COLUMN ONE : Smoke, Fire and Funding : Has the state’s anti-smoking program gone too far? Critics decry use of Proposition 99 money for political research, lobbying and brass-knuckled ads. But backers cite dramatic gains.

When voters decided in 1988 to slap an extra 25-cents-a-pack tax on cigarettes, they also launched an unprecedented experiment in persuading California smokers to kick the nicotine habit.

Funded by the anti-smoking initiative, Proposition 99, the programs mix public persuasion, including a brass-knuckled ad campaign, with political action, promoting local laws to banish smoking from work sites and public places.

Admirers say that no government anywhere in the world has attacked smoking with such vengeance--or results. The programs are widely credited with helping reduce cigarette consumption in California by 27% in the last five years--a faster drop than anywhere else in the nation.

But the state’s assault on tobacco has raised hackles among smokers rights advocates and some politicians, who say the programs go far beyond the initiative’s provisions and the voters’ intentions.

The arguments over Proposition 99 have heated up again because the law that details how the tax money should be spent is expiring Friday. Within the next few days, the Legislature and governor must decide whether to renew the programs as they are, expand the anti-smoking efforts as many health groups want, or redirect millions of dollars to health care programs for the poor that are threatened by the state’s deepening budget crisis.

Whatever California decides will be watched closely around the country. As concerns about secondhand smoke have risen, several states have begun to imitate California’s aggressive anti-smoking programs.

The Proposition 99 cigarette tax has collected $3.1 billion over the last five years and the initiative broadly specifies how the money should be spent. To date, about two-thirds has gone for health services to the poor. At least 20% is designated for health education and 5% for research.

Critics say too much of the money has gone to what they regard as government-paid lobbying to restrict the use of a legal product. Defenders say the growth of health care programs for the poor threatens to gobble up cash needed for the nation’s most effective anti-smoking campaign.

At the center of the debate is how the state Department of Health Services has used the $213 million doled out to communities and health groups for programs that encourage teen-agers to shun smoking and that promote local anti-smoking ordinances--in effect, using tax money to generate political action. An additional $73 million has been spent on an often witty, sometimes vituperative media campaign that depicts tobacco industry executives as cynical purveyors of death for a profit.

Also on the table for examination is $136 million used for research, some of it to examine the tobacco industry’s campaign contributions and lobbying activities. These few studies have been used to criticize politicians for caving in to tobacco interests.

It is clear that Proposition 99’s aggressive programs exceed anything spelled out in 1988 by the initiative or by its backers--a coalition of doctors, hospitals, nonprofit health agencies and environmental groups. In writing the initiative, these groups agreed that portions of the new cigarette tax would be divided among the various causes they supported. The doctors and hospitals wanted health care for the poor; the environmentalists wanted to expand wildlife habitats, and the nonprofit agencies wanted programs to reduce tobacco use.

The proposition’s language does not discuss advertising campaigns or the formation of advocacy groups to mobilize public support for smoking bans. It simply called for “programs for the prevention and reduction of tobacco use, primarily among children, through school and community health education programs.”

The programs’ champions say the media campaign and the political activity are exactly what voters wanted--finding innovative ways to attack smoking--and reflect a growing intolerance of a dangerous and addictive substance.

Using the Proposition 99 tax in the name of public health, state tobacco control officials say they have set out not to outlaw tobacco, but to “de-normalize” its use.

“Our goal is to put the tobacco industry out of business,” said Colleen Stevens, who heads the state’s media campaign.

Stevens and other state officials cite statistics to show that their approach has worked.

Per capita consumption in California has dropped at a rate almost three times faster than the rest of the nation since 1988, according to a state-funded study by UC San Diego professor John P. Pierce.

Pierce and others suggest that the tax increase, the paid advertising and community programs have all helped to cut smoking, although it’s unclear which programs are most effective. (One disappointing finding: overall smoking among teen-agers has remained fairly constant in California. But in the rest of the country, it is rising.)

