Greater 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 study, "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.

"It appears 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 theAmerican 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.

While 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.

According to 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 inBest Practices for Comprehensive Tobacco Control Programs, there would have been 2.2 million to 7.1 million fewer smokers by 2003.

Yet despite 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 CDC-recommended levels.

The study 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 adults aged 25 or older, while increases in cigarette prices had a stronger effect on 18– to–24–year–old smokers.

Source: Health Resources Publishing