Anne Landman is addicted to cigarettes.
She's never actually smoked a whole one, but she can't stop thinking about them: how they're made, how they're marketed, what's in them, who buys them, who makes sure they'll always be for sale.
"People think I'm obsessed, a one-issue person," Landman says. "It's more like I'm wrapped up in a really good murder mystery that I can't stop reading -- except it doesn't end."
Landman is an environmentalist and activist who lives in Glade Park, Colorado, a tiny high-desert hamlet ten miles outside of Grand Junction. The town is so small that newspapers don't deliver to its roughly 300 residents and shopping is limited to a convenience store that sells little besides gas, cheese and lottery tickets. It is about as far from Corporate America as you can possibly get, which is the point: In 1995, Landman and her husband decided to build a life very much off the grid. In the sandstone plains of Mesa County, they constructed a plaster-and-glass, eco-friendly "earthship," a house made out of 4,000 tires with an indoor garden watered by roof runoff.
It is from here, in the middle of nowhere, that Landman has made a career out of watching the world's most powerful corporations. She is one of the most visible tobacco researchers in the United States -- and a professional pain in Big Tobacco's ass.
"I'm like a throbbing brain in a jar," she says, peering out from a computer screen covered with sticky notes. "I've got these tentacles out everywhere to people I never see or talk to. It's a very strange way to live."
A transplant from West Hollywood, the Jewish daughter of a doctor, Landman spent twelve years as a respiratory therapist in Grand Junction during the early '80s. At that time, the town was a rural, workaday community of about 40,000 -- one that sustained five oxygen companies, thanks to the population's smoking habit.
"It was the saddest, most tragic stuff, very tough to see," she says. "You had people who felt like they were drowning, just knowing that as their illnesses progressed, life would get harder and harder. I think it would have been easier if they just died."
But it wasn't until 1999 that tobacco truly changed Landman's life. While working as a regional program director for the American Lung Association of Colorado, she stumbled upon www.tobaccodocuments.org, which contained materials related to a multi-state lawsuit brought against the tobacco industry in 1997. A consortium of attorneys general representing 45 states, including Colorado, the District of Columbia and five U.S. territories, had argued that the manufacturers owed a debt to states -- and to smokers -- for the damage done by their products. They presented evidence that the industry had deceived the public about the dangers of tobacco and had aggressively marketed to young people.
The Master Settlement Agreement of 1998 resolved the suit for more than $200 billion over 25 years. The major tobacco corporations -- including the R.J. Reynolds Tobacco Company, Philip Morris Incorporated, Brown & Williamson and the Lorillard Tobacco Company -- agreed to cease marketing to youth and to post online reams of documents that were unearthed during the discovery phase of the lawsuit. Smokefree.net, a web-driven tobacco-awareness organization based in Washington, D.C., compiled the bulk of the MSA data on tobaccodocuments.org, creating one searchable site that gave the public its first real glimpse into the industry's inner life.
Once she began reading, Landman was hooked.
"It was just so creepy and fascinating," she says. "It was like being able to walk into the offices of some corporate executive and opening the file cabinet to see what they'd been doing. It definitely appealed to my prurient interest. It was like looking up somebody's skirt."
There are currently more than 27 million tobacco documents online, from the mundane -- budgets, employee manuals, press releases -- to the damning, including an infamous 1963 Brown & Williamson legal brief that states, "We are in the business of selling nicotine, an addictive drug." And more come every day: The tobacco companies must upload their correspondence to the web through 2010.
Landman hasn't read every document, but she sometimes feels like she has. With support from tobaccodocuments.org, she maintains Doc-Alert, an e-mail newsletter highlighting material she's sprung from various sites. (Each of the major tobacco companies has its own documents site, and the University of California at San Francisco maintains a searchable archive at legacy.library.ucsf.edu/ index.html.) Several times a week, the newsletter beams out to 3,000 public-health administrators, activists, smokers, former smokers, professors and physicians in more than 35 countries.
"Anne is a passionate activist and a very tenacious researcher," says Michael Tacelosky, founder of Smokefree.net. "We've got six million documents on our site, and her list allows people to get bite-sized bits of it. Rather than learning the dictionary, say, you learn one word a day. A lot of people have gut feelings about what has gone on in the tobacco industry, but the list allows them to really see for themselves: pieces of paper, hard evidence, documents. There's a lot of power in her list."
In Glade Park, where people keep mostly to themselves and only three channels come through on TV, the listserv gives Landman a conduit to the larger world. It also keeps her company, since she spends most of the day on the computer, accompanied only by her dog, Jack.
