California Voters to Decide on Increasing Cigarette Tax

On June 5, California voters will decide whether the state should impose a $1 per pack tax on cigarettes, as well as a corresponding tax increase on other tobacco products.

The tax is projected to raise about $810 million for cancer research and anti-smoking programs in the first full year, according to the state’s legislative analyst.

As Tuesday's presidential primary election draws near, both proponents and opponents are taking their cases to the public.

Stanton Glantz, PhD

The ballot initiative is supported by the American Cancer Society, bicycling superstar Lance Armstrong’s Livestrong Foundation, the American Heart Association and the American Lung Association. These organizations have raised about $5 million to support the measure.

Opponents of Proposition 29 include Californians Against Out-of-Control Taxes & Spending and California Citizens Against Wasteful Taxes, according to the No on Prop 29 website. The nearly $40 million campaign against Prop 29 has, to date, been financed almost entirely by tobacco companies Philip Morris and R. J. Reynolds, according to the San Francisco Chronicle.  

University of California policy prohibits use of resources for campaign purposes. However, under UC guidelines, faculty may objectively evaluate a ballot measure’s impact on matters of University concern, which in UCSF’s case includes promoting health and conducting research in cancer and tobacco-related diseases. UC guidelines for participation in ballot campaigns are posted online.

California’s official voter information guide for the June 5 election states, “The University of California and the California Medical Association support Prop 29 because it raises $585 million per year for research and will help California's best research institutions find cures to cancer, heart and lung disease.” The statement is signed by UCSF Nobel laureate Elizabeth Blackburn, PhD, among others. Blackburn’s title is used for identification purposes only, and she is not acting as a UCSF spokesperson.

Opponents of Prop 29 assert in the official voter information guide that "Cancer research is important, but if we're going to spend $735 million a year, we need to have strict controls and make sure our tax dollars are spent in California. Prop 29 is flawed and deserves a ‘no’ vote.” Opponents argue that the proposition would allow the new tax revenue to be spent in other states.

John Maa, MD

UCSF’s Stanton Glantz, director of the Center for Tobacco Control Research and Education at UCSF, disagrees. “Our research shows that just the opposite is true,” he says. “Prop 29 will cut cigarette sales by $1 billion a year and $800 million of that is now leaving the state to go back east to tobacco companies. Because people are not smoking that money will be spent here generating new economic activity and creating 12,000 new jobs.” Glantz’s study is posted on the UC scholarship website. 

The funds that Prop 29 would allocate to research would be managed by a nine-person committee comprised of chancellors from UCSF, UC Berkeley and UC Santa Cruz, cancer center directors and other experts, with grants made on a peer-review basis like the National Institutes of Health funding. Prop 29 clearly states in its purpose section that these programs are to be located in California, said Glantz, who agreed to speak in favor of Prop 29 in TV commercials as an individual.

Opponents counter by saying the measure “permits ‘conflicts of interest’ by allowing organizations represented by commissioners to receive taxpayer funding,” according to the official state voter guide. They also say it ‘”prohibits the Governor and Legislature from making changes to the initiative for 15 years, even in the case of fraud or waste.”

Game Changer with Global Implications

Glantz, a professor of medicine at UCSF who has studied the tobacco industry for more than 30 years, has conducted academic research on the likely impacts of Prop. 29. 

“If it passes, it could really be a game changer with global implications,” he says. “California could within a few years be a largely smoke-free society. And it will have the potential to reinvigorate the movement all over the country and the world.”

Regis Kelly, PhD

John Maa, MD, an assistant professor in the UCSF Department of Surgery, has participated in smoking-cessation projects since 2004. He agreed to appear as an individual in a pro-Prop 29 commercial.

From a surgeon’s perspective, Maa says, “Active smoking is clearly linked to an increased risk of perioperative cardiovascular, pulmonary and wound-healing complications, including infections, anastomotic dehiscence, re-intubation and respiratory failure. These complications in turn result in longer hospital stays, higher rates of ICU admission, greater need for repeat surgery and higher overall costs of care.”

Regis Kelly, PhD, director of the California Institute for Biosciences (QB3), is also speaking out in commercials, acting as an individual and not as a representative of UCSF.

“It’s not the sort of thing a professor normally does,” says Kelly, PhD, a neuroscientist who arrived at UCSF in 1971. “But I wanted to make the point that support for this is widespread.”

For Kelly, who emphasizes he was speaking for himself and not UCSF, it’s personal.

One of his three children started smoking when she was 17. She developed an infarction that required a double bypass at age 21. Fourteen years later, his daughter was diagnosed with malignant breast cancer while pregnant. She lost the baby and barely survived.

“She’s 45 now and she still can’t stop smoking,” Kelly says.

Kelly said there’s logic to taking money from cigarette smokers and using it to develop better treatments. “You tax people and try to give them better health,” he says.

As a teenager, he tried cigarettes a few times when he had a girlfriend who was a smoker.

“But I’m a frugal Scotsman,” Kelly says. “And I hated to see my money going up in smoke.”

Lisa Cisneros contributed to this report.