Tobacco control advocates began to use ballot initiatives to enact tobacco control measures in the late 1970s. In response, the tobacco industry worked for over two decades to change laws governing initiative and referendum processes to prevent passage of such measures. In 1981 the tobacco industry's political lobbying arm, the Tobacco Institute, created a front group that presented itself as a neutral initiative research clearinghouse to effect changes in state initiative and referenda laws. In 1990 the Tobacco Institute began creating an in-house team and worked with third-party groups to try to change state initiative laws. While the industry ultimately abandoned both efforts when neither achieved immediate success, over time the industry's goals have penetrated legitimate discourse on the initiative and referendum process in the United States, and many specific ideas it advocated have garnered mainstream support. Direct democracy advocates, as well as public health advocates and policy makers, need to understand the tobacco industry's goals (which other industries adopted) of limiting the direct democracy process to ensure that any changes do not inadvertently increase the power of the special interests that direct democracy was developed to counterbalance.

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