Critics contend that health officials have overstepped their bounds by funding efforts to initiate local anti-smoking ordinances. Others argue that some expenditures have been just silly--citing a scientific study of whether smoking causes facial wrinkling and subsidies for tobacco-free ski events for children and teen-agers.

The ads that try to deglamorize smoking and alarm people about the dangers of secondhand smoke are especially irritating to smokers rights groups.

As might be expected, the spicy mix of programs and in-your-face tactics has angered a lot of people--not only smokers and tobacco executives but also politicians.

UC San Francisco professor Stanton Glantz, who has used a Proposition 99 research grant to assess the impact of tobacco industry campaign contributions on legislators, has angered Assembly Speaker Willie Brown (D-San Francisco). In a series of reports, Glantz singled out Brown for taking almost $500,000 in contributions from tobacco interests since becoming Speaker in 1980--more than any other politician in the country.

In an incident reported in Harper’s magazine earlier this year, Brown was quoted as telling University of California executives: “If this guy gets one more cent of state money, you’ll be in trouble with me!”

In a recent interview, Brown denied that he ever sought retaliation against Glantz, but he said that a study of campaign contributions was a misuse of Proposition 99 money intended to investigate tobacco-related disease.

“The research done by these gentlemen (Glantz and his UC San Francisco colleagues) doesn’t deserve to be classified as research,” Brown said. “It’s what we in politics do to each other when we’re running for election.”

Glantz’s tobacco tax grant has expired and his proposal for a new one was turned down by a UC-appointed review committee. In an unsuccessful appeal of that decision, Glantz challenged the qualifications of the reviewers, one of whom questioned whether Glantz could ever show a direct causal link between campaign contributions and legislative tobacco policy.

Glantz, who does not believe that politics played a role in the state decision, has won a National Cancer Institute grant to continue his work.

Bob Merrell, who heads an organization called Californians for Smokers’ Rights, argues that the state Department of Health Services-run program is illegally spending tax money to lobby local governments to pass ordinances that bar smoking in the workplace.

“Big Brother is stepping in and saying, ‘No, you can’t do it (smoke),’ ” said Merrell, a dedicated smoker.

Merrell has sent legislators lists of state-funded anti-tobacco programs that sound frivolous or suggest that tax money is being used “by Department of Health, Tobacco Control Section, to build and operate a statewide political organization.”

The accusations by Merrell and others have won over supporters in the Capitol.

Assemblyman Curt Pringle (R-Garden Grove) has proposed amending state law to bar the use of Proposition 99 tax money to promote “the passage of any smoking law or ordinance.” The number of cities and counties with anti-smoking ordinances has almost doubled since the initiative’s passage to nearly 300.

Pringle also wants a truth in advertising standard applied to ads paid for out of the tobacco tax account. But a number of legislators have joined forces with health groups like the American Lung Assn. to defend the state programs.

Sen. Tom Hayden (D-Santa Monica), whose Campaign California organization helped pass Proposition 99, says the initiative has been an unmitigated success: “A million fewer people are smoking and on their way to preventable and premature death as a result of that proposition.”

Hayden had high praise for a recent research report by UC San Francisco’s Glantz, titled “The Twilight of Proposition 99.” The study, like others that infuriate Speaker Brown, shows contributions to individual legislators and then grades them on their anti-tobacco stance. (Glantz asked “eight individuals knowledgeable about the Legislature and tobacco policy” to rate the legislators but will not reveal who they are.)

“I’ve never seen an analysis like that in a state-subsidized document,” Hayden said. “They account for every penny of every (industry) campaign contribution and to whom. Unbelievable.”

Anti-smoking groups agree with Glantz and Hayden that the state’s most effective--and controversial--anti-smoking programs are in mortal peril. Americans for Nonsmokers’ Rights complains that education programs have been short-changed by almost $170 million, and the group has sued to return the money to programs that directly combat smoking.

