengthening tobacco control laws while providing little substance is a standard tobacco industry tactic to undermine effective smoking restrictions. HB 2483 was introduced by Del. Albert Eisenberg as a “minors provision” law. Eisenberg’s bill would allow smoking in any restaurant or bar that posted signs that prohibited minors, with up to a $250 fine for violation by the proprietor. However, the proprietor was given affirmative defenses, preventing liability if the proprietor had asked the minor to leave the establishment. The bill also did not prevent minors from being in outdoor areas of restaurants or bars that allowed smoking. SB 1382 introduced by Sen. Kenneth Stolle was also a “minors provision” bill. The bill prohibited smoking in restaurants, except those that only allowed entry to persons 18 years of age or older. It allowed any bar, or bar area of a restaurant, to allow smoking. All restaurants built after July 1, 2009, could only allow smoking in designated smoking rooms. If any restaurant allowed smoking, they were required to have a no-smoking area of an unspecified size. The fine schedule for violations was similar to HB 2483, and proprietors were allowed an affirmative defense to violation if the proprietor had asked the violator to move from the prohibited area and posted signs stating “No Smoking” and minors were prohibited in designated smoking rooms. This “minors provision” language was a variation of the standard industry “red light, green light” tactic.

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VFHF noted in its announcement that support for the tax was strong throughout Virginia

Virginia’s involvement in SLS helped to bring tobacco farming interests and tobacco control advocates together in the Southern Tobacco Communities Project , which led to the “Core Principles Statement Between the Public Health Communities and the Tobacco Producers,” a memorandum of understanding between regional farming and tobacco control interests on the tobacco control policy areas that the farming interests represented by the STCP would support.Advocates and farmers agreed that a significant infusion of money be made available to tobacco growing communities. They also agreed that tobacco products should not be marketed or sold to minors, that a portion of federal cigarette excise taxes should be used for public health initiatives if a portion is dedicated to farming communities, and that the “prohibition of the use of tobacco products by informed adults of legal age is not a goal of the public health advocates or tobacco producers.”The understandings embodied in the Core Principles led both health advocates and farmers to support the division of MSA funding between tobacco community revitalization and youth tobacco prevention programming. This agreement led to the formation of the Virginia Tobacco Settlement Foundation and the Virginia Tobacco Indemnification and Revitalization Commission in 1999 . The SLS grant ended in 2004. After SLS, RWJF created a new national tobacco control funding program, called “Tobacco Policy Change: A Collaborative for Healthier Communities and States.” There was no continuity with SLS in staffing or in its specific mission.Tobacco Policy Change looked at the results from the SLS grant to identify where disparities in tobacco use still existed, and focused on those areas.In Virginia, AHA applied for a Tobacco Policy Change grant, but were denied after RWJF conducted a site visit.In Virginia,rolling track shelving systems sporadic attempts to raise the statewide cigarette tax from 1966 levels occurred in the decade before 1990, but only around the time that the statewide Virginia Indoor Clean Air Act was passed in 1990 did the number of attempts increase.

At that time, Virginia faced a budget deficit that reflected the economic downturn of the time. Estimated at around $1.4 billion in 1990 , the deficit came at a time when the political leadership under Gov. Douglas Wilder generally resisted tax increases of any sort and attempted to balance the budget using program cuts. However, RJ Reynolds came to the conclusion that some form of statewide excise tax increase was possible in 1990-1991 due to the severity of Virginia’s budget crisis. The industry sought to utilize use its lobbying strength, as well as inherent political opposition to taxation at the state level, to combat state tax increases. Thus, the early attempts at increasing the cigarette tax met with failure. For example, in 1990, Del. Dudley Emick introduced a cigarette tax bill, SB 414, which sought to increase the statewide tax from 2.5 cents to 5 cents, to generate $14 million for medical services for about 880,000, people without health insurance.Opponents decried it as a “version of socialized medicine” and Emick’s proposal was tabled indefinitely in the Senate Education and Health Committee soon after being introduced.There is no evidence that public health groups were involved with Emick’s proposal. A case study in the interplay between powerful tobacco industry interests and tobacco control advocates can be found in the 1992 session, where the industry fought off several tax proposals despite a sense among legislators that an increase was likely. 1992 was a transitional session, with the state mired in a deep recession along with the rest of the country. Additionally, several powerful tobacco industry legislative allies were no longer present. Del. A.J. Philpott , the powerful House Speaker who protected tobacco interests, had died the previous year. Additionally, a powerful industry voice in the Senate, Howard Anderson, Jr. , had retired. Anderson’s tenure as Chairperson of the Senate Finance subcommittee during the early 1990s was characterized by a systematic opposition to any tobacco tax proposals. Redistricting had increased the number of urban legislators, diluting the traditionally pro-tobacco rural General Assembly contingent.It was in this environment that the State Board of Health attempted to push a tax increase.

A wide range of tobacco industry interests, business associations and labor unions arrayed themselves against cigarette excise taxes for the 1992 session. James Frye, a lobbyist for Philip Morris, described to the media that the industry had established coalition of groups lobbying against taxes as a “vital economic bulwark in Virginia.”The coalition at this time included the Virginia Tobacco Growers’ Association, the AFL-CIO, the Virginia Farm Bureau, the Virginia Agribusiness Council, the Virginia Wholesalers and Distributors Association, the Virginia Food Dealers Association, the tobacco companies themselves, and suppliers like Reynolds Metals Co.Before the 1992 session began, Virginia’s Board of Health proposed a 24 cent per pack increase in the excise tax. The rationale for the increase was health concerns; Board members testified before legislators about the health problems stemming from cigarette use and argued that the revenues from a tax increase be used for healthcare. However, the Board did not have any paid lobbyists and their efforts were limited to having Board members testify or call on legislators directly. In addition, the Tri-Agency Council declined to take a position on the Board of Health’s proposal, characterizing it as an “economic” issue. Without the lobbying support of tobacco control advocates or any effective lobbying power of their own, the proposal died without even being introduced into the legislature in the face of determined tobacco industry opposition.The primary goal of the 2002 campaign was a 60-cent increase, which, if implemented, would place Virginia close to the national average.The additional revenue would have been used to offset the budget deficit, with no specific funding for tobacco control, although VFHF welcomed the secondary benefit of discouraging smoking initiation. One of the primary individuals working on this campaign was Donna Reynolds, community relations director for the ALA.Reynolds had previously participated in the Southern Communities Tobacco Project and had established relationships with some of the tobacco farmer representatives that participated in STCP, particularly the Concerned Friends for Tobacco , a Virginia-based political action committee.CFT adopted a position that they would “not oppose” tobacco tax legislation, and informed legislators of this position.Additionally, Cathleen Grzesiek recalled in a 2009 interview that some individual tobacco farmers helped with VFHF’s tobacco tax campaign.

However, other farming groups, notably the Farm Bureau, staunchly opposed any tobacco tax increase .Others involved in the VFHF tax campaign included contract lobbyists for the Virginia chapters of the national voluntary health organizations and staff lobbyists Keenan Caldwell and Cathleen Grzesiek .The “2.5 Cents to Common Sense” campaign for a 60-cent increase utilized several tactics, including press releases and other messaging emphasizing that the state had “the lowest cigarette excise tax in the nation and that the state had to move from ‘2.5 Cents to Common Sense.’” The campaign identified three elected officials, the governor, Senate Finance Committee Chair, and the House Majority Leader, as the key figures who needed to be swayed in order to increase the tax. To put pressure on these figures, the coalition utilized pamphlets,customizable shelving system radio and TV advertising and a website.In addition, VFHF had recruited a large number of groups to support their tax increase campaign through grassroots efforts, and activities such as providing testimony at public hearings .In early January 2003, the coalition reiterated its call for higher taxes, calling a press conference to call attention to the health benefits of raising the tax. Warner struck a cautious tone, repeating his position from the previous year that he would consider increasing “sin taxes” to balance the budget, but would not spearhead any such measure. Ultimately, two bills were endorsed by VFHF in the 2003 session: HB 2796 by Del. Mitchell Van Yahres and SB 1113 by Sen. Mary Margaret Whipple D – Arlington, Policy Score 10.0, Total Tobacco Industry Campaign Contributions: $1,000. Both intended to raise the tax to a total of 60 cents. SB 1113 stalled and subsequently died in the Senate Finance Committee soon after being introduced. HB 2796 met the same fate in the House Finance Committee. These bills supported by the coalition did not make much progress through the legislature, despite constant lobbying pressure from VFHF members as a continuation of their“2.5 Cents to Common Sense” campaign.Prospects in the House, controlled by Republicans, were unfavorable after the 2003 session due to increased anti-tax and anti-tobacco-control ideology measures, became even more unfavorable after the 2003 session, especially considering the dismal performance of tax-increase bills in the 2003 session.According to Cathleen Grzesiek, the head of the coalition in 2009, Virginia legislators were unwilling to consider a tax increase until Warner chose to propose it in the 2004 budget.Also, the support of Sen. John Chichester , who was President Pro Tem of the Senate and chair of the powerful Senate Finance Committee at the time, influenced the legislature.Polling in 2004 funded by VFHF and conducted by the Campaign for Tobacco Free Kids , the primary source for technical assistance for VFHF and an advisory group to the VFHF Steering Committee,helped tobacco control advocates advance their positions in favor of increasing the excise tax on tobacco products. In February 2004, TFK contracted the poll to Mason-Dixon Polling, and the survey demonstrated high support for an increase in the cigarette tax for a second year in a row: 71% of respondents supported a 75 cent tax increase.VFHF issued a press release highlighting the results, and stressed that increasing the cigarette tax would be a “win-win” situations for legislators and public health.

