New Study Shows Tobacco Control Programs Cut Adult Smoking Rates
investments in state tobacco control programs are independently and
significantly associated with larger and more rapid declines in adult
smoking prevalence, according to a study by researchers at Centers for
Disease Control and Prevention (CDC) and RTI International, an
independent nonprofit research institute based in Research Triangle
Park, N.C. Researchers were able to quantify the link between
comprehensive tobacco control programs and a decrease in adult smoking
— observing a decline in prevalence from 29.5 percent in 1985 to
18.6 percent in 2003.
"The Impact of Tobacco Control Programs on Adult Smoking," is believed
to be the first of its kind to use multi-state survey data on smoking
to examine the association between cumulative state tobacco control
program spending and changes in adult smoking prevalence. Combining
educational, clinical, regulatory, economic, and social strategies,
these comprehensive programs encompass coordinated efforts to establish
smoke-free policies and social norms, to promote and assist tobacco
users to quit, and to prevent initiation of tobacco use.
that sustained, well–funded programs become increasingly
effective over time," said Matthew Farrelly, Ph.D., RTI International,
who was lead author of the study. "As states build capacity for tobacco
control, they make better and better use of each additional dollar."
The study, published in the February 2008 issue of the American Journal of Public Health,
analyzed data from all 50 states and the District of Columbia and found
that among individual states the declines in adult smoking prevalence
were directly related to increases in state per person investments in
tobacco control programs.
increases in the cost of cigarettes have been shown previously to lead
to declines in smoking rates, this new study finds that state program
funding had an effect on adult smoking, independent of price.
the study, if all states had started in 1995 to fund their tobacco
control programs at either the minimum or optimal levels recommended by
the CDC in Best Practices for Comprehensive Tobacco Control Programs, there would have been 2.2 million to 7.1 million fewer smokers by 2003.
extensive research demonstrating the effectiveness of tobacco control
programs in reducing smoking prevalence and improving health, as of
2005, only four states funded their programs at the minimum levels
recommended by CDC. Many states have substantially reduced funding for
their tobacco control programs. Overall funding for state tobacco
control programs declined by 28 percent between fiscal years 2002 and
2005. As of 2007, only three states were funding their programs at the
also found that increases in both tobacco control program expenditures
and cigarette prices were effective in reducing smoking prevalence
among adults, with tobacco control program expenditures somewhat more
effective in reducing smoking prevalence among adultsaged 25 or older,
while increases in cigarette prices had a stronger effect on 18–
"These results show that if states consistently fund programs at recommended levels — outlined in Best Practices for Comprehensive Tobacco Control Programs —
they could substantially reduce adult smoking prevalence, and thus
reduce smoking-related morbidity, mortality, and economic costs," said
Terry Pechacek, Ph.D., associate director for science, Office on
Smoking and Health, CDC, and one of the authors of the study.
supports the conclusion of not only the 2000 report of the U.S. Surgeon
General but also 2007 reports from the Institute of Medicine, the
National Institutes of Health, and the President’s Cancer Panel
that comprehensive state tobacco control programs are effective public
health investments. The study also complements recent studies
demonstrating that tobacco control program expenditures are associated
with declines in smoking prevalence among youths and declines in
per-person cigarette sales.
disease accounts for an estimated 438,000 deaths per year in the United
States, and remains the leading cause of preventable death and disease.
Tobacco use accounts for more than $190 billion annually in direct and
indirect medical costs, and at least 8.6 million Americans are living
with at least one serious illness caused by tobacco use.
The full study is available at www.ajph.org/. Call CDC’s Office on Smoking and Health at (770) 488-5493 to obtain a copy of the study.
For more information about CDC’s Best Practices for Comprehensive Tobacco Control Programs–2007, visit CDC’s Web site at www.cdc.gov/tobacco.