"The Internet is a surrogate community," she says. "It helps with the loneliness. You don't realize how much people mean to you until you move away from them. Like people at the grocery store, on the street -- the guy who brings my coffee at my favorite coffee shop. Every time I go to town, I just get so excited to see him."
People are excited to hear from Landman, too. Her first Doc-Alert post five years ago was a 1964 memo she'd uncovered that became known as the "Kent Safety Image." Earlier that year, a Surgeon General's report warning of the dangers of smoking -- particularly unfiltered cigarettes -- got everyone talking about tobacco. A Reader's Digest article on the topic released shortly after the report named the filtered Kent brand as the "safest" cigarette available. The Lorillard Tobacco Company saw the article as an opportunity to launch a new advertising campaign celebrating the protective powers of the Kent cigarette filter. "KENT was marketed as a 'safer' cigarette for the smoker who was concerned about smoking and health," wrote Lorillard's M. Yellen to the company's CEO. "Lorillard exploited this advantage so that within a short period of two years the KENT volume grew from less than four billion cigarettes to thirty-eight billion annually."
Elsewhere in the nine-page document, Yellen referenced the launch of Newport, a then-new menthol cigarette: "The brand was marketed as a 'fun cigarette'.... It was advertised as such and obtained a youthful group as well as an immature group of smokers...."
"The Kent Safety Image was an astonishing little window into their world," Landman says. "It gave us a peek into this parallel universe where public health is bad, threats to the company can become marketing opportunities, and the broad education of the masses is bad for sales.
"I got a lot of feedback from people after I posted that, and I realized that this is kind of a golden moment," she continues. "Whatever we can capture before 2010, we can work with forever. We've really just started to scratch the surface of how this information can be used: Doctors are using it, scientists, all kinds of researchers. Right now it feels unlimited."
Anne Landman is friendly, articulate, compelling and funny -- but as I navigate the narrow switchbacks that lead out of Glade Park, I'm relieved to be away from her.
A couple of hours into our meeting, I got that feeling -- an itchy, irritating, insistent craving that is actually painful. Physiologically, my brain wanted serotonin, the satisfaction-stimulating chemical transmitter triggered by nicotine. But in the middle of Landman's sweet-smelling earthship, I just wanted a smoke.
When I left Denver six hours and 258 miles ago, I threw my pack on the kitchen table and didn't stop for another one during the long slog across the Western Slope. I didn't want Landman to know that I smoke, even though I've been hooked for more than a decade. Like 90 percent of American smokers, I started as a curious teenager, at fifteen. At 29, I haven't been able to completely stop, even though I'm fully aware that unless I do, smoking may very well kill me.
I want to quit smoking. I do. I've tried five times this year. But statistically, I won't be able to without some serious help. Of the 640,000 adult smokers in Colorado -- just under 20 percent of the population -- more than half have tried to quit, but only about 3 percent have been successful. That leaves 620,800 of us huffing toward eternity, breathlessly tempting fate as we march to that big smoking section in the sky.
Clearly, it's in my best interest to quit. According to the Colorado Department of Public Health and Environment, smoking is directly related to 4,200 deaths annually, and the number of smoking-related illnesses is about twenty times that. My successful quitting is in Colorado's best interest, as well: Smokers like me suck about a billion dollars out of the public-health system annually, costing each taxpayer roughly $250 each year. It's to the benefit of my employer, as smokers miss more work than non-smokers, and my car, which smells like a casino when I turn on the heat. My closet, the receptacle of so many smoke-smelly garments after a night on the town, and my two cats, who sneeze and eye me disdainfully when I light up in the house, would really be better off if I just gave it up, already.
The only group that really doesn't benefit from my quitting smoking is the Santa Fe Natural Tobacco Company Inc. of Santa Fe, New Mexico, which manufactures my cigarette of choice: the Natural American Spirit Ultra Light. I love American Spirits. Slow-burning and smooth, they take a while to smoke, and they taste good, with none of the chemical aftertaste of Marlboro or Camel lights.
When I switched to American Spirit Ultra Lights five years ago, they were hard to find. Now you can get them everywhere, because in 2001, Santa Fe Natural Tobacco was sold to Reynolds Holdings Incorporated -- the parent company of R.J. Reynolds Tobacco Company -- for $320 million. The new owners broadened distribution and marketing efforts, which routinely play up the fact that American Spirits are 100 percent additive-free tobacco -- never mind that the gases in tobacco smoke itself contain, on average, 4,000 chemical compounds, most of them toxic.
