Explaining post-settlement state tobacco control appropriations

While a solid science foundation bolsters policymaking on tobacco control, it does not appear sufficient to explain state policy outcomes. The political science literature points to timing, framing, and leadership as critical factors in legislative success. Funding is a critical measure of political support for a policy initiative, throughout legislative deliberation, executive approval, and implementation. This research used qualitative and quantitative methods to identify factors important in explaining state tobacco control appropriations following the landmark tobacco industry state settlements. With existing cross-sectional data on all 50 states, a multiple linear regression model was developed to test factors' explanatory value on FY02 tobacco control funding. Five factors were significantly associated with the outcome and explained 49% of the variance. The 26 states with Gross State Product from Tobacco (an annual measure of state economic activity) had lower allocations for tobacco control. The 27 states with laws preempting stricter local ordinances (a policy outcome favored by the tobacco industry) were less likely to allocate funds for tobacco control. States that had Democratic governors with a high degree of executive authority allocated more funding for tobacco control. Lastly, citizen liberalism (an index of public opinion in the state) was positively associated with higher allocations for tobacco control. These results imply that a strong scientific case for tobacco control is not sufficient to secure prevention funding at the state government level. Instead, attention to political aspects of the state budget process could lead to increased tobacco control funding.