Failure to defend a successful state tobacco control program: policy lessons from Florida.
OBJECTIVE
This investigation sought to define policy and political factors related to the undermining of Florida's successful Tobacco Pilot Program in 1999.


METHODS
Data were gathered from interviews with public health lobbyists, tobacco control advocates, and state officials; news reports; and public documents.


RESULTS
As a result of a recent legal settlement with Florida, the tobacco industry agreed to fund a youth anti-smoking pilot program. The program combined community-based interventions and advertisements. In less than 1 year, the teen smoking prevalence rate dropped from 23.3% to 20.9%. The program also enjoyed high public visibility and strong public support. Nevertheless, in 1999, the state legislature cut the program's funding from $70.5 million to $38.7 million, and the Bush administration dismantled the program's administrative structure. Voluntary health agencies failed to publicly hold specific legislators and the governor responsible for the cuts.


CONCLUSIONS
The legislature and administration succeeded in dismantling this highly visible and successful tobacco control program because pro-health forces limited their activities to behind-the-scenes lobbying and were unwilling to confront the politicians who made these decisions in a public forum.
Givel
M S
MS
Department of Medicine, University of California, San Francisco 94143, USA.
Glantz
S A
SA
D000293:Adolescent; D000329:Advertising / Q000191:economics*; D003153:Community Health Services / Q000191:economics*; D003659:Decision Making, Organizational; D005378:Financial Support; D005431:Florida / Q000453:epidemiology; D006266:Health Education / Q000191:economics*; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D010865:Pilot Projects; D011057:Politics; D015995:Prevalence; D015397:Program Evaluation; D012907:Smoking / Q000453:epidemiology / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D019460:Tobacco Industry / Q000331:legislation & jurisprudence*; D014342:Truth Disclosure