R.J. Reynolds, which has had enormous success pimping the additive-free attributes of another of its signature brands, Winston, is also the source of such factory-floor imprints as Bargain Buy, Best Choice, Best Value, Bonus Value, Quality Smoke, Value & Quality and Extra Value. But it's best known for its bread-and-butter brand, Camel, which gave the world the lovable phallic cartoon mammal, Joe Camel, in the early '90s. However, as part of the Master Settlement Agreement, the tobacco companies agreed to stop marketing their products to teenagers, as they had for decades, and Joe Camel suffered a premature death, like so many chain-smokers before him.
On Tuesday morning, Anne Landman meets me at a coffee shop off Grand Junction's spectacularly unhappening main drag. She really does seem excited to see the guy who brings her coffee. Before settling into a table on the patio -- as far as possible from the nearby smoking section -- she says hello to him, to a woman with a dog, to a man in a pickup truck.
"Coming to Grand Junction for me is like going to the big city," she says. "I just walk around, stand on the corner like, 'Oh! People!' I try to soak it up."
Landman moved to Grand Junction in 1982 to escape life in West Hollywood. After two of her friends were murdered there in 1977, she felt confined and unsafe. "I wasn't comfortable in California anymore," says Landman, who discovered Colorado on a river-rafting trip. "I liked that you could have some space, that the town was small. The more people there are in one place, the less they care about each other, just out of necessity. People tend to have more respect for each other in places like this."
Ironically, many of the elements that drew Landman here -- a culture of openness and wide-open spaces, of blue skies and spirited individualism -- have also have long bound the tobacco industry to Colorado. The romanticized West has been a major influence in the marketing and mythology of smoking, from the Marlboro Man to the Camel-smoking cowboys that colored billboards and magazine spreads before the Master Settlement Agreement restricted such imagery in advertising. Likewise, the libertarianism of the region has provided a philosophical blueprint for the tobacco industry's defense against the anti-smoking movement: In the West, smoking is often seen as a right that should be protected from unreasonable governmental control rather than a public-health issue. In 1996, senators Norma Anderson and Tom Norton introduced a bill, later vetoed by then-governor Roy Romer, that would have defined smoking as a property right, thereby making it more difficult for government to limit. Though Colorado's smoking rates are lower than the national averages, we also have fewer controls: Colorado's excise tax on tobacco is the lowest in the nation, and we're one of the few states that doesn't charge sales tax on cigarettes or smokeless tobacco.
The industry has done its best to keep Colorado's tobacco-control measures in check, fighting everything from statewide increases in tobacco taxes to local restrictions on smoking in public and the workplace. Ten years ago, the tobacco industry spent more than $5 million to oppose a statewide initiative that would have raised Colorado's cigarette taxes by fifty cents per pack. The anti-tax campaign was aggressive, media-savvy -- one of its commercials featured an image of a flaming Constitution -- and ultimately victorious. Though early polls projected the initiative would pass, it was trounced by voters. The defeat sent a message that those who took on tobacco would do so at their own great expense, as the industry wasn't afraid to battle for the ballot box.
Even the smallest campaigns have piqued the industry's interest. In 1998, for example, Philip Morris fought a proposed smoking ban in Montrose, population 11,000, albeit indirectly. "We have our usual very capable team of folks at work on the situation," wrote a consultant to Philip Morris at the time. "Our people are working very effectively with third-party allies, as is the usual mode of operation in local efforts."
Despite their efforts, the Montrose City Council finally passed a modified version of the measure in 2001.
"It was just this little tiny smoking ordinance," Landman says, "and they flew people out to Montrose, and they challenged in city council. They got some local restaurateur to say it was going to cripple the economy. Montrose is this kind of nowhere place you stop on your way to somewhere else. But they treated it as if it was going to strike at the very heart of their industry if it passed there."
So far, the tobacco companies have been relatively quiet about Amendment 35, the most drastic statewide smoking-control measure ever to roll down Colorado's political pipeline. Voters haven't heard much from Philip Morris. Or R.J. Reynolds, which acquired Brown & Williamson in July, or Lorillard, or anyone at all. Because as the public has gotten smarter about the dangers of smoking, the industry has retreated from the frontlines of popular ballot initiatives to save face with the public as well as money.
Voters will decide on November 2 whether to raise cigarette taxes from twenty to 84 cents per pack in order to fund tobacco- and health-care-related programs. The 64-cent increase would still place Colorado's cigarette tax below the national average. Currently, smokers across the state pay an average of $3.21 a pack compared to $5.78 in New York, which has the highest cigarette tax rate in the nation at $1.50 a pack. Under Amendment 35, Colorado smokers would fork over about $3.85 for a pack, which is still less than their counterparts in neighboring states Arizona ($4.26), Nebraska ($4), New Mexico ($3.98), Utah ($3.91) and Kansas ($4.08).