A commissioned by TFK analyzed the fiscal and economic consequences of a 50 cent tax increase on Virginia. The report, prepared by Brian Gottlob of the PolEcon Research group,was designed to be presented to legislators and Governor Warner to debunk several of the industry’s arguments about the negative effects of an increase. Notably, the report demonstrated that despite a decline in sales, a cigarette tax increase generally is followed by an increase of state revenue that more than offsets the decline in sales. The report also showed that despite arguments to the contrary, the burden of a cigarette tax mainly falls on households with incomes of $30,000 or more. Perhaps most important to Virginia, with Richmond’s Philip Morris manufacturing presence, was a finding that an increase in excise taxes corresponds with very small changes in overall employment in the state. The report found that a 10% decline in sales would lead to only a 0.1% change in retail employment. Several bills advanced different excise tax increase proposals during the 2004 Special Session I, but ultimately it was HB 5018, the Omnibus Tax Bill, proposed by Del. Harry Parrish that became the vehicle for the actual tax increase of 30 cents. HB 5018 increased taxes generally, including gasoline and car registration as well as tobacco products . The revenue created by the increased tobacco taxes was to be placed in the Virginia Health Care Trust Fund , created by the Omnibus Tax Bill to provide health care services. These health services were not fully defined by the Act but could include “Medicaid payments, disease diagnosis, prevention and control, and community health services.” The HCTF was funded in several ways. Forty percent of all Master Settlement Agreement payments were to be deposited into the HCTF. In addition, a portion of the excise tax on individual cigarettes was paid into the HCTF. Additionally, “roll-your-own” tobacco would be taxed at10% of the sales price, and all of which went into the HCTF. HCTF funds were to be used exclusively for the health care services and the funds would not revert to the general fund at the end of each fiscal year. No provisions were made for HCTF funds to be used for tobacco prevention, control, or the treatment of tobacco-related diseases. Donna Reynolds, a member of VFHF and the community relations director for the American Lung Association of Virginia, remarked to the press in 2004 that much of the success of HB 5018 was due to the fiscal crisis in the state at the time, which created legislative support for generating revenue outside of the lobbying efforts of health advocates.However, Reynolds felt that the lobbying efforts of the tobacco control groups helped set the stage, and additionally prompted “people in leadership roles [to talk] more about what is important to our organization and to Virginians,” especially concerning the need to reduce youth smoking rates.VFHF’s efforts in this regard included face-to-face meetings between VFHF staff, lobbyists, and legislators, as well as grassroots efforts across all VFHF member organizations.

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One amendment simply replaced mistakenly deleted wording and did not change the thrust of the bill

Retail stores were not included on the list of public breathing spaces and therefore, as “unprotected breathing spaces,” it was left up to the owner or manager to “develop a written policy for restricting smoking areas” and left the size of the no-smoking areas up to customer demand. Macfarlane’s SB 440 also considered restaurants to be unprotected breathing spaces, leaving no-smoking areas up to the discretion of the proprietor in contrast to HB 562 and SB 150, which required 40% of a restaurant’s seating capacity to be smoke-free. Macfarlane admitted to the press that he would not support retail restrictions at all, characterizing them as “an invasion of privacy rights.”His introduction of a weak bill, SB 440, was consistent with the industry strategy of enacting a weak bill to prevent the potential passage of a stronger one. With the Virginia affiliates of the voluntary health organizations supporting a different bill than their former allies Michie and Cohen, the health advocacy position was in disarray. It was in this environment that the tobacco industry decided to introduce its own bill, SB 486, sponsored by Sen. Virgil Goode . The bill was specifically represented to the public and press as a moderate bill compared to the GASP-supported bills, and was introduced by concerned industry-aligned elements, in order to head off what was feared to be a rout by tobacco control interests. Michie and Cohen felt that they had enough votes to pass their legislation, and these comments were exploited by the tobacco industry as an excuse to introduce Goode’s bill as a “moderate” alternative to the stronger Michie and Cohen bills.Soon after being introduced, Cohen’s SB 150 was referred to the Senate Education and Health Committee. There it survived an attempted amendment that sought to weaken the bill by adding preemption language. In reaction to this success, Macfarlane allowed industry lobbyists to draft the new provisions for SB 440 according to David Bailey, a VCIA lobbyist.These new provisions drew directly from the industry-supported SB 486 and eliminated the “protected breathing spaces” language that allowed more stringent local ordinances for “public breathing spaces,” hydroponic shelf and included instead standard industry preemption language that disallowed localities from passing local ordinances stronger than the statewide law.

Despite his willing adoption of the new language, some health advocates such as Lucy Blackford, associate director of the ALA, felt that Macfarlane was still making a good-faith attempt to move forward; however, the preemption language he had utilized did alienate the health groups.According to Blackford, Macfarlane may have adopted industry-supported preemption language to ensure passage of his bill, not realizing that the industry language would so damage the bill’s support from health advocates.Others, like David Bailey, questioned the need for such a move “when the votes were there” along with health groups’ support.After adopting the industry language, 11 out of the 13 co-sponsors of Macfarlane’s bill withdrew their support.The result was that any distinction between the Macfarlane and Goode bills was further eroded, as SB 440 had been amended with language derived from SB 486. SB 440 then became the leading bill for the industry and Goode lent his support to promoting it. This led the health groups to drop their support of SB 440, shifting their support behind Michie’s SB 150.Michie publically questioned Macfarlane’s decision, with Michie stating to the Roanoke Times “I’m astounded that the senator from Roanoke [Macfarlane] has the temerity to support this bill thrust upon him by the tobacco industry.”In early February, Macfarlane’s bill failed to pass its third reading in the Senate by a 21- 18 vote. Donley credited this to Sen. Michie, whose bill had passed the Senate a few days before, stood up and “put his personality, his reputation on the line” to kill the bill.Macfarlane’s bill was immediately reconsidered and defeated again, preventing it from being revived in the same year. While Goode’s bill was still alive in committee, it seemed unlikely to pass due to its similarity to Macfarlane’s bill.This situation left Michie’s bill the only one to have a reasonable prospect of success in the Senate. At this point, the Tri-Agency Council threw their support behind Michie’s bill, mobilizing grassroots support. Early in the 1990 session, Del. C. Richard Cranwell , chair of the powerful House Finance Committee, introduced HB 1055 which was promoted as a limited preemption repeal. But after the death of SB 440, HB 1055 was amended with a substitute bill, transforming it into a vehicle for tobacco industry language.The only statewide protection against smoking that HB 1055 provided was that government-owned buildings must provide reasonable no-smoking areas. Most importantly, the new substitute bill preempted local ordinances and presented mandatory provisions that local ordinances must include.

The bill also stated that any local ordinance must provide that where smoking was permissible, a building’s owner or manager would be exclusively responsible for designating no-smoking areas. The changes to HB 1055 satisfied no one, causing an immediate uproar from most tobacco control advocates and industry representatives alike. HB 562 was considered by the tobacco industry to be the most threatening of the bills being carried in the General Assembly because it did not include preemption and encouraged local ordinances to exceed the standards it set. It was aggressively opposed by the industry. RJ Reynolds , in response to HB 562 being reported out of the House General Laws Committee to the House floor on February 12, made phone calls to smokers and local smokers’ groups as well as industry allies such as outdoor billboard advertisers, customers, tobacco growers, and hospitality groups. All were asked to make phone calls to legislators in opposition of HB 562. The bill was subsequently defeated on the House floor by a vote of 57-40 in the face of significant industry pressure.After the defeat of HB 562, Cohen and Michie tried to block Cranwell’s bill, but in the end both sides felt the need to compromise, so Cranwell agreed to meet with Cohen in an attempt to work out a bill agreeable to both sides. One of the main points of contention involved which part of the code the bill would be part of. Cohen and Michie wanted the bills to be part of the health code , meaning that if the law were ever modified, it would first have to go through the health committees, generally favorable to tobacco control legislation, and bypass the hostile local government committees in both the House and the Senate. Cranwell sought to house the bill in the local government section of the code , ensuring it would end up in those committees.Cranwell ultimately prevailed, and both SB 105 and HB 1055 added new language in the local government section of the code. On February 14, 1990, Cranwell’s bill passed the House by an overwhelming majority of 92-5. With no health-group-supported bills left, Del. Cohen endorsed the bill, stating, “It’s better to have half a loaf than no loaf at all.”Part of Cohen’s support for Cranwell’s bill was an agreement by health advocates and their legislative allies not to pursue stronger language or revisions to the bill for two years.This tendency for legislative allies of the health groups to compromise in order to pass a bill would foreshadow legislative attitudes about tobacco control in the future,mobile shelving system hampering advocates of strong bills and setting the stage for future half-measures and compromises.

A similar situation played out in another tobacco-growing state, South Carolina, during the same year.South Carolina’s tobacco industry lobbyists convinced health advocates to support a weak statewide law, which resulted in a lopsided compromise that strongly benefitted the tobacco industry. The health groups were motivated by a feeling that statewide support for a clean indoor air law was strong, and that they had to capitalize on this positive sentiment or lose their opportunity to get anything passed . The tobacco industry was in a position of strength in South Carolina, losing nothing if a statewide law did not pass, but being in a strong position to dictate the terms of any compromise agreement. This was also true of the tobacco industry in Virginia. Ultimately, with the support of both the tobacco industry and the health groups, the South Carolina “compromise” language embodied in H 3303 and S 138 passed both houses in May 1990 and took effect in August of the same year. Opinions among the health advocates on the Cranwell bill were mixed. On one hand, some coalition advocates like the League of Women Voters and the VCIA supported the bill, with the VCIA’s lobbyist, David Bailey, stating that the coalition was “delighted” with Cranwell’s proposal, explaining that while the agency preferred the Cohen/Michie proposal, they felt positively about Cranwell’s bill.On the other hand, Anne Donley of GASP complained about the bill’s weak language.On March 2, SB 150 was amended to be identical to HB 1055. Both bills passed both houses by strong majorities on March 9, forming the basis for the final version of the Virginia Indoor Clean Air Act . On March 10, however, Gov. Douglas Wilder made two amendments to the bill and sent it back to the Legislature for final approval.The other amendment was substantive, and exempted prisons from the purview of the VICAA: “The provisions of this chapter shall not apply to office, work or other areas of the Department of Corrections which are not entered by the general public in the normal course of business or use of the premises.” On April 18, the Legislature approved Gov. Wilder’s amendments, and Wilder signed the bill into law on April 25th. . The law went into effect July 1, 1990. Almost immediately after passage, both health advocates and industry representatives sought to define the provisions of the bill as favorable to their interests as well as set the tone for enforcement. In April 1990, the Tobacco Institute opened the debate by observing to reporters that the 1990 bill was a boon for the tobacco industry and that “Virginia’s sensible level of accommodation is a model for the rest of the country.”The Tobacco Institute also took credit for the VICAA. For example, Page Sutherland, a regional director for the Tobacco Institute, accurately stated to the press that “Most of the provisions of the law we enacted are taken from pieces of legislation that we introduced.”Tobacco Institute representatives also took the initiative to produce interpretive guidelines for the public and proprietors of venues covered by the new law. Health advocates responded defensively about the Tobacco Institute’s moves by referring to them as public relations ploys serving as “damage control,” and, inaccurately, pointing to the new law as a strong one. Jane Roberts, a spokesperson for the VCIA, said to the press that “This is the strongest measure among the top tobacco-producing states in the nation,” a statement that was true in a technical sense but ignored the weak provisions of the bill, such as preemption.Early in the 1991 legislative session, Del. Cohen and Sen. Michie introduced legislation, HB 1796 and SB 815, to clarify the enforcement provisions of the VICAA. The industry responded strongly, claiming that instead of the minor technical revision that the proponents claimed, the bills represented a violation of the agreement between health advocates and the tobacco industry not to amend the law for two years. Originally, both bills sought to declare that the penalty for violating the VICAA was civil in nature, allowing the private citizen complainants to go to a civil court to file the complaint. In addition, the Commonwealth Attorney could participate in the enforcement action. The aim was to continue to allow private citizens to take direct action through the court system, as Anne Donley had previously done.Soon afterwards, the House version was amended so that city and county attorneys and not Commonwealth attorneys enforce the law. Eventually, the Legislature adjourned before the bill could pass, effectively killing it. The companion bill, SB 815, had died in the Senate Education and Health Committee almost a month earlier.We were unable to locate any actions by the health groups to support either of these bills. The tobacco industry put significant pressure on the Legislature during this period.

