Written by Asya Marsh, DMD 2018


Proposition 56 Message Training Webinar conducted by the CDA on August 30, 2016

The information presented below is taken exclusively from the resources shared by CDA during the Proposition 56 Training Webinar.

Proposition 56 otherwise known as The California Healthcare, Research and Prevention Tobacco Tax Act of 2016 has successfully passed on the ballot with the help of thousands of volunteers that collected one million signatures.  On October 10th 2016 the vote by mail ballots will begin and continue until November 1st, 2016.  It is our turn to once again spread the grassroots message regarding this valuable measure to the public, to our patients, amongst our friends, families and colleagues. 

Proposition 56 proposes a California statewide tax increase on cigarettes by $2 per pack.  An equivalent increase will be applied to products containing nicotine derived from tobacco, including e-cigarettes.  Smoking is a costly and deadly habit and the number one cause of preventable death in California, killing 40,000 Californians annually. (CTFK, 2016) Tobacco related disease and cancer kill more people than car accidents, guns, alcohol, illegal drugs and AIDS combined. (Richert, 2009) Tobacco related illnesses are the number one public health problem in California. (Richert, 2009) The majority of funds generated by the tobacco tax will be used to improve existing health care programs, prevent smoking and fund research into cancer and other tobacco related diseases. This measure is carefully crafted to make sure that the money the state makes is used to offset the cost of medical care for thousands of Californians.  Currently, California taxpayers, whether they smoke or not, are paying 3.5 billion dollars annually to medical programs that provide resources to low-income families. (CTFK, 2016) Proposition 56 will allow smokers to help mitigate these costs placed on all tax payers and the health care system. Therefore, Proposition 56 will bring funding to offset these costs and reduce tobacco use long term, generating resources to increase access to health care for low-income communities and fund smoking cessation programs. 

Additionally, $30 million in annual funding would be dedicated to the state Dental Director’s oral health program, specifically for education and prevention of dental disease.  The Office of Oral Health, currently run by California’s Dental Director Jake Kumar is developing a 10-year strategic plan with the CDA and other stakeholders to expand the public health dental services available across the state, particularly to children in underserved areas. The program will provide education, prevent dental disease, support tobacco cessation and early detection of tobacco related illnesses. Proposition 56 will help to further fund this program and secure its success. (CDA, 2016)

Among the many coalition partners supporting proposition 56 are the American Cancer Society, the American Heart Association, the American Lung Association, the Cancer Action Network, the California Dental Association, the California SEIU, The California Medical Association, Nextgen California, California Hospital association and the Blue Cross of California.  Those behind the initiatives know that taxing tobacco saves lives, by preventing many from starting smoking and leading others to quit.  To battle these initiatives, large tobacco companies have invested millions of dollars to oppose such proposals and sway public opinion.

Tobacco companies have begun their fight against proposition 56 investing 36 million dollars to oppose supporters making blunt and utterly false claims to deceive the public. (CDA, 2016) One such claim utters the false notion that proposition 56 was written to enrich special interest groups.  The San Francisco chronicle called this claim “ludicrous.” Proposition 56 does not benefit special interests; it raises funds for Medi-Cal which provides health coverage for low income Californians. (CDA, 2016) Proposition 56 works to reduce smoking and ensure smokers’ pay for healthcare costs and relieves the burden from California taxpayers. (CDA, 2016) Additionally, Proposition 56 has built in safeguards, including independent audits and strict caps on overhead spending and administrative costs, specifically prohibiting politicians from diverting funds for their own agendas. (CDA, 2016)

Even more alarming is big tobacco’s attempts to target young children by marketing candy flavored e –cigarettes and themed packaging with images of childhood characters such as Hello Kitty, Minions, Barbie and Hot Wheels.  The sad truth is that 9 out of 10 smokers start smoking as teenagers.  As reported by the Campaign for Tobacco-Free Kids, 17,000 kids become addicted to smoking every year while one third eventually die from tobacco related illnesses. (CDA, 2016) Hoping to address this epidemic, research conducted by the Campaign for Tobacco-Free Kids has shown time and time again that increasing taxes on tobacco products reduces teen smoking with the financial burden it creates. (CTFK, 2016) However, California’s tobacco tax is among the lowest in the nation. The initiative can help prevent a new generation of kids from taking up a deadly addictive habit. 

For decades tobacco companies have targeted the public with false claims about the dangers of tobacco and have spent millions to target young adults and children.  Ironically, they now claim to care for the well being of our children by stating that proposition 56 deceptively cheats schools out of $600 million a year by amending the state constitution to bypass California’s minimum school funding guarantee. 

These claims could not be further from the truth as the California School Boards of Association itself states, “Proposition 56 protects school funding while helping to keep our kids from getting hooked on deadly, addictive tobacco.” (CDA, 2016) Additionally the California Superintendent of Public Instruction Tom Torlakson, along with elected school board members, legislators, and finance experts say that these claims are not only misleading but they are flat out wrong.  In fact, Proposition 56 raises revenues for school based tobacco prevention and intervention programs. (CDA, 2016) The legislative analyst’s office estimates that Prop 56 would add tens of millions in new funding for comprehensive anti- tobacco instruction and cessation efforts in classrooms. (CDA, 2016)

To further their expensive attempt to fight Proposition 56, tobacco companies have claimed that e-cigarettes help smokers quit.  However, the FDA has never determined e- cigarettes to be cessation devices, in fact if the FDA did approve e-cigarettes as cessation devices they would be exempt from this tax.  Additionally, with incoming research results and publications, we now know that e-cigarettes are toxic and contain nicotine, which is addictive.  As a recent study published in June 2016 in the Journal of Adolescent Health by the University of Texas Health Science Center at Houston reveals significant levels of 31 harmful chemical compounds and two carcinogens in e-cigarette vapors. (Mantey, 2016) In a June 2016, UCLA School of Dentistry researchers found that toxic substances and nanoparticles in e –cigarettes may increase users risk of oral disease.

(Singh, 2011-2015) Centers for Disease Control study published in April 2015 reported that adolescents who smoked e-cigarettes were six times more likely to start smoking traditional cigarettes than those who never used e-cigarettes. (CDC, 2015)

You have the opportunity to save a life by building support with your local community. Share your experiences of the impacts tobacco has on dental health and support Proposition 56.  Say YES to Prop 56.


1. CTFK. (2016) Campaign for Tobacco Free Kids, Toll of Tobacco in California. “Raising State Cigarette Taxes Always Increases State Revenues (and Always Reduces Smoking).”

2. Richert, Catharine, “Claims that smoking kills more people annually than other dangerous activities combined: True,” PolitiFact, June 29, 2009. other-da/.

3. CDA. (2016). Proposition 56. 

4. Mantey, D. S., Cooper, M. R., Clendennen, S. L., Pasch, K. E., & Perry, C. L. (2016). E-Cigarette Marketing Exposure Is Associated With E-Cigarette Use Among US Youth. Journal of Adolescent Health, 58(6), 686-690. doi:

5. Singh T, Arrazola RA, Corey CG, et al. Tobacco Use Among Middle and High School Students — United States, 2011–2015. MMWR Morb Mortal Wkly Rep 2016;65:361–367. DOI:

6. (CDC) Centers for Disease Control and Prevention. Cancer Prevention [last updated 2015 Jul 21; accessed 2015 Oct 19]