"The feeling was that because the legislature has failed to adequately fund tobacco programs on its own, we needed to find a way to get that money back into the system," says Chris Sherwin, director of the Colorado Tobacco Education and Prevention Alliance, one of forty groups sponsoring the amendment under the moniker Citizens for a Healthier Colorado. "It'll give local programs a greater ability to do outreach in their communities, to really raise the visibility of the issue."
Though the most high-profile proponents of Amendment 35 include the Campaign for Tobacco-Free Kids, the American Lung Association of Colorado and the Colorado Tobacco Education and Prevention Alliance, it is being touted as a public-health initiative, not just a tobacco-control measure. The $175 million in projected tobacco-tax revenue would be dedicated to a broad range of health-care programs, including an expansion of Medicaid and the Children's Health Plan Plus, and creation of community health-care clinics to serve the state's 700,000 indigent and uninsured. The money would also finance a number of statewide tobacco-prevention, cessation and research programs and would pay for screenings and treatments for smoking-related maladies, including cancer and lung and heart disease, through National Jewish Medical Center.
"Health care often gets put on the cutting block when you've got a budget crisis in the legislature," says Mike Melanson, who is directing Citizens for a Healthier Colorado's campaign. "It becomes a question of what do you cut? We need prisons, roads, a lot of things that get priority treatment over health care. We see that mentality in our own lives: Maybe we can take that risk and survive at diminished levels. But this amendment creates a dedicated revenue stream that would help expand programs rather than cut them."
The successes of similar tax packages that have recently passed in 32 states makes Melanson confident that Amendment 35 will easily prevail on November 2. In fact, Melanson estimates that Amendment 35 has broad support even among smokers.
"We've talked to a number of smokers who have been eager to support it," he says. "They'll say, 'I wish I didn't smoke.' They started as kids; they're hooked as adults. They think, 'If this can stop someone else from going that way, I'm for it.'"
Earlier this month, the Protect Our Constitution/ Vote No on 35 committee formed to oppose the ballot initiative. Protect Our Constitution is led by Wilson Croom, executive director of the Colorado Association of Distributors, a political action committee that has historically opposed tobacco-tax increases. Though the group hasn't yet collected any contributions, Philip Morris has pledged to play a role in the efforts, as has R.J. Reynolds.
"Smokers in Colorado already shoulder their fair share in taxes," says R.J. Reynolds's David Howard. "The question people should be asking is, where is all of the money that was intended for health-care programs? Was it the smokers who put the state in a budget crunch?"
Philip Morris has already landed one clear strike to the amendment. A study funded by the tobacco-maker's parent company, Altria Corporate Services Inc., through the Colorado Center for Tax Policy determined that the amendment's spending requirements would suck resources from local public services such as police and fire. Elements of that study have been included in the guide voters will receive before the election.
"Philip Morris USA, like many corporations, is actively involved in the legislative process," says company spokeswoman Jamie Drogin. "Our intention is to work with them, because we agree with them that amending a tax to the constitution is not the appropriate way to fund programs or manage a state fiscal situation.
"Tobacco is a declining force of revenue that declines 1 to 2 percent a year," she adds. "It's unsound fiscal policy to fund programs with a revenue source that isn't secure. It's a domino effect."
Protect our Constitution joins the Golden-based Independence Institute as the amendment's only visible opponents. "We oppose tax increases on just about anything," says senior fellow Beth Skinner, laughing. "And we just don't think it's fair to single out smokers the way this amendment would."
Skinner also adds that curbing smoking would eventually have a negative impact on the state's bottom line: "Smokers, in the short run, do cost more," she says. "But in the long run, economically -- not morally -- speaking, smokers eventually benefit society. Frankly, they die sooner, so they don't collect pension and Medicare and Social Security and things like that. The tobacco industry is certainly not going to go around saying, 'What a bargain.' But there you go."
At 47, Anne Landman wears strappy, complicated sandals and her dark, wild hair cut short and off her face. She's part of a group the tobacco industry has called the "Antis." At a sales conference in 1988, Philip Morris's then-vice president of international corporate affairs, J. Dollisson, described them in even more colorful, if contemptuous, terms: "Our war is not with the competitors but anti-smokers, anti-advertisers and the like -- the müesli eating, stool watching joggers who know what is best for all of us." During a 1991 speech, R.J. Reynolds exec Herbert Osman attributed a puzzling decline in cigarette consumption to "anti-smoking zealots." "How did smoking, once a simple pleasure enjoyed and accepted by the people, become the subject of so much disdain and moral outrage?" he wondered.