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A corporate tax bill including a tobacco quota buyout as an amendment was passed in the U.S.

Despite the decreasing importance of domestic tobacco farming to the tobacco industry, tobacco growers represented an important source of legitimacy for the tobacco manufacturers’ political goals. Therefore, despite the increasing divergence between the two groups, maintaining a seemingly close relationship was beneficial to the tobacco companies because, as one Philip Morris representative put it in 1990, “local growers have more credibility in legislatures than do hired guns.”The importance of the relationship also extended outside of merely legitimizing their lobbying efforts, resonating in the public sphere as an important public relations tool. Thus it was in the tobacco industry’s best interest to maintain an appearance of commonality with tobacco growers, despite the underlying tensions over quotas. In the late 1990s, several proposals circulated in the federal government to eliminate the quota system, all of which would have included a “quota buyout” to compensate existing quota holders . Tobacco manufacturers preferred to maintain the quota and price support systems, because the system gave them considerable flexibility and control over the market with the fall back of the price support system for growers. Manufacturers argued that the cost of eliminating the program and compensating quota holders would have exceeded the amount gained for manufacturers by lower prices achieved without a price support system. The disparate positions of growers and manufacturers over the regulation of the tobacco market was the root of a series of conflicts between 1997 and 2004 which distanced tobacco companies from their traditional grower allies.The changing attitudes of tobacco growers in Virginia did result in the formation of the Southern Communities Tobacco Project ,racking company a dialogue between farmers and tobacco control advocates intended to find common ground.

This dialogue led to an understanding between farmers and advocates that MSA money would be spent both on tobacco community revitalization and restrictions on youth access to tobacco. At the same time, health groups nationwide began to push for the inclusion of tobacco within the regulatory purview of the federal Food and Drug Administration . Health groups, particularly the Washington DC-based Campaign for Tobacco-Free Kids and the voluntary health organizations leveraged the distance between tobacco growers and tobacco manufacturers over a quota buyout to garner growers’ support for FDA regulation of tobacco products in exchange for support of a quota buyout. Building tobacco control alliances with growers increased the impression among tobacco growers that their interests were divergent from those of manufacturers. Public health groups had already begun a partnership with tobacco growers at the urging of President Bill Clinton to find ways to limit smoking while protecting tobacco producing communities, resulting in the March 1998 Core Principles document to that effect signed by prominent grower and public health organizations.The first serious consideration of a tobacco quota buyout took place within the context of the 1997 proposed “global tobacco settlement” of multi-state lawsuits against the tobacco companies seeking compensation for Medicaid expenditures of tobacco-related illnesses. This “global tobacco settlement” took the form of the U.S. Senate’s consideration of the controversial “McCain bill,” which was eventually defeated, setting the foundation for the Master Settlement Agreement in 1998. The McCain bill would have included both FDA regulation of tobacco and a quota buyout plan as well as de facto immunity from future lawsuits for the manufacturers. Tobacco companies secured the support of many tobacco growing organizations to join them in opposing the McCain bill and its quota buyout provisions by promising a $28 billion payout to growers under a separate settlement.

The McCain bill failed to pass and was replaced by the private Master Settlement Agreement , which included a separate settlement between manufacturers and tobacco growers, known as Phase II, to compensate growers for potential loss of revenue associated with the MSA’s provisions. However, under the MSA’s Phase II payments to tobacco growers, the growing community was to receive only $5.2 billion, not the promised $28 billion. This failure by tobacco manufacturers to stand by their agreement with growers led to the first major break of the manufacturer-grower organization alliance. In December 1999, tobacco farmers filed a classaction lawsuit against cigarette manufacturers, DeLoach vs. Philip Morris, alleging that the tobacco companies misled farmers when they encouraged them to oppose the removal of the quota system and accused manufacturers of rigging the federal price support system to keep prices low. This suit was settled by Philip Morris and other major tobacco companies in 2003 and by RJR in 2004, after 175,000 tobacco farmers had joined the suit, providing approximately $254 million to those growers .In March 2000, Philip Morris exacerbated existing tensions with growers by announcing that it had developed a direct contract system for purchasing burley tobacco, under which they would arrange to buy a set amount of tobacco from a specific grower at a set price, circumventing the Tobacco Price Support Program by setting the price and purchasing the tobacco prior to the tobacco reaching federally-controlled auctions. The direct contract system provided little protection and high risks for farmers compared with the federal tobacco program, and the expansion of this program would undermine the quota and price support system further by manipulating both supply and demand outside the system. Philip Morris began executing this system in 2000 over opposition by most growers and grower organizations. It was not until 2004 that a bill ending the federal tobacco program made significant headway.

House of Representatives in early 2004, generating a significant push by public health advocates partnering with tobacco growers to pass a buyout bill that would include FDA regulation of tobacco as well as a quota buyout. The final version of the federal tobacco quota buyout passed in October 2004 and dismantled the 70-year-old price support, tobacco quota and allotment system. In exchange, quota holders received $10 per pound of their 2002 quota, with $7 to quota holders and $3 to growers if the allotment had been leased. This amounted to a total $10.1 billion buyout.The buyout resulted in a shift to fewer, larger tobacco farms and therefore fewer individual growers directly engaged in tobacco growing. It also led tobacco grower organizations to actively oppose the tobacco industry’s lobbying force and instead partner with public health groups over a tobacco control measure, FDA regulation. Both of these factors had a tangible effect on tobacco growers’ opinions of tobacco control and of the tobacco companies. Research on North Carolina tobacco growers’ attitudes towards tobacco control, public health and tobacco manufacturers quantified this shift. It showed that tobacco farmers’ perceived public health and tobacco control efforts as 7.5 times more threatening in 1997 as in 2005, that tobacco farmers decreasingly associated tobacco companies’ interests with their own and that they increasingly perceived risk from foreign tobacco production. Additionally, a 2005 survey of North Carolina tobacco growers and ex-tobacco growers indicated that 80 percent would be neutral or actively support comprehensive tobacco-free school policies.Nationwide and in Virginia, the net effect on farmers was that many immediately stopped producing tobacco. Moreover, the remaining production was consolidated on fewer but larger farms. Finally, some Virginia production of flue-cured tobacco,tierer rack free from the geographical constraints of the quota system, moved to regions with lower production costs such as North Carolina.As far as impact on tobacco control advocacy, the MSA’s quota buyout provisions gave the tobacco companies an excuse to divert significant funds away from tobacco control measures and into tobacco community revitalization, which was intended by the tobacco industry to placate tobacco farming interests. In Virginia the tobacco farming organizations did not publically break lockstep with the tobacco industry and continued to support industry tactics to oppose tobacco control efforts. For example, in the mid-1990s, the Virginia Farm Bureau, the Virginia Agribusiness Council, and the Virginia Wholesalers Association worked closely with Philip Morris to develop a public relations measure that pretended to address youth access to tobacco. In reality, this move was intended to prevent effective youth tobacco access measures from being implemented .

This situation was different from that in South Carolina, where the animosity between tobacco growers and the tobacco industry led traditional tobacco industry allies like the Commissioners of Agriculture and the South Carolina Farm Bureau to shift to neutral positions on tobacco control efforts.South Carolina legislators representing tobacco-growing regions also became less hostile towards tobacco control legislation.All of these factors fundamentally weakened the tobacco industry in South Carolina and it could no longer dominate the tobacco control debate in South Carolina.Unlike South Carolina, however, the formation of the SCTP did not lead legislators representing tobacco-growing regions to become less hostile towards tobacco control, and did not cause any major tobacco grower association to shift to a neutral position on tobacco control. Tobacco manufacturers in Virginia remained able to control the dialogue on tobacco control despite the diminished presence of tobacco manufacturing in the state and the strains in their relationships with tobacco growers nationwide. This does not preclude the possibility that these divisions may occur in the future, and if they do, tobacco control advocates in Virginia should exploit them. The national nonsmokers’ rights movement began in the early 1970s, with loose networks of grassroots activism. The most prevalent among these loose networks was the Group to Alleviate Smoking in Public . Early successes occurred in Arizona in 1973 when smoking was restricted in a limited number of public places like elevators, libraries, and theaters.Minnesota mandated separate smoking areas in restaurants in 1975.In 1977, Beverly Hills passed a city ordinance mandating separate no-smoking sections in restaurants and restricting smoking in indoor public spaces.On May 15, 1978, Newport News passed a city ordinance that prohibited smoking in elevators, healthcare facilities, cultural facilities and public schools. There were exceptions, primarily to allow smoking areas in parts of restaurants, in theater lobbies, and in some in-patient sleeping facilities.While the mayor of Newport News, Joseph Ritchie, opposed the ordinance as an intrusion on personal liberty, other city officials supported the move after hearing from emphysema victims during the council meeting. Tobacco industry representatives were present to speak against the ordinance, but it was passed by a vote of 4-3.The law went into effect on May 25,but enforcement was lax. The city attorney for Newport News allowed restaurants to set aside just one table as a no-smoking area to avoid being fined for noncompliance.The next month, in June, restaurant owner Phyllis Alford was fined $10 for refusing to post the sign required by the city’s ordinance designating a no-smoking section. Appearing in court, Ms. Alford pled guilty because, as she put it, “I’m not going to stand up and lie. I refused to put up the sign.”Her refusal was based on an argument that the requirement was unconstitutional, an argument that eventually reached the Supreme Court of Virginia in the case Alford v. Newport News.Alford was represented by several attorneys including Charles Morgan, Jr. of Charles Morgan, Jr. and Associates. Morgan worked closely with the Tobacco Institute, attending at least two of their Executive Committee meetings.At the 64th Meeting of the Tobacco Institute Executive Committee, Morgan spoke about contemporary efforts to restrict smoking, and “commented that the approach of some of the anti-smoking groups might well be described as ‘fumiphobia,’ and he indicated that he would consider possible methods to reply to some of the current anti-smoking campaigns.”It is not clear whether the Tobacco Institute or other tobacco industry organizations paid for Ms. Alford’s defense, but her attorneys were closely aligned with tobacco industry views. In the decision of Alford, handed down on November 21, 1979, the state Supreme Court found that Newport News’ police power “may not be used to regulate property interests unless the means employed are reasonably suited to the achievement of that goal.”The court found the enforcement of the ordinance, merely allowing one table to satisfy the no-smoking area requirement, was “not reasonably suited to the achievement of the legislative goal” of protecting the health of restaurant goers from toxic smoke exposure. Furthermore, the signs required by the ordinance could “lead the non-smoking diner to expect the place he has chosen to patronize is a wholly protected environment,” when in fact that diner would be almost certainly be exposed to smoke because of the city’s enforcement of the ordinance. Due to these factors, the court held that in this specific case, the ordinance was an unconstitutional exercise of the city’s police powers, because the sign posting requirement was held to be an unreasonable regulation of the use of private property.

