1. Maintaining Tobacco Control Funding in Tough Budget Times Presented by: Kathleen A. Mangskau, RDH, MPA Director, Division of Tobacco Prevention and Control North Dakota Department of Health kmangska@state.nd.us

2. Overview  Policy strategies to sustain state programs  Insight in to the opposition’s approaches

3. Objectives  Describe advocacy strategies to maintain funding Agenda setting Policy promotion Understanding the opposition Countering the opposition

4. Background  Youth tobacco use ranks among the highest in the nation  Only 10 percent of MSA funding dedicated to health  Budget deficit creates challenges to compete for additional funding  Tobacco industry exerts powerful influence in state

5. The Policy Plan  Increase the excise tax on tobacco products  Maintain funding for local tobacco control programs  Increase funding for cessation State employees cessation program Statewide quitline  Preventing preemption

6. Engaging Policy Makers  Executive Branch Work with Governor’s policy staff  Legislative Branch Secure champions

7. Agenda Setting  National Governor’s Association Policy Team Governor’s policy staff Key legislative leaders Key advocates

8. Policy Promotion  Educate policy makers on evidence-based approached NGA Policy Team Facts sheets Press conferences/news releases Testimony Grass roots efforts

9. Evidence-Based Approaches  Increasing the excise tax on tobacco products  Establishing statewide quitline  Sustaining state tobacco control efforts over time to build a comprehensive approach Community Preventive Services Guide Reducing Tobacco Use: A Report of the Surgeon General

10. Understanding the Opposition  Powerful influence of tobacco industry  Industry agenda setting Questioning the credibility of advocates Nuisance bills Promoting corporate image

11. Challenges to the Policy Plan  22 tobacco bills  Countering bad bills  Sequencing of the bills

12. Countering the Opposition  Prohibition bill  Age 21 bill  Internet tax bills  Excise tax

13. Tallying the Score  Successes Increased funding for cessation Maintained funding for local tobacco control Banning bidis Reporting to schools same as other drugs  Losses Tobacco excise tax

14. Major Successes  Funding for local grants program maintained  Increased funding for: State employee cessation program Statewide quitline

15. Conclusions  Be aware of the opposition’s tactics  Use evidence-based approaches to support your positions  Develop counter strategies to the opposition