Landman's not a jogger. She prefers long, aimless walks through Mesa County's limitless canyons and trails. And though she supports Amendment 35, she's not actively involved in the campaign. She doesn't consider herself an Anti. Rather, she sees herself as more of a detective -- the consummate outsider piecing together a complex world from a distance.
"I'm not necessarily anti-tobacco," she says. "One of my main goals is to enhance people's literacy of our corporate culture -- and a lot of corporations take their leads from tobacco-industry strategies.
"But," she adds dryly, "if I do make their lives a little harder, I'm okay with that."
As the force behind Landman Tobacco Document Research & Consulting, she makes a modest living by doing freelance work for universities, law schools, physicians, the American Lung Association and state public-health agencies, including the Massachusetts Department of Health. She's also been an expert witness in two lawsuits and is frequently quoted as a source in tobacco-related news reports across the country.
Landman likes documents that illustrate the industry's dual role as a product manufacturer and a political force. She cites a 1987 Philip Morris plan to expand efforts in the Middle East as an example of the company's far-flung political ambitions at work: "Philip Morris and the industry are positively impacting the government decisions of Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and UAE...," the memo states before outlining the need to "...identify Islamic religious leaders who oppose interpretations of the Qu'ran which would ban the use of tobacco and encourage support for these leaders."
She's also developed a dark appreciation for many of the materials she's mined. One of her favorites is "How to Reach the Target," an undated proposal to market Dakota cigarettes, an R.J. Reynolds brand, to "a tough, not wimpy" crowd. The Dakota marketing team suggested pumping the brand as "the first cigarette you can't buy on Sunday -- says it must be wicked, makes you want to be rebellious." To reach the target, the team suggested fashioning voodoo dolls to look like college students, hosting beer-guzzling seminars and erecting a landmark at Mt. Rushmore.
"The Dakota campaign materials were classic," Landman says. "You just read them with your jaw dropping open. The whole theme was anti-college, anti-education. The message was supposed to be 'It's lame to be smart.' It was really out-there stuff. They proposed marketing the product with Clearasil. It's like, 'Hey, who says the tobacco companies don't care about kids?'"
Some of her juiciest finds have been accidents. One night in April 2001, bored at her kitchen table, she started inputting weird search terms into tobaccodocuments.org just to see what would come back. When she entered two phrases -- "pig" and "scum" -- she unearthed "Project SCUM," an R.J. Reynolds marketing plan with a cynical view of its target demographic. Subtitled "Sub-culture Urban Marketing," Project SCUM was a plan to introduce Red Kamel to consumers in San Francisco, including gays, Generation X-ers, "street people" and those of "international influence" -- presumably immigrants and non-whites who would think it "hip/cool to smoke Camels."
Project SCUM became a cornerstone of an anti-tobacco media campaign and led to a (short-lived) boycott of R.J. Reynolds brands by gay groups in San Francisco. In a letter to SF Weekly newspaper, which broke the story on Project SCUM with documents provided by Landman, R.J. Reynolds CEO Andrew Schindler apologized for the "wholly unacceptable and offensive document."
"Project SCUM was one example of how the tobacco industry figured out a way to use powerlessness as a marketing tool," Landman says. "It's really the same thing as marketing Kent cigarettes as safe: It's a perversion of psychology. They use it against people. They do it all the time."
Landman doesn't have direct contact with the tobacco companies themselves -- "I've never had a bullet in my mailbox," she says spookily -- but she knows they watch her as she watches them. Several of her posts are among newly uploaded industry documents on the web, and her name crops up in e-mails and memos from time to time. Landman's critics dismiss much of her research because the documents she posts are presented out of context. Worse, they're sometimes years, even decades, old -- relics of an industry that's evolved responsibly over time.
"The Master Settlement Agreement fundamentally changed the way tobacco products are manufactured and sold in the United States," says Philip Morris's Drogin. "We agreed to make those documents available to the public for the purpose of historical reference. We continually make those available. But if you're talking about documents of the past, they're not in any way an accurate representation of what we do today."
But Landman says the documents, however dated, remain relevant, if only as roadmaps to an industry that still sells a deadly product to millions. And as much as she may distrust and resent it, she views the tobacco industry with a certain amount of awe.
"You have to admire a company like Philip Morris," she says, gazing out on the vast expanse of nothing that surrounds her property. "They are an extremely sophisticated, creative company. The tobacco industry as a whole is at least ten years ahead -- strategically, logistically, politically. There's a real elegance to the way they operate."