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Why Does Vertical Farming Reduce Greenhouse Gases

Vertical farming has the potential to reduce greenhouse gas emissions compared to traditional agricultural methods due to several key factors:

  1. Reduced Transportation: Vertical farms are often located closer to urban centers,rolling shelf rack where the demand for fresh produce is high. This proximity reduces the need for long-distance transportation of food from rural farms to urban markets. Transportation, especially when involving trucks or planes, contributes significantly to greenhouse gas emissions.
  2. Energy-Efficient Lighting: Vertical farms rely on artificial lighting systems, usually LED lights, to provide the necessary light for plant growth. These LED lights are designed to emit specific wavelengths that plants need for photosynthesis. Unlike traditional outdoor farming that relies on sunlight, vertical farms can tailor their lighting to the exact needs of plants, resulting in less wasted energy and reduced emissions.
  3. Controlled Climate: Vertical farms maintain a controlled environment with precise temperature, humidity, and CO2 levels. This reduces the need for excess heating or cooling that can lead to energy waste in traditional open-field agriculture, which relies on the natural climate.
  4. Water Efficiency: Vertical farming systems, such as hydroponics and aeroponics, use water more efficiently than soil-based farming. Water can be recirculated within the system, reducing overall consumption and the energy required to pump and distribute water.
  5. Reduced Pesticide and Fertilizer Use: In controlled indoor environments, vertical farms are less prone to pest infestations and diseases, reducing the need for chemical pesticides. Additionally, the precise delivery of nutrients to plants in hydroponic systems minimizes excess fertilizer use, which can lead to emissions of nitrous oxide, a potent greenhouse gas.
  6. Carbon Capture Opportunities: In some designs, vertical farms can incorporate carbon capture technology, which involves capturing carbon dioxide (CO2) from the air and using it to enhance plant growth. This not only increases plant productivity but also helps mitigate atmospheric CO2 levels, a key driver of climate change.
  7. Recycling and Resource Efficiency: Vertical farming can implement efficient waste management practices, such as composting organic waste or recycling nutrient solutions. This minimizes the release of methane, a potent greenhouse gas, from decomposing organic matter in landfills.
  8. Land Conservation: Traditional agriculture often leads to deforestation and land conversion, marijuana grow system which releases stored carbon into the atmosphere. Vertical farming’s ability to produce food in a smaller footprint can help preserve natural ecosystems and reduce carbon emissions from land use change.

While vertical farming holds promise for reducing greenhouse gas emissions, it’s important to note that the overall environmental impact depends on factors such as the energy sources used, the efficiency of the farming systems, and the life cycle assessment of the materials used in construction. To maximize the benefits, vertical farms should strive to integrate renewable energy sources, energy-efficient technologies, and sustainable farming practices.

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Martz’ office responded to the health advocates’ criticisms through a statement to the press

It is also likely that newspaper coverage of the billboard spread its message to a wider audience, though it seemed to have little effect on the next budget hearing before the House Committee on Appropriations. At the March 5, 2001 hearing before the House Committee on Appropriations, Rep. Christine Kaufman moved to restore the $6 million to the TUPP that was being cut under Martz’ proposed budget.Kaufman asserted that Montanans had expressed a desire for MSA money to be spent on tobacco prevention by voting for the MSA health trust, and Rep. Rosalie Buzzas expressed her support for the motion. In supporting Gov. Martz’ proposed budget, Committee Vice-Chair Rep. Dave Lewis countered that money was scarce, and that the tobacco prevention program would still have federal funds of $1 million in addition to the $500,000 per year from the MSA. Lewis argued that the reduced TUPP budget would allow the state to maintain other worthwhile programs, stating “it’s simply a matter of priorities.”Montana residents, anti-tobacco groups, and the health organizations continued their efforts to convince the legislators to maintain prior funding levels for tobacco prevention programs. On March 7, 2001, about 200 people converged on the Capitol to urge the 2001 Legislature to add money to the state’s Tobacco Use Prevention Program proposed budget.The Helena Independent Record reported that “to drive their message home, supporters of the program… filled the Capitol with 1,400 daffodils, four to a vase. The total represents the number of people who die each year in Montana of tobacco-related illnesses; the distribution stands for the four people who die each day.”The article also reported that “[o]n placards standing around the rotunda down the hall from the governor’s office,racks shelves several dozen Montanans posted messages on what rally organizers called the ‘Wall of Hope.’”Health advocates continued to make their arguments to reporters covering the March 7, 2001 rally.

Jeri Domme, a member of the Governor’s Advisory Council representing the American Heart Association, explained that reduction of the TUPP budget by more than 80% would essentially eliminate the program. Dr. Shepard, Advisory Council member representing the American Lung Association, criticized the elected officials who failed to support tobacco prevention, asking ,“How big does the number have to be before we get people’s attention?” and “how much money does it have to cost?.”In response the criticisms made by rally attendees, Mary Jo Fox, Communications Director for the Governor, told reporters that Gov. Martz had not changed her mind about funding the prevention program at $500,000 a year. Fox asserted that tobacco prevention was a low priority in a fiscally tight period, saying “in a year where funds are scarce, choices have to be made,” and that though she thought tobacco prevention was a good program, “we don’t have funds for it at this time.”Local news continued to report the criticisms made by health advocates about Gov. Martz’ handling of the tobacco use prevention budget. In an April 3, 2003 article by the Associated Press, Dr. Robert Shepard, stated that the state officials “have failed to address the leading cause of preventable death in Montana,” and that “for this program to be cut by 86% is outrageous.”The article also quoted Joan Miles, Director of Lewis and Clark County Health Department, who said that “…it would be disgraceful if we would accept tobacco settlement dollars without appropriating some of them to preventing disease and death.”The Associated Press story was carried by state newspapers, the Helena Independent Record and the Billings Gazette.Gov. The administration’s statement said that Martz had made her position clear in January: “Tobacco use prevention is a worthy cause, but will have to make due with $1 million [for the 2002-2003 biennium] in tight fiscal times.”The Governor’s press secretary, Anastasia Burton, reiterated the claim to reporters that the governor believed in the tobacco use prevention program.

The Governor’s claims of believing in tobacco use prevention program, however, were inconsistent to previous statements, in which she told the Governor’s Advisory Council on Tobacco Use Prevention that she was reducing prevention funds because the program lacked results. The Governor’s statement also said that the reduced budget was based on her belief that $1 million was adequate to get the job done, even though all state officials involved with the TUPP believed that the program might be eliminated due to her funding proposals. Indeed, Drew Dawson, Chief of the Health Systems Bureau of the DPHHS which directly oversaw the tobacco-use prevention program, stated in February 2001 that it was unclear what the department could accomplish with such a dramatic reduction in funding.State health advocates held a press conference in Helena on April 9, 2001 to continue their public criticisms of Martz’ proposed tobacco prevention budget cuts, as well the support Republican legislators had given to the cuts. At the press conference, representatives from the American Heart Association, American Cancer Society, and the Campaign for Tobacco Free Kids made public statements around a table topped by 4 body bags, symbolizing the 4 people each day that die in Montana from tobacco-related illness.American Heart Association Lobbyist Cliff Christians stated that the Governor and Legislature were failing to adequately support tobacco use prevention, but that there was still time to increase proposed funding for the TUPP.Kristen Page Nei with the American Cancer Society called the administrations budget constraints argument “hogwash” and “downright insulting.”Nei pointed out that the 60% of the MSA money not dedicated to the trust fund was in the state for the purpose of addressing tobacco use prevention, and was “not intended to balance the budget.”Gov. Martz met with the Governor’s Advisory Council on Tobacco Use Prevention on April 12, 2001. During the 40 minute meeting, Gov. Martz told the Advisory Council “I don’t want to argue with you. I believe in what you’re doing,” and that “I believe in the programs, I just don’t have the money.”184 Again, the Governor contradicted assertions made earlier in the year that she did not believe the programs worked.

Members of the Advisory Council repeated arguments they had been making since December 2000: that the program was not given enough time to show results, that tobacco related illness was a major health danger, and that cutting the TUPP budget by $6 million would effectively eliminate the program. Gov. Martz, now claiming she wholeheartedly believed in tobacco prevention, responded by putting all of the blame on a budget constraints: “I believe every word your saying. I can understand why you’re so adamant about it… I’m not heartless. I’m not a cold blooded person. But I have a whole state to find an ending fund balance for.”Advisory Council members at the April 12, 2001 meeting also repeated the suggestion that the state could raise money as well as reduce the smoking rate by raising the tax on cigarettes. Martz rejected the idea,vertical dispensary reasserting her pledge not to raise any taxes.Martz did offer to help the council find additional money in the private sector, but made clear that unless the state discovered new revenue, tobacco-use prevention spending would not be increased. Already at risk of elimination from drastically reduced funding, the Tobacco Use Prevention Program was further weakened on April 18, 2001, when Senate Finance Chairman Robert Keenan  moved that the House-Senate Conference Committee transfer the entire program and its funding out of the Department of Health and Human Services and into the Montana Interagency Coordinating Council for State Prevention Programs.The ICC was physically housed in the DPHSS, but was administratively attached to the governor’s office, which would directly supervise its members. The ICC was created by Legislative statute in 1993 for the purpose of creating and sustaining a comprehensive system of prevention services in the state of Montana. The ICC was comprised of ten Montana state agency directors, the Lieutenant Governor, and two persons appointed by the Governor who had experience in prevention programs and services.Among the goals of the ICC were to reduce the rates of child abuse, drug abuse, high school drop-outs, violent crime, and teen pregnancy in the state.