Even with the alleged shortchanging, more than $300 million has gone to the state Department of Health Services’ tobacco control efforts; $146 million has gone to the state’s schools.

Glantz calls the department’s tobacco control program “the most effective public health intervention since the invention of sewers.”

With unabashed anti-tobacco fervor, a small cadre of public health workers oversees the state’s war on tobacco.

In addition to the advertising campaign, the weaponry includes grants to nonprofit agencies and funding for the anti-smoking efforts of 61 local public health offices.

“The media program is the air cover, and we’re the ground troops,” said Carol Russell, who oversees local anti-tobacco programs for the state office.

Traditional attempts to discourage smoking--cessation classes that feature lectures on the destructive effect of tobacco on health--have failed to do the job, Russell says.

So the state has turned to unorthodox attempts to fight tobacco--often battling the tobacco companies on their own turf with advertising and sponsorship of glamorous events.

As a result, there have been controversies.

The state office, for example, has been blasted for the skiing program it has funded at the Kirkwood Ski Resort in Alpine County.

Similarly a $200,000 grant to the Bay Area Cancer Coalition was used in part to sponsor a Tobacco Free Challenge race car over three racing seasons.

“We’re going where the (tobacco) companies are and they hate us for it,” Russell said.

Equally controversial has been the use of state money to form tobacco-fighting coalitions and to support local health departments in the push for local smoking bans.

In San Francisco, the local health department last year plastered the city with signs saying “Support Smokefree Legislation. Call the Board of Supervisors Today.” At the bottom of the sign, the printer added the words, “This sign will be removed by the committee after the election,” a phrase added to political posters.

Two weeks later, the supervisors began to consider a citywide ban on smoking in the workplace, which was later enacted.

State health officials say there is a distinction between general advocacy of sound public health policy and the lobbying of legislators, supervisors or city council members on specific proposals. And in a February memo, the state tobacco control office told local health departments that the tax funds “are not and may not be used to support lobbying activities.”

“Public health has always had a responsible role in policy development,” Russell said. “We’ve seen it in the chlorination of water supplies and the vaccination of dogs.”

And with projects like California Smoke-Free Cities, the state is providing technical assistance to local agencies that are considering anti-smoking ordinances. Today, partly as a result of the state effort, about 44% of Californians live in communities that restrict smoking in restaurants or workplaces.

“We’re hurting them,” Russell said, “We’re hurting these (tobacco) companies.”

One result: California’s anti-smoking programs are proving to be contagious.

Several states are considering higher tobacco taxes to launch their own programs. In 1992, Massachusetts approved an initiative similar to Proposition 99. Candace Pierce-Lavin of the American Cancer Society says: “We saw that trying to tackle tobacco problems in traditional ways was not solving the problem, and we saw tremendous progress out there in reducing smoking rates.”

NEXT: How should the Proposition 99 money be spent in the future?

Proposition 99

The 1988 anti-tobacco initiative, Proposition 99, doubled the state tax on cigarettes, raising it by 25 cents a pack. The initiative required that the money be divided among several broad categories: 20% for health education, 5% for research, 5% for wildlife preservation, 45% for physician services and hospital care for the poor, and 25% in an unallocated account that can be used for any of the other purposes.

Here is how the $3.1 billion raised by the initiative has been used since the added tax went into effect on Jan. 1, 1989:

* Health education (tobacco control programs): $447 million (15%)

* Health education (maternal and child programs): $166 million (5%)

* Tobacco disease research: $148 million (5%)

* Wildlife preservation*: $213 million (7%)

* Medical care (hospitals, physicians and unallocated): $2.1 billion (68%)

*In 1990, voters approved Proposition 117, the wildlife protection initiative, which required that 2.5% of the Proposition 99 tobacco tax be taken from the unallocated fund and used for programs to protect mountain lions and other threatened species.

Sources: Department of Health Services; “The Twilight of Proposition 99,” by Michael E. Begay, Michael Traynor and Stanton A. Glantz