Whether or not Joe Camel's death has had anything to do with it, young people aren't smoking as much as they used to. According to a 2003 survey by the University of Michigan and the U.S. Department of Health and Human Services, use among twelfth-graders is down by more than 30 percent. In Colorado, where teen smoking rates are historically higher than the national average, usage numbers have inched down as well.
Though Philip Morris takes some credit for the slump because of its teen-smoking prevention program and "We Card" campaign, the decline in teen smoking tracks most of all with the infusion of money from the Master Settlement Agreement that started coming into public health departments in 2000. That year, Colorado received roughly $100 million -- and thus began a legislative food fight over how the money should be spent. In 2000, Senator Norma Anderson introduced and passed Senate Bill 71, which devised a formula for divvying up the $90 million to $100 million that the state is slated to receive each year until 2025. In addition to funding a variety of health and education initiatives, SB 71 allocated 15 percent of the MSA money to tobacco prevention, research and education.
Although still shy of the number recommended by the Centers for Disease Control, which places the cost of a comprehensive, statewide tobacco-control program at $24 million, that figure was enough to fund a number of new state- and community-wide programs. In 2000, the State Tobacco Education and Prevention Partnership launched a threefold plan of attack that included programs to help adults quit smoking; blitzes over the dangers of secondhand smoke; and outreach and education to keep cigarettes out of the hands of teenagers. They worked for teens and for adults: After STEPP programs took hold, smoking by Coloradans declined by 10 percent per capita, twice the national average.
I wasn't among those quitters. Though I have cut down, my four or five cigarettes a day are still more than enough to formally render me a stinky addict with a stupid habit I never intended to get saddled with. I'm insanely jealous of teenagers who've never smoked -- with their pink lungs, their unbridled breathing capacity, their non-prematurely-wrinkled skin. Unlike me, they'll never find themselves scanning the outskirts of Grand Junction, searching for a 7-Eleven, a Loaf 'N Jug, anywhere to buy a pack of smokes.
When I tell this to STEPP director Karen DeLeeuw, she says it's never too late.
"The key is to keep trying and trying," says the former smoker. "A lot of people who use our programs have tried five, six times in one year. You just go along until something sticks. One day you may just find that it's not as difficult as it used to be; you can just let it go."
I have tried one of STEPP's programs, the Colorado Quitline, three times over the past year. Quitline is a 24-hour telephone hotline where counselors gauge the severity of your addiction and then guide you through the step-down process to a smoke-free life. Every time I called, the Quitline counselors were friendly, knowledgeable and supportive. And every time, I wound up blowing them off. When I stopped returning their calls -- shamed by my inability to keep my agreed-upon quit date -- they sent me letters. This annoyed the shit out of me until I realized that it was a gentle, and effective, reminder not to give up.
Quitline is the state's most successful cessation program: Twenty-six percent of its users report they've remained smokeless six months after calling. It's also one of the few statewide programs to survive a recent round of cuts that effectively gutted Colorado's comprehensive tobacco-control program. State tobacco funding has dwindled from an all-time high of $14 million in 2002 to less than $4 million last year, when more than forty million MSA dollars originally earmarked for tobacco programs were moved to the general fund to help ameliorate serious budget woes.
The most recent MSA allocation formula, House Bill 1410, fixed the amount at $5 million. Currently, only the state's most populated 36 counties see any kind of dedicated tobacco dollars, and they operate only skeletal versions of the once-triangulated approach. Public-health officials must now, for example, choose between operating a teen-prevention hotline or an adult-cessation group.
"In some cases, we had so little funding to offer them that they just said, 'No, thanks.' They didn't even want to bother with it," says DeLeeuw. "It's disappointing, because there is a direct comparison between the investment you make and the outcome you get. You have much better results when you have things going on in all three of the areas we outlined. It's hard to keep kids from smoking if they see all of the adults smoking, for example. You're much more effective when you're getting consistent messages out there."
DeLeeuw expects declines in smoking rates to plateau once the data catches up with the cuts, undoing a lot of hard-won battles to separate Coloradans from their cigarettes. STEPP has already seen the impact of serious reductions in the Quitline operation. The hotline's hours have been nipped, as have its marketing efforts, and as a result, calls are down by about 50 percent. The program's still there. It's just that no one knows about it.
But, DeLeeuw points out, her office is still open for business. Five years ago, it didn't exist.