On April 18, 2001, the House-Senate Conference Committee voted unanimously to move the $1 million in state funds and about $2 million more in federal disease-prevention money from the fledgling Tobacco Use Prevention Program in the DPHSS, and into the Gov. Martz controlled ICC. Senate Finance Chairman Keenan, in explaining his motion to move the program, reasoned that the governor’s office already had vast resources to tackle prevention efforts, and he believed that government prevention programs were being duplicated.The day after the House-Senate Conference Committee vote, on April 19, 2001, the Helena Independent Record observed that this likely meant the elimination of a long effort by public health advocates for a fully funded, separate and high-profile anti-tobacco campaign in the state.To the surprise of the state health advocates, tobacco use prevention efforts would now be one of the several programs run through the ICC; in addition, the reduced budget for tobacco prevention was approved by the legislature on April 21, 2001.Shortly after the Legislature restructured the state tobacco prevention programs, it was announced that Gov. Martz might let the Governor’s Advisory Council on Tobacco Use Prevention sunset after its two-year term ended in September 2001.Although the administration claimed to reporters on April 24, 2001 that it had not made a final decision on the Advisory Council’s fate, Ken Pekoc, a public information officer for the DPHHS, told reporters that his department had prepared a draft letter informing members of the demise of the Advisory Council. According to Pekoc, the letter was then changed on April 24, 2001 into a list of pros and cons regarding the council that was released to the public.Mary Jo Fox, Communication Director for the Governor, denied that she or the Governor had seen the letter, and claimed that the Governor was awaiting a recommendation from DPHSS Director Gail Gray before making a decision about the council.190 It was reported in an April 24, 2001 Helena Independent Record article that Gray herself had not yet made a recommendation to the governor, though she was likely to suggest eliminating the Advisory Council because of reduced funding and restructuring. The DPHHS Director made no comment on the draft letter informing of the Council’s demise, which was allegedly prepared by her own department.Communications Director Fox claimed that the Governor was not looking for retribution against Council members who criticized here actions, but was reacting to the Legislature’s wishes regarding the program funds and structures. Such a justification contradicted the history of the conflict between Martz and health advocates, however, since it was Martz herself who originally recommended reducing the Tobacco Use Prevention Program budget.Council members said they were not surprised by the Governor’s decision. In reaction, Dr. Shepard told reporters that, “it is not a reasonable approach to throw out the expertise of 24 volunteer members who have been working hard on this program,”Dr. John Hauxwell, another member of the Advisory Council who represented the Indian Health Service, told the press that the council was being eliminated because “[w]e were a burr under [Gov. Martz’] saddle reminding her that she was backing way from what’s essentially a public health crisis.”Though the contentious relationship between anti-tobacco advocates and Gov. Martz was well known and widely reported by the local press, it should also be noted that conflicts with Gov. Martz were not exclusive to tobacco control advocates. On April 25, 2001, the Center of Environment Politics , a Montana-based political watchdog group established in 1998, held a news conference on the steps of the state Capitol to criticize Gov. Martz’ administration.The CEP charged that the first 100 days of Gov. Martz’ administration were marked by a lack of openness, inclusiveness and accountability, though the governor’s spokeswoman dismissed the criticism as little more than a rally hosted by the Montana Democratic Party.

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The sole opponent testifying at the hearing was Speaker of the House John Mercer

The combined opposition against HB 131 resulted in a 42-57 defeat.In explaining her opposition to HB 131, Swanson explained that “Democrats believe it is more important to fund health care programs for Montanans than it is to give multinational corporations tax breaks,” and that Democrats wanted to send a message: “We didn’t want to go out of here saying we approved of any of it. That money was never intended for tax relief.”Swanson also gave indications that she believed MSA money could be more successfully allocated through other bills, and expressed confidence that MSA spending for tobacco use prevention and health care could be added to the bill that allocates the budget for all state government departments, House Bill 2.106 Indeed, Swanson would unsuccessfully attempt to achieve the same MSA allocations specified in HB 131 with another bill she sponsored, HB 240. Swanson would also propose allocations of MSA money for tobacco use prevention and health programs under HB 2, the state general allocation bill, would become one of most debated issues at the end of the 1999 session. The state Democratic and Republican parties became more polarized over the spending of MSA money, and the degree of cooperation between them further deteriorated, with the attempted passage of House Bill 240. HB 240, sponsored by House Minority Leader Emily Swanson would have created a 5-year tax credit for individual and small business employers as an incentive to provide health care to employees.Also within the bill, though it was not indicated in the bill’s title,flood tables for greenhouse was a provision specifying that “[f]unds deposited in the tobacco settlement trust fund account may be used only to provide refunds to employers providing health care benefits pursuant to [HB 240],” thereby excluding all other uses of MSA funds.

When the first hearing regarding HB 240 took place before the House Joint Select Committee on Jobs and Income on January 11, 1999, Swanson’s description of the bill and all proponent testimony , and representatives from the Montana’s Framer’s Union, the Hotel Employees and Restaurant Union, and Blue Cross and Blue Shield of Montana, focused heavily on the need to provide health care to employees of smaller business, and the inability of lower wage workers to pay for medical services.None of the proponent testimony mentioned that HB 240 excluded all other uses of the MSA money, and no opponents to HB 240 testified.The House Committee on Jobs and Income passed the bill on January 19, 1999, and referred it to the House Committee on Taxation for review.At the February 1, 1999 hearing for HB 240 before the House Committee on Taxation, many of the same proponents again testified, and were joined by representatives from the American Association of Retired Persons, the National Federation of Small Business Association, and the Montana Association of Health Care Providers Association, along with some individual business owners.The lack of affordable health care and medical services for low income workers was reiterated as the main focus in proponent testimony.Again, no mention was made of the HB 240 provision that excluded all other uses of MSA money, and no opponents to HB 240 testified. HB 240 was passed in the House Taxation Committee on March 29, 1999, and sent to the full senate for consideration.HB 240 passed in the House by a vote of 88 to 12 on March 30, 1999.The next day, April 1, 1999, the Billings Gazette and the Associated Press reported that the provision in HB 240 making MSA money exclusive to its purposes had unknowingly slipped by Republican legislators.Swanson admitted to reporters that she intentionally omitted any mention of the MSA provision in hopes that she could keep the bill alive, stating, “I didn’t want to give them [Republican legislators] an excuse to kill the bill,” and believed that HB 240 had a better chance of being passed if it reached the Senate.Most Democrats felt that the intended and most appropriate use of the MSA money was for health care programs, and Swanson asserted that the tax incentives under HB 240, which would increase health care insurance among low and middle wage workers, fit well with that intent, stating that “[i]f this isn’t health care, what is?” Swanson also expressed her belief that HB 240 would prevent Republicans from diverting MSA money to non-health related programs such as corporate tax relief.In response to reporters who wondered how representatives could vote for HB 240 without being aware of the language the exclusively allocated all of the MSA money, House Speaker John Mercer stated, “[t]hat issue didn’t come up,” and that “it slipped through.” Mercer also expressed his belief that the MSA money was meant for tax relief, as well as for health care programs.On April 13, 1999, the Senate Committee on Taxation held a hearing on HB 240, where sponsor Emily Swanson revealed what appeared to be a long developed strategy to reintroduce the MSA allocations that had failed to pass in HB 131 . Swanson’s testimony in favor of the bill was joined by proponents State Auditor Mark O’Keefe and representatives of the National Federation of Independent Businesses and the Montana Farmer’s Union.At the hearing, Swanson proposed amendments that would change HB 240 so that the MSA allocations were very similar to those set out in failed HB 131: 30% would be deposited in the general fund, with the remainder to be “appropriated by the legislature for health related programs, including but not limited to CHIP, the Montana Comprehensive Health Association, and health prevention grants.” Speaker of the House John Mercer, in testifying against HB 240 at the Senate taxation committee hearing, apologized that the bill was before the Senate, characterizing it as an attempt to reintroduce the failed proposals of HB 131 into the Senate after sneaking the MSA allocation provisions through the House. Mercer then urged the committee to remove any reference to the tobacco settlement funds, saying “if it’s a good idea, then pass it without reference to tobacco money.”Bill sponsor Swanson, in her closing statement, noted that the failure of HB 131 was that it inappropriately gave half of the MSA funds to tax relief, when it should be used for the kinds of health-related purposes which would be achieved by her proposed amendments to HB 240.Although the Senate Taxation Committee accepted Swanson’s amendments, they subsequently tabled it. That same day, April 13, 1999, Senate Democrats made a motion to take the bill out of the Tax Committee and put it before the full Senate, but the motion failed in a 20- 30 vote.In addressing the Senate after the defeat of HB 240, Senate Majority Leader John Harp said that the tobacco money would still go to pay for health programs,ebb and flow tray system including health coverage for poor children and uninsurable adults, but that those allocations would be made in the final version of House Bill 2, the chief state spending bill for the upcoming two-year budget period. Harp also made reference to the controversial MSA allocation provision in HB 240 when he told the Senate, “[w]e’re going to be up front on how we spend the tobacco money,”Senate Bill 323 was introduced on January 29, 1999 by sponsor Steve Doherty , and proposed submitting for public vote an amendment to the Montana Constitution that would require the legislature to dedicate 50% of the MSA proceeds to a permanent trust fund and the other 50% to be put into the general fund.

