Background: Tobacco use is the leading preventable cause of death in the United States. A direct contributor to this massive health burden is the effectiveness of the tobacco industry's activities, including campaign contributions.
Methods: Voting records of 527 members of the 106th U.S. Congress were obtained for 49 tobacco-related bills between 1997 and 2000. Tobacco industry political action committee (PAC) contributions for each member were summed from 1993 to 2000. A cross-sectional, multilevel model was constructed that predicts voting behavior based on amount of contributions, political party, home state, and amount of state tobacco agriculture. The data were analyzed in 2002, 2003, and 2004.
Results: A total of $6,827,763 was received by the legislators from 17 tobacco industry PACs, an average of $12,956 per member. Senate Republicans received the most money (mean $22,004), while Senate Democrats received the least ($6,057). Republicans voted pro-tobacco 73% of the time and Democrats voted pro-tobacco only 23% of the time (p <0.001). Pro-tobacco voting percentage varied significantly by state (intraclass correlation coefficient=0.27, p <0.001). The amount of PAC money received by a member of Congress was positively associated with voting pro-tobacco (p <0.01), even after controlling for political party, state, and state tobacco farming. For Democrats in Congress who voted pro-tobacco, for every $10,000 contribution they received, they were 9.8% more likely to do so. On the other hand, for Republicans who voted pro-tobacco, for every $10,000 received, they were only 3.5% more likely to do so.
Conclusions: Tobacco industry contributions, political party, and state-level factors influence the voting behavior of Congress members. In the 106th Congress, Republicans voted pro-tobacco over three times as often as Democrats. However, for those Democrats who voted pro-tobacco, the relationship between receiving tobacco industry PAC money and a pro-tobacco vote was stronger than it was for Republicans.