The Impact of Tobacco Control Programs on Adult Smoking

Abstract

Objectives. We examined whether state tobacco control programs are effective in reducing the prevalence of adult smoking. Methods. We used state survey data on smoking from 1985 to 2003 in a quasi-experimental design to examine the association between cumulative state antitobacco program expenditures and changes in adult smoking prevalence, after we controlled for confounding. Results. From 1985 to 2003, national adult smoking prevalence declined from 29.5% to 18.6% (P<.001). Increases in state per capita tobacco control program expenditures were independently associated with declines in prevalence. Program expenditures were more effective in reducing smoking prevalence among adults aged 25 or older than for adults aged 18 to 24 years, whereas cigarette prices had a stronger effect on adults aged 18 to 24 years. If, starting in 1995, all states had funded their tobacco control programs at the minimum or optimal levels recommended by the Centers for Disease Control and Prevention, there would have been 2.2 million to 7.1 million fewer smokers by 2003. Conclusions. State tobacco control program expenditures are independently associated with overall reductions in adult smoking prevalence.

Tobacco Control in the United States--Recent Progress And Opportunities

“…Moreover, research clearly shows that increased spending on tobacco-control activities by states with such programs is associated with greater reductions in youth and adult smoking prevalence. 2,48 Despite growing evidence of their effectiveness, several comprehensive tobacco-control programs in the nation have now been jeopardized by severe budget cuts. 49,50 Tobacco-control advocates and experts, including the CDC, have long recognized the crucial need for adequate and sustained funding for these state programs.…”

Variation in Delivery of the 10 Essential Public Health Services by Local Health Departments for Obesity Control in 2005 and 2008

“…Policy intervention strategies have been proven to be effective in other public health practices, such as tobacco control. 28 Moreover, to reverse the obesity epidemic, policy and environmental interventions have been universally accepted and proposed as complementary strategies. 29,30 Currently, CDC provides funding and technical assistance to states and communities to address the problem of obesity.…”

Effect of the California Tobacco Control Program on Personal Health Care Expenditures

“…This specification controlled for common national trends in per capita health care expenditures and smoking over time (e.g., trends in medical practice, insurance status, access to care, medical cost inflation, demographic changes): The difference between California and control states' per capita cigarette consumption was modeled as a function of the difference in cumulative per capita California and control state tobacco control expenditures and cigarette prices. Cumulative expenditures were used because some types of expenditures in any given year (e.g., training, community mobilization to effect policy change) are unlikely to change cigarette consumption immediately but will affect it over a longer period and expenditures for specific programs and services (e.g., media interventions, quit lines) may affect consumption several years later, because successful cessation is a process that usually takes many years and multiple quit attempts, and cohorts of youth with decreased initiation rates will slowly enter the population [22]. Thus, we obtain The linear deterministic trend was included in Equation 2 because a preliminary specification without it produced ambiguous results for unit root tests for stationarity of the cointegrating regression residuals, suggesting the need to include a linear deterministic trend.…”