The amendment would have allowed the interest from the trust fund to be appropriated for health care programs, though the allocation to various programs was not specified in the bill. At the February 5, 1999 hearing before the Senate Committee on Finance and Claims, Doherty explained that the 50% division in the bill resulted from his desire to find a balance between the immediate need for funding health care and prevention programs, and a desire to safeguard the fund from future uncertainties.Other proponents of SB 323 testifying at the hearing were Chris Tweeten, Chief Counsel for the Attorney General, Art Dickhoff, representing the American Cancer Society ; and Dennis Alexander, representing the American Lung Association . Tweeton explained that a statutory trust, as opposed to a Constitutional trust, would be illusory because it could be raided when a simple majority of the legislature wanted the money. A Constitutional trust, as laid out in SB 323, would require approval of two thirds of the members of each house of the legislature. Dickhoff of the ACS, in suppoting SB 323, suggested that a portion of the money dedicated to health programs under the bill be used for a comprehensive tobacco control program, and Alexander of the ALA advised the committee that the trust would be good idea because funds would be needed for health care costs in the long term.No opponents of SB 131 testified at the hearing. The Senate Finance Committee passed the bill in a 15 to 2 vote and referred it to the Senate Public Health Committee for consideration.At the February 15, 1999 hearing for SB 323 before the Senate Committee on Public Health, Welfare and Safety, sponsor Doherty reiterated the reasoning behind the bill and was joined by proponent testimony from Attorney General Joe Mazurek and Jim Smith from the American Cancer Society.Mazurek again explained the illusory nature of a statutory trust, since it could be removed by a simple majority of the legislature, and noted that such dismantling of statutory trusts had previously occurred in Montana. Thus, Mazurek explained, a Constitutional trust was necessary to truly protect the MSA funds.The Committee on Public Health approved the bill in a 9 to 2 vote on February 18, 1999, and sent it to be heard by the full Senate. On February 22, 1999, the Senate voted against SB 323 in a 24 to 26 vote, but because it was a constitutional amendment proposal, the bill had to be heard by the full legislature, and was required to receive two-thirds support, or a combined total of 100 affirmative votes, from both House and Senate. Thus, it was required that SB 323 be voted on by the House. Since SB 323 had received only 24 votes in the Senate, it would need to receive 76 House votes to make it to the ballot.117 A hearing in the House Human Services Committee was held on March 19, 1999, where 11 proponents testified, including Attorney General Joe Mazurek and representatives of the American Lung Association of Montana, the American Cancer Society, the Montana Senior Citizen’s Association, the Montana’s Nurse’s Union, the Citizens with Tobacco Induced Diseases group, and the Better Breathers group. No opponents testified against SB 323, and the House Human Services Committee passed the bill in a 12 to 5 vote on April 9, 1999.Because the number of necessary House votes needed for passage was so high, the final vote on SB 323 was considered by reporters to be a mere formality before its ultimate failure. The members of the Republican majority in the House had already publicly expressed that the 50% set-aside in the bill was too high, and Gov. Racicot, though in favor of putting the money into a trust fund, initially was not strongly supportive of creating a constitutional trust because he wanted the MSA money available in case the state needed it in the future.Rep. Tom Zook , Chairman of the House Committee on Appropriations, commented to reporters that under SB 323 the state would have a large amount of money unavailable for future government programs. Zook said that “[y]ou really can’t project all the needs that are going to be there,” and that “the more flexibility you allow your future legislators, the better off you’ll be.”On April 19, 1999, the House vote on SB 323 was tied at 50 to 50, twenty-six votes short the number needed for passage. Though SB 323 failed, the idea of asking voters to put a large portion of the tobacco-settlement into a health care trust fund would return only months later, and with greater political support.

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The contribution limit was raised in 2003 to $130 for House and Senate candidates

In its final form, substitute HB 235 was essentially a signage law, requiring the proprietor or manager of a public place to post a sign at all public entrances stating whether or not there were areas within the establishment reserved for non-smokers. Substitute HB 235 also segregated smoking areas in public health care facilities, but contained no penalty provisions. Most significantly, substitute HB 235 allowed for an entire establishment to be declared a smoking area.A Tobacco Institute Legislative Bulletin dated March 16, 1979 from Washington D.C. discussed the passage of HB 235, and described it as an “already weakened substitute,” and that lobbying against it “was like lobbying against courtesy,” since it contained no penalties and no enforcement procedure.Courtesy, or the notion that individual discretion would be enough to keep smokers from exposing others to second-hand smoke, was an alternative to legislation often given by the tobacco industry and its allies. The Legislative Bulletin further shows that the industry was attempting to attack the bill through more direct contact with government officials, though believed it’s chances were slim: “We are meeting with Governor Thomas L. Judge to explore the possibility of a veto, but this action appears remote at this time.” Despite the beginnings of a larger tobacco control movement occurring nationwide, the tobacco industry had little to be concerned about with regards to the Montana Clean Indoor Act. There would be little change to the act in the subsequent decades, with the exception of HB 794, also sponsored Rep. Ellerd, which amended the Montana Clean Indoor Act in 1981 to provide for a criminal penalty of $25.At the HB 794 hearing before the House Human Service Committee on Feb. 20, 1981, State Department of Health and Environmental Services representatives explained that many owners of public establishments had refused to post signs,ebb and flow flood table causing enforcement problems which the DHES believed solvable by the proposed bill.

Other proponents testifying at the February hearing were representatives from of the Montana Lung Association and the Montana Medical Association. Of the three people testifying in opposition to HB 794 at the House Committee hearing, two were representing the Montana Tavern Association: Lobbyist Don W. Larson and Bob Durkee, both of whom would again testify against the bill at the subsequent Senate Public Health Committee meeting, where it would be heard after HB 794 passed in the House in a 53 to 41 vote on February 25, 1981.At the March 18, 1981 Senate Public Health Committee hearing on HB 794, supporting testimony again came from the DHES, as well as the Lewis and Clark County Health Department and the Montana Medical Association.Testimony in opposition to the bill was heard from the two representatives of the Montana Tavern Association who spoke at the House Committee hearing , as well as from Tom Maddox, executive director of the MATCD and a Tobacco Institute lobbyist.Maddox stated that his organization opposed the bill because there was already substantial compliance with the law throughout the state, and that HB 794 would trigger thousands of dollars in litigation. However, the Senate showed agreement with the recommendation from the Department of Health, and voted in favor of HB 794 on March 31, 1981. It was then signed by the Governor on April 15, 1981.In 1983, Gov. Ted Schwinder proposed House Bill 511, introduced and sponsored in the House by Rep. Francis Bardanouve on January 26, 1983, to increase the cigarette tax from 12 cents to 15 cents a pack,“in order to finance long-range building bonds.”HB 511 would raise approximately $4 million per year.The main motivation behind the proposed bill was the need to raise funding for long-range government building programs, as opposed to a desire to curb the state’s smoking rate. Indeed, no health organizations, health advocates, or public health officials testified at the House Taxation Committee hearing on March 3, 1983 regarding HB 511.

Proponents of the bill who did testify were representatives of the Office of Budget and Programing, Women Involved in Farm Economics, the Montana Pilots Association, the Associated Students of Montana State University, the Associated Students of the University of Montana, and the Montana Arts Advocacy organization. Each of these groups would be benefitted from building programs that were to be funded by the HB 511 cigarette tax.In contrast to the absence of health advocates and lack of public health arguments in the HB 511 debate, the tobacco industry and its allies had a strong presence in both the House committee hearings and in the public arena. The tobacco industry again used its strategy of encouraging supporters to contact legislators in order to spread its message and create the impression that it had wide public support,this time utilizing the Tobacco Action Network . As explained in a Philip Morris 1978 manual for employee participation in TAN, “TAN is an umbrella organization formed by the member companies of the Tobacco Institute . Its purpose is to bring together and coordinate all segments of the tobacco family – growers, manufacturers, wholesalers, retailers, and vendors – as well as our allies.”In the second edition of the TAN manual, Philip Morris explained that the purpose of TAN was to “oppose the enactment of restrictive laws and the imposition of punitive taxation.”At the March 3, 1983 House Taxation Committee hearing, testimony in opposition to HB 511 came from tavern and liquor sales associations .Among the opponents were the Silver Bow Tavern Association, three individuals representing the Montana Tavern Association , and Jerome Anderson, the registered lobbyist for the Tobacco Institute who had been a member of the State House of Representatives , and the 1961 Majority Floor Leader in the House.Anderson passed out a prepared document stating four main reasons for opposing the increased cigarette tax: it would interrupt the growth trend of cigarette sales and, thus, decrease a revenue source; it would increase the regressive tax burden on smokers, especially the poor; it would further penalize smokers who pay a disproportionate share of tax; and the livelihood of retailers and wholesalers would be hurt.Despite the lack of any health proponents at the hearing, the tobacco industry failed to stop the passage of HB 511 in the house, which benefitted from strong support from a Democratic governor leading a Democratic majority in the House, with many legislators believing that the cigarette tax would bring much needed revenue in a time of deficit.

On March 22, 1983, HB 511 passed the House by a 60-37 vote, and was referred to the Senate Taxation Committee. At the hearing before the Senate Taxation Committee on March 23, 1983, the Tobacco Institute again testified against HB 511, represented by two of its registered lobbyists, Jerome Anderson and Otis Tucker.A prepared document was again distributed at the hearing, reiterating many of the same arguments made by TI in the House Committee hearing, with the additional argument that alternative methods to fund the Long Range Building Program existed,rolling grow trays thus making the increased cigarette tax unnecessary.Among the other organizations testifying in opposition at the senate hearing were the Montana Candy and Tobacco Distributors Association and the Montana Taxpayers Association. As was the case in the House Committee hearing, no health groups or advocates testified at the Senate Hearing for HB 511. Testimony in support of the bill came from groups that wanted funding for the state’s long-range building program which would come from the increased cigarette tax, such as the Montana Arts Advocacy organization, and the Office of Budget and Program Planning.Even without the support of any health minded proponents, HB 511, raising the cigarette tax from 12 cents to 16 cents, passed on April 13, 1983 in the Senate by a 42-6 vote, and was then signed by the Governor, becoming effective on July 1, 1983.Nationally, the grass roots clean indoor air movement was well underway in the late 1980s, and several events had occurred to push the tobacco control issue forward. By 1986, more than 75 ordinances had been enacted in California,and in that same year Raymond Pritchard, chairman of the Board of Brown and Williamson Tobacco, said in the US Tobacco and Candy Journal, July 17, 1986: “Our record in defeating state smoking restrictions has been reasonably good. Unfortunately, our record with respect to local measures… have been somewhat less encouraging.” It was also in 1986 that the 19th U.S. Surgeon’s General Report, “The Health Consequences of Involuntary Smoking,” concluded that “[i]nvoluntary smoking is a cause of disease, including lung cancer, in healthy nonsmokers,” and warned that, “[o]n the basis of the evidence presented in this Report, it is clear that actions to protect nonsmokers from ETS [environmental tobacco smoke] exposure not only are warranted but are essential to public health.” As described by Roger Monzingo, director of state activities at the Tobacco Institute, in a December 19, 1986 “State Activities’ ETS plan of Action” memorandum to Samuel Chilcote Jr., President of the Tobacco Institute, this report was a “watershed event” for the industry, and the negative press coverage of the secondhand smoke issue was so serious that unless the Institute acted, “there will be no ‘long run’” for the tobacco industry.

