Campaigning Against Tobacco

  • Public-Policy Reform
  • 1991

The Robert Wood Johnson Foundation began a long-term public crusade against tobacco use in 1991. Moving far beyond traditional medical efforts and using all the levers of public-policy advocacy, the group invested more than $700 million of its own funds and recruited allies to contribute more. This massive philanthropic investment hastened many changes in law and policy that damped smoking: the Synar Amendment requiring states to prohibit the sale of tobacco to minors, public-health warnings against secondhand smoke, smoking bans on airplanes and in public spaces, bans on tobacco advertising, and agreements with Hollywood to stop glamorizing smoking in movies and TV. Starting in 1998, the Master Settlement Agreement transferred billions of dollars from cigarette companies to state governments to settle suits over the public costs of treating smoking-related illness.

In 1996, Johnson joined the American Cancer Society, American Heart Association, American Medical Association, and others in launching the National Center for Tobacco-Free Kids. The foundation put $84 million into that effort over the next 11 years.

The foundation pushed hard for higher cigarette taxes to suppress use. “Raising tobacco taxes is our No. 1 strategy,” said one collaborating activist. “The tobacco industry…can’t repeal the laws of economics.” RWJ devoted $99 million to its SmokeLess States program. When the campaign was over, more than 30 states had increased cigarette taxes and six had approved indoor-air laws that proscribed smoking in workplaces and restaurants. The federal government doubled cigarette excise taxes in 2009.

It’s not clear what would have happened to tobacco use absent this intervention led by the Robert Wood Johnson Foundation. The decline in smoking in the U.S. has actually been quite steady since the first U.S. Surgeon General report warning of tobacco’s dangers appeared in the mid-1960s. In any case, the fraction of active cigarette smokers in America fell from 27 percent in 1994 to 15 percent in 2015, and it is estimated that more than 8 million lives have been saved as a result of reduced tobacco use—which proceeded faster and further in the U.S. than in most other countries.

Even with these sharp changes, smoking remains America’s largest preventable cause of death, and donors continue to support anti-smoking education. In 2016, the CVS Health Foundation committed $50 million over five years to reduce youth smoking, with initial grants to nonprofits like the National Association of School Nurses.