Prop 99

How 25 Cents Saved One Million Lives and 135 Billion Dollars in Health Care Costs: Introduction

/ Curt Mekemson / 28 Comments
In 1989 the tobacco industry would mount an "an unprecedented campaign," according to the Tobacco Institute, to defeat California's Proposition 99, an initiative effort to increase the tax on cigarettes by $.25 and devote a substantial portion of the funds to discouraging tobacco use. The industry recognized that passage of the initiative would pose one of the greatest threats to tobacco use it had ever encountered.

In 1989 the tobacco industry would mount an “unprecedented campaign,” according to the Tobacco Institute, to defeat California’s Proposition 99, an initiative effort to increase the tax on cigarettes by $.25 and devote a substantial portion of the funds to discouraging tobacco use. The industry recognized that passage of the initiative would pose one of the greatest threats to tobacco use it had ever encountered.

Irritating people with power is an unfortunate talent of mine. I’ve burned enough bridges in my life to cross the Mississippi, Amazon, Congo and Nile Rivers combined— at flood stage. In the fall of 1986, I added Jay Michaels to the list of people annoyed with me. Jay was the Executive Director of the California Medical Society (CMA), one of the most powerful organizations in California, which made Jay one of the most powerful people in California. He and I were working together on an effort to increase the state sales tax on tobacco. But ‘working together’ was a misnomer. Jay didn’t like my allies, he didn’t like me, and he didn’t like how I proposed we spend the revenues.

One day I had a phone call from two of his staff members, wanting to take me to lunch.

“OK,” I had responded, more than a little curious— make that massively curious. I also admit I was amused about going to lunch on Jay’s dollar. They suggested we meet somewhere Jay was unlikely to frequent.

“First, Curt,” they explained when we sat down, “understand that we aren’t here. This lunch is not taking place. We’d be fired if Jay knew we were meeting with you.” CMA, apparently, wasn’t paying for the lunch.

Looking back, I think it took a great deal of courage for the two of them to do what they did. They shared several things with me. Although they had reservations about the environmental programs I was supporting, they were totally behind my primary objective for the use of the tax funds, which was the prevention and control of tobacco use. They told me they would be as supportive as they could be, given the circumstances. Just as we were wrapping up, they gave me a warning. I suspect it was their primary reason for meeting with me.

“Jay was talking about you at a staff meeting last week and he smashed the pencil he was holding into the conference table. He hit the table so hard the pencil shattered.”

“He can destroy your career, Curt,” they told me in all seriousness. I laughed; I couldn’t help myself. It wasn’t about the pencil, which was scary. It was about the career. I had none to destroy. Given the worst-case scenario, I would scoot off into the woods. It is what I do to celebrate, but it is also what I do to lick my wounds. In fact, any excuse for taking off into the wilderness works for me.

A few months earlier I had returned from a major wound-licking session of backpacking alone for six months in the wildest places I could find in the western United States. Part of my therapy afterwards was taking on the tobacco tax, doing penance so to speak. The story of how I became involved, the campaign, and the end results of the effort will be the subject of my Friday essays for the next several weeks. Some of the tales I have blogged about before, others, such as the confrontation with Jay, I am writing about for the first time.

So join me next Friday when, suffering from depression, I left my job as Executive Director of the Alaska Lung Association and fled down the Alaska Highway toward an effort that would eventually become one of the largest, most successful prevention programs in history. I’ll even take you backpacking.

One Million Lives and 86 Billion Dollars Saved… California’s Proposition 99

/ Curt Mekemson / Leave a comment

In the late 80s the tobacco industry mounted an "unprecedented campaign," to defeat California's Proposition 99, an initiative designed to increase the California tax on cigarettes by $.25 and devote a substantial portion of the funds to discouraging tobacco use. The Tobacco Institute recognized that the initiative posed one of the greatest threats to tobacco consumption it had ever encountered.

My friend Ken Lake sent me an article from the Sacramento Bee a few weeks ago. It reported on the latest results from California’s Proposition 99, a massive tobacco use prevention effort kicked off by a tobacco tax initiative passed by California voters in the late 80s.

According to the California Department of Health Services, an estimated one million lives and 86 billion dollars in health care costs have been saved because of prevention programs funded by the tax. California now has the second lowest incidence of tobacco use in the nation and the state is virtually smoke-free. It has the lowest incidence of cancer for 6 of the 9 cancers caused by tobacco use. Fewer teens smoke in California than any other state.

These figures are remarkable. How many times in history has a single act saved one million lives? How often do health care costs go down instead of up? And there is more, much more.

Tobacco use is the single most preventable cause of death and disease in America and a major factor in preventable death and disease worldwide. The revolution in disease prevention that took place in California is a revolution that has reverberated throughout the United States and around the world, a fact recognized by both the National Centers for Disease Control and Prevention and the World Health Organization.

As a result, the million lives and billions of dollars saved in California can be multiplied several times over on a national and global basis. Prevention works.

Credit for the success of Proposition 99 in the quarter of century since its inception goes to a cast of hundreds, if not thousands. Certainly the Tobacco Control Section of the California Department of Health Services and its dedicated staff have been critical but dozens of organizations, hundreds of staff people and thousands of volunteers have also played key roles.

In the beginning, however, in the very, very beginning, it was a handful of people in Sacramento who put the effort together and made the critical decisions that would allow Proposition 99 to become the revolution in prevention it has become.

I was privileged to be one of those people.

Over the next two months I will do a series of blogs that provide an inside look at what happened during Prop 99’s first critical months starting in September of 1986. It’s a story of how and why a small group of friends decided to take on one of the worlds most powerful, amoral industries in the cause of preventing the death and crippling disease caused by tobacco use.

It’s a good story, worth telling on its own merits. Greed, power politics, human emotion and sacrifice are all included. There’s even some humor. But I also want to make the point that a few dedicated and knowledgeable individuals can make a significant difference. It’s an important message for today’s world where ideology, ambition and greed triumph over working together in the common interest.

In my next blog I will tell the story  of Prop 99’s beginning and how I became involved. Believe me, I did not start out to become an anti-tobacco warrior.