In Montana, tobacco industry strategy for the state during the late 1980s was revealed in the “Guideline for Northwest Regional Grass Roots Program,” dated July 10, 1986. The Guideline reveals that one of the tobacco industry’s primary goals in the region was to organize a concerted effort between “local tobacco company executives, legislative counsel, distributors, and the Tobacco Institute” to oppose any possible tobacco control legislation.The tobacco industry intended to accomplish this by showing the “national and regional chains” and “local retailer outlets” the “correlation between adverse legislation and public perception, as a result of that legislation,” making the point that it “must be shown as a negative impact on the profits as it relates to the companies, the distributors, the sales force. They must be shown that legislation impacts their ability to maintain the level of income they need – that legislation and sales go hand in hand.” The tobacco industry wanted to create an alliance which could be used as a mechanism through which the Tobacco Institute could oppose any tobacco control legislation. Despite very little activity from health organization and advocates in Montana during the 1980s, the tobacco industry in 1986 was planning sophisticated strategies “[i]n preparation” and “in anticipation” of anti-tobacco legislation by “bringing everyone concerned to a united front,” and by setting up a mechanism that could be triggered by “an action alert sent by TI,” or, “if a crisis arises unexpectedly,” could be put into motion by TI contacting “key individuals by phone…”The tobacco industry’s forward-looking strategies were likely motivated by the national tobacco control movement that was continuing to make progress in the late 1980s. A June 15, 1987 “Special Report” by the state activities division of the Tobacco Institute commented that “[n]ot since 1975 – the year after the first significant Surgeon General’s report attacking smoking – have so many states passed smoking restriction measures. In the wake of the 1986 Surgeon General’s report, 15 states have enacted new restrictions thus far in 1987.”As late as 1987, the tobacco industry still did not consider health advocacy groups in Montana a serious threat. A “1987 State of the States” report written by the State Activities Division of the Tobacco Institute “assessing the economic and political climate of each of the 50 states as they affect the tobacco industry, and evaluating industry resources for action on legislation projected for 1987,”was written for the apparent purpose of assisting the tobacco industry and its allies in preparing legislative lobbying activities. The report observed: “Montana does not have the traditional anti-tobacco forces at work in the legislature, at least not on the surface. Most anti-tobacco legislation in past years has come from one or two specific legislators with a particular interest in tobacco restriction efforts.”Though the report does say that at least one health group and some advocates had made occasional, if unorganized, appearances regarding tobacco legislation: “On occasion, the local Helena Lung Association does make its presence known to the legislature, and similar groups in Great Falls and Billings have contacted their local legislators.”

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Cooks may be more likely to remain in the room while cooking with kerosene fuel

Except for three cases, none of the participants who had smoked reported that they had ever quit smoking for 6 months or more. Therefore, we classified smokers as ever-smokers and never-smokers. The median smoking experience for both cases and controls was 8 pack years . More cases than controls had had household members with TB. Moreover, cases were more likely to be using BFS or KFS than were controls . The distribution of cooking fuel used by the study participants was biomass from wood or crop residues , LPG , kerosene , and biogas . We created a heating fuel variable that treated participants who reported either using electricity or using no heating fuel as the reference category, and the remaining subjects, who mainly used wood , as the biomass fuel category. The biomass group included a few women who used coal and kerosene for heating. We verified stove-fuel types and ventilation characteristics in the houses of 28 participants. All 18 participants who had reported their main cook stove as being a biomass stove were found to be correct, as were the five reporting use of a LPG stove. One of the four participants who had reported using a kerosene stove, however, was found to be using an LPG stove. On that basis, the accuracy of stove reporting was 96%. In the inspection of ventilation characteristics, one participant who had reported not having a window in her kitchen was found to have a temporary outside kitchen with a window sized opening. Two participants who reported having a window in the kitchen actually did not have a window. Based on these data, the accuracy for reporting ventilation was 89%.We considered the possibility that this may have been because some Buddhists who live around Pokhara are Tibetan and reside in refugee camps. Crowded conditions in those camps could facilitate TB transmission. However, only 8 of 40 Buddhists in the study were Tibetan refugees—an insufficient number to explain the finding. Other studies have also shown differences in TB rates between racial and religious groups, including Tibetan Buddhists . Before concluding that statistical associations are causal,rolling benches for growing it is important to consider alternative explanations, particularly whether study results might be a result of selection bias, information bias, or confounding in the study design, data collection, or analysis.

As with all case–control studies, selection bias in the recruitment of controls is a potential concern. In this study, a systematic procedure for recruitment of all controls from inpatient and outpatient departments of MTH was used, and only one potential control refused to participate. Because most cases were recruited from the RTC, and all controls from MTH, the catchment areas for MTH and RTC might have been different. RTC patients came from a broader area, because it is a referral center for the western development region of Nepal. A higher proportion of cases than controls were from five districts other than Kaski. The Kaski district includes Pokhara city, and in general, Kaski residents are more likely to live in urban areas and to be wealthier. This could simply mean that living outside of Kaski is associated with higher exposure to TB risk factors but, alternatively, could indicate some selection bias. We adjusted for area of residence in the final model, but this would not necessarily have eliminated such a bias. Another possible source of selection bias arises because we did not exclude some other, non-TB respiratory disease cases from the control group. Unfortunately, control diagnoses were not collected at the time of the study and proved impossible to obtain in retrospect, because of the limited period for which the hospital retains patient records. Because absence of TB was confirmed in controls by X-rays, we can, however, be confident that no chronic obstructive pulmonary disease or pneumonia cases were among our controls. It is possible that inclusion of respiratory disease cases among the controls could have produced a bias toward the null, if risk factors for those cases were similar to risk factors for TB. Information bias may take the form of outcome mis-classification or exposure mis-classification. Because all cases were newly diagnosed with active pulmonary TB on the basis of evidence from clinical tests, and controls were also confirmed by chest X-ray and on-the-spot sputum smear testing as not having active pulmonary TB, we consider that disease mis-classification is unlikely to have occurred.

We obtained all the exposure data by questionnaire. Case–control studies are often considered susceptible to recall bias, in that cases may be more likely than controls to remember past exposures. Because questions asked in this study were about common exposures, however, which both cases and controls experience on a day-to-day basis, we expect recall to have been accurate and any differential recall to have been minimal. We verified the high level of accuracy of reporting of two key exposure variables by visiting the homes of 28 study participants. Considering this, and that there is no prevailing belief that indoor smoke exposure from biomass-burning stoves or kerosene-burning stoves or lamps is related to TB occurrence, we believe exposure misclassification is likely to be minimal. One possible limitation, however, is that we only asked about the main cooking fuel used. This might have led to some misclassification of exposure status. The third main area of potential bias is confounding. We collected data on a much more comprehensive range of exposures than did previous studies and investigated their potential to confound the associations with fuel use. Although confounding was present, adjustment with these variables did not eliminate the key associations. There may, of course, be some residual confounding due to mis-specification of the variables, and there is no way to rule out the possibility of unknown confounding factors causing the associations found. One possibility is malnutrition, for which we obtained no data and which is a known risk factor for TB. However, family income, for which we did obtain data and which is an excellent indicator of a family’s ability to feed itself, was taken into account. A notable finding in our study was the association with biomass used as a heating fuel. This was unexpected because the study design focused on cooking-fuel use. Hence, the study population was limited to women, who generally do the cooking in Nepal. Although we collected data on history of stove and cooking fuel use, we did not collect a comparable level of data for heating fuels and so are unable to examine heating-fuel use for evidence of an exposure–response relationship.

In hindsight, the findings with biomass as a heating and a cooking fuel make sense. Women may light a cooking fire, set the pot atop it, and leave the room, returning only periodically while cooking takes place. On the other hand, use of heating fuel involves minimization of ventilation and deliberate exposure,commercial drying racks as the family sits around the fire. In tropical India and Africa, where several of the other TB and biomass studies have been carried out, use of heating fuel is less common than in the mid-hills of Nepal, where nighttime and winter temperatures are lower. Our study also found the OR for TB to be high among both kerosene stove and lamp users, particularly the latter. Kerosene cooking fuel and kerosene lamp users were for the most part mutually exclusive groups. Only one of the 22 kerosene lamp users in the study used a kerosene stove. Kerosene stove users were more likely to use electricity for lighting. With one exception, as far as we are aware, no previous studies have examined a relationship between kerosene and TB . This one study, carried out in Mexico, obtained crude ORs for use of kerosene-burning stoves of 1.9 for active TB and 4.4 for past TB; no adjusted estimates were presented. We have been unable to find any studies where the relationship between kerosene lighting and TB has been investigated or even incidentally reported. The question arises as to why kerosene as a cooking fuel could be a TB risk factor but not biomass cooking fuel. This could have something to do with the nature of the emissions. Biomass burning produces very obvious smoke, which may irritate the eyes and respiratory tract, encouraging avoidance behavior. Kerosene, on the other hand, has the appearance of burning more cleanly, even if it does produce substantial amounts of fine particulate matter and vapor-phase chemicals, and may not encourage the same avoidance behavior as biomass smoke.There are also likely to be differences in the toxic effects of the pollutant mixtures from the two fuels. Kerosene is one of the main sources of cooking fuel in urban areas and lighting fuel in rural areas of developing countries, including Nepal. Therefore, if kerosene burning can be confirmed as a TB risk factor in other studies, the public health implications would be substantial. In rural areas not connected with electric power, kerosene wick lamps are burned at least 4–5 hr every day. Commonly, these lamps are homemade devices that are highly energy inefficient, with low luminosity. Simple wick kerosene lamps emit substantial amounts of smoke and particles . A study conducted in rural Malawi has shown a higher loading of particulates in alveolar macrophages in men from exposure to kerosene in lamps compared with candles, hurricane lamps, and electric lamps . Other emissions from kerosene combustion include carbon monoxide, carbon dioxide, sulfur dioxide, nitrogen dioxide, formaldehyde, and various VOCs .

An indoor air pollution study conducted in Bangladesh slums has shown significantly higher concentrations of benzene, toluene, xylene, hexane, and total VOCs emitted from kerosene stoves than from wood burning stoves . The use of kerosene fuel is associated with harmful effects that have been documented in a few studies. These effects include impairment of ventilatory function and a rise in blood carboxyhemoglobin in women exposed to kerosene fuel smoke , and a higher incidence of acute lower respiratory infection in children in homes using KFS and BFS . A causal relationship between exposure to biomass fuel smoke and TB is biologically plausible. The smoke could affect either risk of infection or risk of disease in infected people, or both, as has been shown to be the case with tobacco smoking . Without knowledge of the time of infection, however, the present study cannot distinguish between the two possibilities. Inhalation of respirable particles and chemicals found in smoke from these sources generates an inflammatory response and impairs the normal clearance of secretions on the tracheobronchial mucosal surface, and may allow TB bacteria to escape the first level of host defenses, which prevent bacilli from reaching the alveoli . Smoke also impairs the function of pulmonary alveolar macrophages, an important early defense mechanism against bacteria . Alveolar macrophages isolated from the lungs of smokers have reduced phagocytic ability compared with macrophages from nonsmokers and secrete a lower level of proinflammatory cytokines . Exposure to wood smoke in rabbits has been shown to negatively affect antibacterial properties of alveolar macrophages, such as their ability to phagocytize bacteria .Pyrethrum spray collections were conducted monthly in 30 randomly selected sentinel houses in each village from January 2012 to June 2014. Mapping of the location of the houses around the study region was done by the global positioning system and the geographical coordinates recorded. The number of people sleeping in each house was recorded during mosquito sampling. Mosquitoes collected were morphologically identified as An. gambiae s.l. or Anopheles funestus. Legs and wings of the female An. gambiae s.l. were frozen at −20°C in labelled vials before molecular identification by PCR into An. gambiae s.s. or An. arabiensis according to Scott et al.. The head and thorax of the mosquitoes were separated from the abdomen and sporozoite ELISA was used to determine their infectivity with Plasmodium parasites.To determine the mosquito active peak hours during night, rotator traps were set up during the dry season in July–August in 2013 and in the wet season in May–June in 2014. These traps were set both indoors and outdoors in three selected sentinel houses.

