EPIDEMIOLOGY OF FAILED TOBACCO CONTROL LEGISLATION

Objective.-To evaluate the influence of tobacco industry campaign dona tions, district location, and political party affiliation on tobacco c ontrol legislation among members of the US Congress. Design.-Data were obtained from the Federal Election Commission on money contributed by the 10 leading tobacco political action committees and by tobacco ind ustry-aligned individuals to members of the US House of Representative s (1991-1992) and Senate (1987-1992). Logistic regression analyses wer e performed using recorded votes and cosponsorship activities concerni ng tobacco control legislation during the 102nd and 103rd Congresses a nd membership on the House Congressional Task Force on Tobacco and Hea lth as the dependent variables and tobacco money received, party, dist rict location, and caucus or committee membership as the independent v ariables. Setting.-United States Congress in 1991 and 1992. Interventi ons.-None. Main Outcome Measure.-Support for federal tobacco control l egislation. Results.-The tobacco industry donated approximately $2.4 m illion to members of Congress from January 1991 through December 1992. House members received an average of $2943 (1991-1992) and senators r eceived an average of $11593 (1937-1992). The more tobacco money a mem ber received, the less likely the member was to support tobacco contro l legislation. In the Senate, on a vote to end the taxpayer subsidy of tobacco products in military stores, the odds ratio that senators in the top quartile of tobacco money recipients did not support the measu re vs senators in the lowest quartile of tobacco money recipients was 42.2 (95% confidence interval, 4.1 to 430.0; P<.001). In the House, on a vote to end a $3.5 million subsidy to promote American tobacco abro ad, the odds that House members in the top third of tobacco money reci pients would oppose the legislation were 14.4 times greater (95% confi dence interval, 5.5 to 39.0; P<.001) than for House members in the low est third of tobacco money recipients. Receiving more tobacco money, b eing a member of the Republican party, and representing a tobacco prod ucing state were all associated with decreased support for tobacco con trol issues. The amount of tobacco money received was the variable mos t strongly and consistently associated with a lack of support for toba cco control legislation, even when we controlled for additional factor s such as district location and party. Conclusion.-Tobacco industry co ntributions to members of the US Congress strongly influence the feder al tobacco policy process. Unless this influence is diminished through a combination of members refusing tobacco money and campaign finance reform, this process of contributing to death by thwarting tobacco con trol will continue to claim hundreds of thousands of lives a year.