In 2003, tough new regulations to ensure smoke-free environments in workplaces and public locations were enacted by the Oklahoma legislature. This was a striking victory for public health and reformers advocating tobacco controls in one of the most conservative heartland states – a victory that no one would have predicted just a few years earlier. For decades, tobacco industry insiders and lobbyists correctly saw their relationship with Oklahoma legislators as a “love fest.” Compared to many other states, Oklahoma did very little to regulate smoking or tax cigarettes, despite mounting evidence of smoking’s adverse impact on health.

Inaction might well have continued but for the arrival in 2001 of an activist new Commissioner of Public Health. Recruited from Florida and installed by Governor Frank Keating, Dr. Leslie Bietsch instituted “emergency” regulations and launched an aggressive public campaign for tobacco controls – getting out well in front of health advocacy groups and provoking ire from lobbyists and many legislators. Bietsch only lasted two years, but his battle against tobacco interests was a critical turning point. Not only was he victorious in the arena of clean indoor air, he also set the stage for increasing Oklahoma’s cigarette taxes to levels more on par with other states. As we analyze in our new book Heartland Tobacco War, Bietsch’s story show how a principled public official can escape the constraints of business as usual and mobilize public pressure to support reforms.
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