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All farms that were not SP were considered as commercial farms

Accordingly, a probiotic approach to the control of drinking water borne opportunistic pathogens has previously been suggested. Additionally, we know that corrosion of other critical infrastructure systems, e.g. sewers, is driven by their micro-biome.Important factors in the building micro-biome are geographic location, occupancy, ventilation rate, and ventilation type , but there are many uncertainties within these factors. For example, while ventilation has been suggested to be a primary driver of the built environment microbial community as a source of microorganisms from outdoor air, the precise influence of ventilation type and operation warrants further investigation. Similarly, the roles of temperature, relative humidity, and light intensity in structuring the micro-biome remain unclear. Further, we know much more about the impact of these factors on the relative abundances of particular taxa than we do about absolute abundances of individual species, their viability, and their function in indoor settings. It would be powerful to be able to predict the micro-biome of indoor spaces and their community dynamics based on knowledge of building factors.With 146 million pigs and a yearly production of about 22 million tons of carcass weight, the European Union is the world’s top exporter and the second biggest producer of pig meat after China . However, several transboundary animal diseases , such as African swine fever , classical swine fever , or foot-and-mouth disease , are of permanent risk of introduction or reintroduction in the EU swine industry . Given the devastating impact outbreaks of such diseases can have on farmers, society, and EU countries economy, the European Commission strengthened the need of preparedness at both national and international levels to mitigate diseases risks and impacts . Epidemic models are increasingly used to evaluate and inform disease surveillance and control policies . As animal trade play a key role in the spread and control of most of TADs ,greenhouse bench tops it is essential to include trade movement patterns to more realistically and accurately simulate the spatiotemporal spread of diseases and the effectiveness of control measures .

Since Regulation no. 1760/2000 of the European parliament, data on pig trade movements are registered at a farm level and daily scale in EU member countries. The full trade networks can be integrated in epidemic models to produce more realistic disease spread simulations [e.g., Ref. ]. However, considering the amount of data available, modeling transmission through full networks is computationally challenging and time-consuming, which would limit the usefulness of such models in a crisis period. Different methodologies can be used to simplify and incorporate the major properties of pig trade patterns in epidemic models. Previous studies mostly used statistics on shipments rates, shipment distances, and mixing patterns between production types . Others included statistics on network topology , as it has been shown that disease spread is sensitive to the topological structure of the contact network . These statistics come from country specific data, expert opinions, or from countries with similar production systems . However, it is not clear how the parameters from one country can be translated to other areas , and few data are available for some specific production systems, such as outdoor or small scale production systems . Moreover, different production systems might coexist within a country, but their specific trade patterns might be hidden when computing statistics at country level. Community detection algorithms have been used to detect groups of premises that tend to trade together . They could be useful to identify different production systems within a country and better characterize their specific trade organization. The objective of this paper was to fill part of those knowledge gaps by unraveling the functional and spatial organization of pig trade in the EU. Our aim was particularly to characterize and compare the trade structure and patterns in different pig production systems, including small-scale and extensive systems, for which scarce information is available so far.

Results would be useful to better inform surveillance and control strategies as well as to more realistically parameterize disease spread models, particularly for TADs and other swine diseases with high economic impact, such as porcine respiratory and reproductive syndrome .Four countries were selected to represent the diversity of European pig production systems: Bulgaria, France, Italy, and Spain. Spain and France are the second and third producers of pig meat in the EU, with intensive production systems, i.e., large-scale high density indoor herds, concentrated mostly in Cataluña, Murcia, and Bretagne . Italy is the seventh producer in the EU with intensive farming concentrated in the northern regions but also with high number of semi-intensive, medium, and small farms . In Bulgaria, such as other Eastern European countries, pigs are mostly reared by small producers , mostly, for self-consumption . Beside these systems, several regions have preserved traditional extensive production systems involving local breeds that are reared outdoor for the production of high quality cured meat. Such systems are observed in south-central Spain, in south-west and central France, in south-central Italy, in the French and Italian Mediterranean islands of Corsica and Sardinia, and in the Eastern mountains in Bulgaria .Data on pig movements and premises characteristics were obtained from national databases, through Bulgarian Food Safety Agency in Bulgaria, the professional database of swine in France, the Istituto Zooprofilattico Sperimentale dell’Umbria e Marche in Italy, and the Ministry of Agriculture, Food and Environment in Spain, under the appropriate confidential data transfer agreements. Registration of pig movements is mandatory in these countries since, at least, 2009. The year 2011, which was common in all databases, was retained for the analysis. Because of the dead-end characteristics of slaughterhouses, these premises were excluded from the analysis. The premises characteristics available were the type of production, the premise size, the type of housing system , the geographical coordinates, as well as the pig company number . In Bulgaria, pig farms were classified as East Balkan pigs , SP , Type B farms , Type A farms , or industrial farms .

For France, Italy, and Spain, pig premises were categorized into seven distinct types: multipliers , farrowing farms , farrow-to finishing farms , finishing farms , SP, trade operators , and unknown premise type . FA included farms which produce piglets until 3 or 25 kg. FI included farms which buy piglets and produce either 25 kg piglets or fattening pigs. For Italy, farrowers and farrow-to-finishers could not be distinguished in the database and were thus both typed as FA. SP were defined as those who produce pigs for self-consumption in Spain, those who have no more than four fattening pigs and produce pigs for self-consumption in Italy , and farms with no more than four pigs in France.Trade operators included traders, collection centers, markets, fairs, and stop points. For those farms with no available coordinates, the centroid location of the smallest geographical administrative unit available was used. The main characteristics of the study area and study pig industries are presented in Table 1. Information on trade movements for all countries included the date of the movement, the unique identifier of the source and destination premises, and the number of pigs moved. For each country,commercial drying rack directed and weighted yearly networks were built, the nodes being all pig premises of the study areas, even those that were not trading pigs during the study period. Movement data were aggregated over the study period and a direct link was drawn whenever a shipment of pigs occurred between the corresponding premises. Two weights wij A and wij B were attributed to the link according to the number of pig batches and the number of pigs moved from premise i to premise j during the study period, respectively. The premises were considered as “active” if they moved pigs during the study period.Descriptive statistics of the pig shipments are presented in Table 3. Shipment rates were generally quite low with a median <1–6 in going and 3–8 outgoing shipments per active premise per year . Heterogeneity was observed between premises and between types of premises, with particularly high rates of incoming shipments for trade operators in France . Median shipment distances varied from 3 km to 44 km . The premise type mostly sending pigs over long-range distances were industrial and type A farms in Bulgaria, multipliers in France and Spain, and trade operators in Italy . Median shipment sizes varied from 4 to 220 pigs . Shipment sizes tended to be higher when the pigs were sent to industrial farms in Bulgaria and to finishing farms in France, Italy, and Spain . Pig batches sent to SP tended to be of small size and to come from local source . Different mixing patterns by premise types were observed according to the country . In Bulgaria, industrial and EPB farms tended to trade with premises of the same type, whereas Type A farms tended to be intermediate between Type B and industrial farms. Multipliers tended to send pigs to multipliers, farrowing and farrow-to-finishing farms in France and Spain, whereas they were more likely to send pigs to multipliers only in Italy. Trade operators tended to be intermediate between farms and other trade operators in France and Spain, whereas they also tended to send pigs to multipliers and producers in Italy.Trade networks were divided into 174, 842, 3,070, and 4,362 communities in Bulgaria, France, Italy, and Spain, respectively. The communities were more isolated, i.e., had fewer pig batches moved to or from premises of other communities, in Bulgaria than in the other countries .

Fourteen, 15, 15, and 9 large communities were identified according to the distribution of community sizes in Bulgaria, France, Italy, and Spain, respectively. They included 37.7% , 51.6% , 15.6% , and 13.7% of active premises. Based on the distribution of the production types and housing system , three types of production systems could be defined: type 1 – intensive: more than 50% of premises were commercial pig farms and <10% raised pigs outdoor; type 2 – commercial outdoor: more than 50% of premises were commercial pig farms and more than 10% raised pigs outdoor; and type 3 – small-scale: more than 50% of premises were small-scale pig farms, raising pigs indoor or outdoor. Only two of the largest communities were of intensive type in Bulgaria, the other being of small-scale type. In France and Spain, most of the largest communities were intensive, except five communities that were of commercial outdoor type. They were located in southwestern, center, and eastern regions of France and in Extremadura and south of Castille y Leon in Spain. In Italy, only three of the largest communities were of intensive type and were located in Lombardia and Piemonte. The others were of small-scale type and were located in center and southern regions of Italy. All communities formed spatial clusters, which tended to cover quite large areas and to overlap when the production system was intensive, but were highly spatially clustered when it was small-scale . All communities were scale-free with average power law scaling parameters comprised between 2.1 and 7.5. All communities of intensive type that included trade operators exhibited small-world properties . The other communities with small-world properties were two communities of SP that included trade operators in Italy . Communities of small-scale type exhibited a star-topology type, reflected by a null clustering coefficient and an average path length of 1 . These communities usually consisted of a commercial farm that sent pigs to SP .This study provides a better understanding of the pig trade structure and characteristics in the EU under diverse production systems, including intensive, commercial outdoor, and small-scale. We also provide valuable proxies for pig movement patterns at country and community levels that can be used to better parameterize more realistic epidemic models under diverse epidemiological scenarios. Results also improve our understanding of trade drivers by highlighting similarities and differences in the functional and spatial organization of pig trade between countries and between production systems. One of the challenges of this study was to identify and describe European pig production systems, which may have different trading patterns and thus different behaviors regarding infectious diseases but can coexist within a country.

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