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Adequate and sustained funding for comprehensive tobacco control programs is effective in reducing cigarette smoking.



Comprehensive tobacco control programs increase cessation success more than raising cigarette prices alone. Evaluations of comprehensive tobacco programs in California, Massachusetts, Oregon, Arizona, and Florida, provide compelling evidence that these programs significantly reduce tobacco use by reducing smoking prevalence, average consumption, and youth uptake, and increasing adult smoking cessation. There is a positive association between the number of quit attempts among current smokers and increases in tobacco control expenditures. One study found that a doubling in real per capita tobacco control program expenditures leads to a 0.5 percentage point increase in the likelihood of current everyday smokers making at least one quit attempt in a 12-month period. The small impact of tobacco control expenditures is attributed to the fact that states spent an average of $0.46 per capita on tobacco control programs in 2012, well below the $3.70 level recommended in 2007 by the Centers for Disease Control for state expenditures on tobacco control programs. If states were to spend at the minimum recommended level, youth tobacco use could be cut in half in just six years.

The UK Stop Smoking Services provided by the National Health Service (NHS) were first introduced in 1998 and now include a wide range of government-funded services such as brief advice, a toll-free telephone quitline, pharmaceutical and behavioral support, as well as the availability of NRT, bupropion, and varenicline either free or for a subsidized fee. It is estimated that in the financial fiscal year 2012-13 NHS provided support for smoking cessation to 36,249 clients. A strong body of evidence demonstrates the effectiveness of these services in helping smokers in the UK to quit. In England, for example, those receiving Stop Smoking Services support from specialist clinics, treatment in groups, and varenicline or combination NRT were more likely to succeed in quitting than those receiving treatment in primary care, one-to-one treatment, and single NRT.



Messer K, Pierce JP, Zhu SH, Hartman AM, Al-Delaimy WK, Trinidad DR, Gilpin EA. The California Tobacco Control Program’s effect on adult smokers: (1) Smoking Cessation. Tob Control. 2007; 16(2): 85-90.

Pierce JP, Gilpin EA, Emery SL, White MM, Rosbrook B, Berry CC, Farkas AJ. Has the California tobacco control program reduced smoking? JAMA. 1998; 280(10): 893-899. Erratum in: JAMA. 1999; 281(1): 37.

Biener L, Harris JE, Hamilton W. Impact of the Massachusetts tobacco control programme: population based trend analysis. BMJ. 2000; 321: 351-354.

Massachusetts Department of Public Health. Adolescent Tobacco Use in Massachusetts: Trends Among Public School Students, 1996-1999. Boston, MA: Department of Public Health, 2000.
See also in Tob Control (2002).

Centers for Disease Control and Prevention. Cigarette smoking before and after an excise tax increase and an antismoking campaign–Massachusetts. MMWR 1996; 45: 966-970.

Centers for Disease Control and Prevention. Decline in cigarette consumption following implementation of a comprehensive tobacco prevention and education program–Oregon. MMWR. 1998; 48: 140-143.

Arizona Department of Health Services. Arizona Adult Tobacco Survey Report. Phoenix, AZ: Arizona Department of Health Services, Bureau of Public Health Statistics. 2000.

Tallahassee FL. Department of Health, Bureau of Epidemiology. Florida Youth Tobacco Survey 2001. Volume 4, Report 1, 2001.

Bauer UE, Johnson TM, Hopkins RS, Brooks RG. Changes in youth cigarette use and intentions following implementation of a tobacco control program: findings from the Florida Youth Tobacco Survey, 1998-2000. JAMA. 2000; 284: 723-728.

Tauras JA, Chaloupka FJ, Farrelly MC, Giovino GA, Wakefield M, Johnston LD, O'Malley PM, Kloska DD, Pechacek TF. State tobacco control spending and youth smoking. Am J Public Health. 2005; 95(2): 338-344.

Farrelly MC, Pechacek TF, Chaloupka FJ. The impact of tobacco control program expenditures on aggregate cigarette sales. J Health Econ. 2003; 22: 843-859.

Farrelly MC, Pechacek TF, Thomas KY, Nelson D. The impact of tobacco control programs on adult smoking. Am J Public Health. 2008; 98(2): 304-309.

American Lung Association. State of Tobacco Control 2013 Report. 2013

U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2012.

Dobbie F, Hiscock R, Leonardi-Bee J, Murray S, Shahab L, Aveyard P, Coleman T, McEwen A, McRobbie H, Purves R, Bauld L. Evaluating long-term outcomes of NHS stop smoking services (ELONS): a prospective cohort study. Health Technol Assess. 2015; 19: 1-156.

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