"Colorado is not unique," she says. "Nationally, only about 5 percent of the MSA money is being spent on tobacco. In retrospect, of course, everyone's saying the MSA should have been more prescriptive, because a lot of states have suffered serious revenue shortfalls, and a lot of [tobacco] programs are disappearing because of it."
The architects of the MSA placed no restrictions on how the settlement money should be spent. In Colorado, as in most cash-strapped states, the MSA money has gone to everything from health care and Medicaid to parks, schools and Read to Achieve, Governor Bill Owens's pet literacy project, which is slated to receive $16 million in tobacco money in 2005. As the MSA umbrella broadens to cover more and more programs, smoking prevention takes the biggest hits: Prevention and outreach programs have been cut by 58 percent since 2000, while tobacco research has been zeroed out completely. During the same time period, Read to Achieve has been cut by only about 15 percent.
"The tobacco money has been looked at as the place to go to fix some very serious difficulties in the state budget," says the Colorado Tobacco Education and Prevention Alliance's Chris Sherwin. "I've no doubt that some very worthy programs are being funded this way. But diverting that money entirely away from tobacco is a real violation of the intent of the Master Settlement.
"We see it as penny-wise and pound-foolish," he adds. "You've got thousands and thousands of people in Colorado addicted to tobacco. We know that these programs work. And yet there's no funding for any of the most promising programs. It's a real shame."
That's bad news for smokers like me. According to the state health department, more than 80 percent of smokers in Colorado want to quit. The consensus among the medical community is that the odds of our succeeding increase by about 20 percent when there's some external support.
"I sympathize. I do," says Representative Brad Young, chairman of the Colorado Legislature's Joint Budget Committee, which oversees the allocation of the settlement money. "But tobacco was the last thing to be added, and it's usually the first thing to go. That's true: For one thing, there aren't any federal mandates on how we fund it, unlike other areas of the budget. It's taking a hit like everything else."
"Some of the grants that went out for tobacco cessation, if you look at them, they're ridiculous," says state senator Norma Anderson. "Some of them don't even tie to quitting smoking, and there's no numbers that prove that they work. So when you make budget cuts, it's not easy. If my choice is funding foster kids or cessation programs, excuse me, I'm going to go with support for the foster kids.
"Some of these people who cry out for cessation and prevention, they have such a narrow focus," she adds. "Until we got into a budget crisis, we were one of the very few states in the nation that spent that tobacco money on health care. They should be happy that we did it at all."
Young says it will take a serious shift in the state budget -- which is still absorbing the impact of a 16 percent reduction in revenues since 2001 -- before tobacco funding comes anywhere near 2000 levels.
"You can go across the board, and everybody is saying, 'Why'd you single us out?'" he continues. "We cut parks, they tell us they're going to have to close half the parks. We cut human services, they say, 'Now you're picking on us.' Higher ed, agriculture, mental health -- it's the same thing. Everyone thinks they're being picked on. The fact is, we are picking on everyone."
In June, Anne Landman released "Tobacco Industry Involvement in Colorado," a blistering 63-page report commissioned by the American Lung Association of Colorado. For two years, she and co-researcher Peter Bialick tried to connect the dots between the tobacco industry and state policy-makers. Citing various documents unearthed through the MSA, as well as news reports and data from the secretary of state, they linked tobacco-industry involvement, both direct and indirect, to a series of defeated cigarette-tax increases and smoking-control measures across the state. The report paints a picture of Colorado as a state historically friendly to the tobacco industry.
"The major goal of the report was just to put a simple idea out there: A lot of diseases come and go -- water diseases, blood-borne viruses, all kinds of stuff," Landman says. "We've found a way to reduce them. We have all kinds of public-health successes in other areas. But for some reason with tobacco, we hit these roadblocks. Mosquitoes don't have a lobby protecting their interests. But tobacco does. And they do."
The report was heralded within the public-health community, and the American Lung Association of Colorado's website logged 4,000 hits in July. "The response was pretty phenomenal," says ALAC CEO Curt Huber. "I think the report helped continue a dialog about what the industry will do to secure its interests. It opened a lot of people's eyes."
"The public has gotten a lot smarter when it comes to this stuff," Landman says. "The Colorado population in general is more educated than they were a decade ago. That's something that a tobacco lawyer actually lamented in a memo I read. It said, ŒThe problem in Colorado is that there are too many people with a college degree.' It's unbelievable."
The report, however, was slammed by many lawmakers, including Colorado Senate president John Andrews, who dismissed it as a "propaganda paper disguised as research."
