Colorado Case Study
Tobacco Excise Tax Constitutional Amendment Referendum Campaign in Colorado
|Healthy People 2010 Objectives||1. Increase the average federal and state tax on tobacco products.|
2. Increase the number of tribes, territories, and states and the District of Columbia with comprehensive, evidence-based tobacco control programs.
|OSH Indicator||Increased price of tobacco products.|
Amount of tobacco product excise tax.
|Goals||Prevent Initiation Among Young People|
Promote Quitting Among Adults and Young People
|Areas of Policy and/or Program Intervention||Excise Taxes: Ballot Initiatives|
Young Adults (18–24)
Other: Adult and Youth Smokers
Policy/Program Objectives of the Intervention
To amend the Colorado constitution to increase the cigarette excise tax by $0.64, from $0.20 to $0.84, and double the excise tax on other tobacco products from 20% to 40% of the manufacturer's list price in order to:
- Prevent the uptake of tobacco use among adolescents and young adults.
- Reduce adult and youth tobacco use prevalence.
- Decrease tobacco consumption among continuing tobacco users.
- Dedicate 16% of revenues generated by the tax increases to fund tobacco education and treatment programs administered by the State Tobacco Education and Prevention Partnership (STEPP) in the Colorado Department of Public Health.
- Dedicate the remaining 84% of revenues generated by the tax increases to expand health care access and for other health improvement initiatives.
Description of the Intervention
During fall 2002, the Colorado Tobacco Education and Prevention Alliance (CTEPA) began serious discussion and planning to put a constitutional amendment before the voters in November 2004 to raise tobacco excise taxes and dedicate revenues generated by the tax increases to tobacco prevention and treatment and to other health-related programs.
Personnel/Key Players/Resources Required for Conducting the Intervention
Colorado Tobacco Education and Prevention Alliance (CTEPA): Longstanding statewide tobacco prevention and control coalition with 501(c) 3 tax-exempt status.
Citizens for a Healthier Colorado (CHC) and its Executive Committee: A 60–member coalition formed in 2003 by American Cancer Society, American Heart Association, American Lung Association, Colorado Hospital Association, primary health care advocacy groups, other health-related organizations and CTPEA for the specific purpose of crafting and enacting the excise tax increases and earmarking revenues generated by the tax increase for tobacco prevention and treatment and other health-related programs.
Campaign co-chairs: persons from a diverse perspective to the issue and high stature throughout the state.
Chris Sherwin: executive director, Colorado Tobacco Prevention and Education Alliance (CTPEA).
Campaign Manager, Citizens for a Healthier Colorado.
Karen DeLeeuw Program manager, State Tobacco Education and Prevention Partnership (STEPP) (Although Ms. DeLeeuw played no role in the campaign itself, her office provided information on science-based interventions to reduce tobacco use, tobacco research and how to implement comprehensive tobacco prevention and treatment programs.)
Campaign staff—campaign manager, media director, and three field outreach staff, increasing to a total of six to seven at the height of the campaign.
Facilitator for the Steering Committee (through summer 2004).
Campaign consultant from California (through summer 2004).
Public relations firm—three to four staff, including one who served as a fundraiser in later stages of the campaign, as well as a lobbyist and an attorney.
In-kind staff assigned to the campaign from participating organizations, totaling from 7 to 12 full time employees.
A total of $2.1 million was raised for the campaign, not including in-kind contributions of staff and resources. The Campaign plan set a January 2004 benchmark to raise $1 million in cash and commitments in order for the campaign to proceed. A total of $1.1 million was contributed by January 2004; another $500,000 was collected through the summer of 2004, primarily from member organizations of Citizens for a Healthier Colorado. The final $500,000 was secured during the final 3 months of the campaign, again primarily from member organizations of the Citizens for a Healthier Colorado.
Place Where the Intervention was Conducted
Approximate Time Frame for Conducting the Intervention
Summary of Implementation of the Intervention
A comprehensive initiative, consisting of multifaceted public education and media campaigns as well as extensive grass roots outreach and advocacy strategies, was successfully executed by the Citizens for a Healthier Colorado to pass a constitutional amendment that raised the cigarette excise tax $0.64, increased the tax on other tobacco products to 40% of the wholesale price, and earmarked the revenues generated by the tax increases to fund the State Tobacco Education and Prevention Partnership in the Colorado Department of Public Health at a CDC-recommended level and various other health-related programs.
Summary of Evaluation/Outcome of Intervention
Amendment 35 passed on November 2, 2004, by a margin of 61%–39%. On January 1, 2005, Colorado's cigarette excise tax increased by $0.64 from $0.20 to $0.84, and the tax on other tobacco products increased from 20% to 40% of the wholesale price. The constitutional amendment was passed increasing the taxes and allocating percentages of the increased revenues to broad categories (16% to tobacco prevention and treatment, 46% for expanded health coverage for low-income children and adults, 19% to boost primary care, 16% for preventing and treating cancer and heart and lung diseases, and 3% to bolster the Old Age Pension Fund and compensate counties for lower sales tax revenues from tobacco). The legislature approved legislation confirming the dollar amounts to each program and the Governor signed.
In addition to the amendment's passage as a measure of the intervention's success, a graduate student pursuing a master's degree in public health is writing her master's thesis on the campaign. When completed, the thesis will provide a more formal evaluation of the overall campaign and its components.
Intervention's Applicability/Replicability/Recommendations for Other Sites
Intervention is applicable and replicable for other states where voter initiatives/referenda are permitted. The Colorado constitution's unique provisions, including a Taxpayers Bill of Rights limiting the legislature's authority to raise and appropriate funds, led CTEPA to propose a constitutional amendment to raise the tobacco excise taxes and allocate the revenues generated by the increased taxes to tobacco prevention and treatment and to other health-related programs. Colorado also has a uniquely detailed process for certifying ballot language and for preparing state-disseminated information about ballot questions. Although the campaign described in this case study can provide information and guidance on how to run a successful voter initiative/referendum campaign to increase tobacco excise taxes and dedicate the new revenues, some strategies will need to be customized to the unique constitutional and statutory requirements of individual states.
The Colorado Department of Public Health STEPP consistently based the plans, goals, objectives, and strategies used in its comprehensive tobacco prevention and treatment program on evidence-based best practices. Furthermore, STEPP required its grantees, contractors, and county-based local health agencies and coalitions to follow these best practices in program delivery. As a result, broad-based public health and health care communities had a high level of awareness and understanding about effective tobacco prevention and treatment interventions. Once an initiative to increase tobacco excise taxes was initially filed in 2003, STEPP contractors' and grantees' only role was to provide scientific information, as requested, to local coalitions and other groups. During 2003-2004, a program to educate teens about tobacco as cheap and deadly, mounted by Colorado's youth movement against tobacco and funded by a grant from the American Legacy Foundation (ALF) was halted by the executive director of the Colorado Department of Public Health before its planned conclusion, because of the director's concern that the department might be perceived as supporting efforts to increase tobacco excise taxes.
This case study was written by Judy Stephany, a consultant for the CDC Office on Smoking and Health, October 2005.
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