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Tobacco control policies increase motivation to quit and number of quit attempts.

Tobacco control interventions include bans or restrictions on smoking in workplaces and other areas, increased the price (via taxation, etc.) of tobacco products and implementation of media campaigns. The evidence for the impact of these and other population based approaches on smoking behaviour is based on a wider range of evidence than randomized trials alone. The review by the Task Force on Community Preventive Services included studies with appropriate designs and found consistent evidence from more than one well-designed study that smoking restrictions or bans reduced consumption, and that smoking bans led to higher quit rates. Increasing the price of tobacco has the most consistent evidence of effect. A Cochrane review of mass media interventions for smoking cessation has found evidence that mass media campaigns can be effective in changing smoking behaviour in adults; however the evidence base is heterogeneous and of variable quality. Similarly Cochrane reviews have been conducted evaluating legislative and institutional smoking bans. The legislative ban review provides evidence that the introduction of bans leads to improved health outcomes through a reduction in second-hand smoke, although the evidence on respiratory and perinatal health outcomes and on smoking prevalence and consumption is limited. The institutional bans review found that settings-based policies reduce smoking rates in hospitals and universities; however overall the evidence base was deemed to be limited and in need of further high quality research.

Further evidence on Population based approaches is given in the Policy Section.

Hopkins DP, Briss PA, Ricard CJ, et al. Reviews of evidence regarding interventions to reduce tobacco use and exposure to environmental tobacco smoke. Am J Prev Med. 2001; 20: 16-66.

Centers for Disease Control and Prevention. Strategies for reducing exposure to environmental tobacco smoke, increasing tobacco-use cessation, and reducing initiation in communities and health-care systems. A report on recommendations of the Task Force on Community Preventive Services. MMWR. 2000; 49: 1-11.

Chaloupka FJ. Macro-social influences: the effects of prices and tobacco-control policies on the demand for tobacco products. Nicotine Tob Res. 1999; 1: S105-S109.

Centers for Disease Control and Prevention. Response to increases in cigarette prices by race/ethnicity, income, and age groups - United States, 1976-1993. MMWR. 1998; 47: 605-609.

Centers for Disease Control and Prevention. Cigarette smoking before and after an excise tax increase and antismoking campaign - Massachusetts, 1990-1996. MMWR. 1996; 45: 966-970.

Pierce JP, Gilpin EA, Emery SL, et al. Has the California tobacco control program reduced smoking? J Am Med Assoc. 1998; 280: 893-899.

A National Action Plan for Tobacco Cessation: Preventing 3 million deaths, helping 5 million smokers quit. Interagency Committee on Smoking and Health Subcommittee on Cessation. 2004.

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