Arizona's tobacco control initiative illustrates the need for continuing oversight by tobacco control advocates

Background-In 1994, Arizona voters approved Proposition 200 which increased the tobacco tax and earmarked 23% of the new revenues for tobacco educatio n programmes. Objective-To describe the campaign to pass Proposition 200, the legislative debate that followed the passage of the initiative, and the development an d implementation of the tobacco control programme. Design-This is a case study. Data were collected through semi-structured in terviews with key players in the initiative campaign and in the tobacco edu cation programme, and written records (campaign material, newspapers, memor anda, public records). Results-Despite opposition from the tobacco industry, Arizonans approved an increase in the tobacco tax. At the legislature, health advocates in Arizo na successfully fought the tobacco industry attempts to divert the health e ducation funds and pass preemptive legislation. The executive branch limite d the scope of the programme to adolescents and pregnant women. It also pre vented the programme from attacking the tobacco industry or focusing on sec ondhand smoke. Health advocates did not put enough pressure at the executiv e branch to force it to develop a comprehensive tobacco education programme . Conclusions-It is not enough for health advocates to campaign for an increa se in tobacco tax and to protect the funds at the legislature. Tobacco cont rol advocates must closely monitor the development and implementation of ta x-funded tobacco education programmes at the administrative level and be wi lling to press the executive to implement effective programmes.