Senator Anderson, who is portrayed in the report as a tobacco ally, also rejects Landman's findings. "From what I understand, she does all of her research by reading old newspaper articles," she says. "I knew that my name was mentioned in her report, but I really didn't think it was worth reading. I know what I've done, and I don't have a guilty conscience. I imagine she's one of those people who thinks that, 'Gee, if you're a politician, you must be a bad person.'"
And yet the majority of Colorado's legislators -- Democrats and Republicans alike -- have received hefty campaign contributions from tobacco companies, including Representative Brad Young. A Republican from Lamar, Young has spent two years as chairman of the Joint Budget Committee and has supported several bills viewed as friendly to the tobacco industry, among them a failed attempt to sell off Colorado's share of the MSA money for one lump sum. But he scoffs at the notion that he's in anyone's pocket, tobacco or otherwise.
"This idea that the legislature is bought and paid for by the tobacco lobby -- I can tell you, I invite anyone who wants to make that statement to come down and sit down in front of the JBC for one day," says Young, who doesn't smoke. "If someone is still saying that at the end of the day, you will have a very insulted budget committee."
However, he is the architect of a bill that would castrate Amendment 35. As written, Amendment 35 would allow the legislature to tap the fund in times of budget crises, with a two-thirds majority vote. But Young's House Bill 1455 effectively claims the $175 million that would be generated by the cigarette tax for the general fund, stamping out the spending requirements outlined in the amendment and routing revenues away from public-health programs, including tobacco prevention.
"Right now everyone is taking their own agenda to the people rather than working through their elected officials," Young says. "You go down a dangerous path when you do that. Shall we fund schools by creating a new tax on school buses and school supplies and paper? How about liquor: Shouldn't we have a liquor tax that's specifically related to alcohol-related diseases?
"It's just human nature that everyone wants to take care of their little part of the budget world, but it doesn't lead to good public policy," he continues. "What are we going to do about the rest of the budget?"
When the bill was introduced, some of Young's colleagues accused him of subverting the will of the voters. Representative Tom Plant said it was a "fundamentally dishonest" move that "kind of lives up to the lowest expectation of politicians." But Young argued that budget planning is not the job of the voters, and others agreed with him: HB 1455 moved swiftly through the House and the Senate and was signed by Governor Owens on June 5.
"It's a blatant attempt to torpedo and attack our initiative," says CTEP's Sherwin. "You can't look at it and say, 'Oh, that's the work of the industry.' But it definitely does match their strategy."
Mike Melanson of Citizens for a Healthier Colorado says he will challenge the bill's constitutionality if Amendment 35 passes. But Young is confident the legislation will hold up.
"I can understand them trying to find some bogeyman that came to me -- that through heavy political influences tried to get me to work for this bill," Young says. "But I can tell you the tobacco interests never approached me about this bill. Nobody prompted me to do this. If this bill is the work of big tobacco, nobody told me."
Landman sometimes feels like she goes up against the bogeyman every day. Even in Grand Junction, she's used to people sighing or spacing out if she starts talking about tobacco. "I think they get kind of sick of me sometimes," she says, taking a sip of coffee. "Sometimes I get sick of it myself. There are days I think it would be fun to come down here, be a barista or something, and not think about this stuff for a while.
But she does. She can't help it.
"I don't know that I'll do this forever," she says. "If there was another industry that I could somehow peek into in the same way, I could get into that. But from my perspective, the corporate world is a different world. People aren't privy unless there's a lawsuit. I guess someone will have to sue the pharmaceutical industry or something.
"I have to remind myself that the tobacco industry kills more people than fires, suicide, heroin and crack combined. When I remember that, it reminds me that maybe I should go back in and take a closer look at how they get away with that."
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On the way out of Grand Junction, I pull up to the Liquor Barn, a massive siding-covered structure near a strip mall and a vast grove of peach trees. At 5 p.m., the parking lot hums with a quitting-time crowd; guys in suits and women in sweatpants leave their cars running while they pop in for six-packs and bottles of wine. More than half return with a pack of cigarettes in their hand.
I'd planned to pick up a pack myself. Instead, I put the car in gear and drive away, hoping the bad FM radio can drown out the itch that's flared up in the bottom of my being. I think about what Karen DeLeeuw said -- that one day not smoking just won't be as hard as it was the day before. When I pull onto I-70, I'm thinking: Maybe today.
But construction on the highway thirty miles out of town makes the trip that much longer. There's nothing but static on the stereo all through Glenwood Canyon. Near Avon, SUVs and trucks hauling ass down curvy mountain passes stress me out so bad I stop to chill out at a Holiday Inn in, where a hippie dude is smoking outside the front door. He smiles as I bum one from him. After fourteen years, what's one more day?