Public health advocates were winning. City after city was innovating ways to reduce smoking and protect public health between the 1960s and 1970s. As former industry lobbyist Victor Crawford observed, you’d “put out a fire one place, another one would pop up somewhere else.”

But in the mid-1980s, this momentum stopped. Big Tobacco had discovered a way to reverse local gains. And according to a 2020 study in the American Journal of Public Health, the industry’s counteroffensive has led to more disturbing and enduring ramifications for public health — and our democracy — than previously understood.

The strategy is called state or “ceiling” preemption: Promoting weaker state public health laws to override stronger local laws. Between 1986 and 1991, the tobacco industry rammed through seven state preemption laws. In the following five years, the industry gained steam, foisting 17 additional preemption policies on states. Laws restricting youth access to tobacco products would be reversed or never see the light of day. Laws establishing smoke-free environments were overridden. Tobacco tax increases were stalled. Restrictions on tobacco retail licensing were loosened.