The Effect of Prices, Programs, and Smoke-free Homes on Smoking Behavior in the 1990s Evidence from...
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The Effect of Prices, Programs, and Smoke-free Homes on Smoking Behavior in the 1990s Evidence from Population Surveys • John Pierce, UC San Diego • Wael Al Delaimy, UC San Diego • Karen Messer, UC San Diego • Dennis Trinidad, UC San Diego • Hao Tang, California Dept. of Health Services
The Effect of Prices, Programs, and Smoke-free Homes on Smoking Behavior in the 1990s Evidence from Population Surveys John Pierce, UC San Diego Wael Al
The Effect of Prices, Programs, and Smoke-free Homes on Smoking
Behavior in the 1990s Evidence from Population Surveys John Pierce,
UC San Diego Wael Al Delaimy, UC San Diego Karen Messer, UC San
Diego Dennis Trinidad, UC San Diego Hao Tang, California Dept. of
Health Services
Slide 2
Overall Goals of Tobacco Control Programs Reduce future health
consequences Encourage smokers to quit For those who dont quit,
reduce their smoking level Discourage nonsmokers from starting
Protect nonsmokers from secondhand smoke
Slide 3
CDCs Recommended Best Practices for Effective Tobacco Control,
1999 1.Increase the excise tax on cigarettes to increase price 2.
Statewide comprehensive programs (has central organization,
technical assistance, demonstration projects) Encouragement and
support of local community initiatives $0.70/person/year School
programs $4-6/K-12 student/year Enforcement programs (e.g. youth
access restrictions $0.43-0.83 per person/year) Counter-marketing
media campaign $1-3/person Cessation programs (statewide quitline,
clinic initiative)
Slide 4
Two Statewide Comprehensive Programs in the United States in
the Early 1990s California: 1989-present Population: 36 million
Includes excise tax increases Includes statewide smoke-free
workplace law (1994) Massachusetts: 1993- 2002 Population: 5
million Includes excise taxes No statewide smoke-free workplace
law
Slide 5
Tobacco Control Per Capita Expenditures: Massachusetts vs.
California Massachusetts California Recommended
Slide 6
Only California Had Smoke-free Workplace Law Smoke-free
workplaces are associated with voluntary smoke-free homes
Smoke-free homes lead to: Lower levels of cigarette consumption
among current smokers Less relapse following quit attempt Lower
levels of uptake by adolescents
Slide 7
Adults (18+ Years) with a Home Smoking Ban
Slide 8
Comparing Effects of California and Massachusetts Campaigns
What State Groups Should Be Used? Need to control for price of
cigarettes and other social norms related to smoking Group 1:
Tobacco-growing states H o : lower price, lower excise tax, lower
social norms Group 2: Two other large states with same price and
excise tax as California and Massachusetts, but no program
Slide 9
Cigarette Price (2002 $s) CA NY NJ * = Tobacco-Growing States
MA Highest price for tobacco-growing states California price
Slide 10
Top 6 Tobacco-Growing States Cash Receipts Excise Tax & in
1994 Rank in 2005 1.North Carolina $871m$0.05 (50 th ) 2.Kentucky
$615m $0.03 (51 st ) 3.South Carolina $187m$0.07 (49th) 4.Tennessee
$178m$0.20 (45 th ) 5.Virginia $147m$0.20 (45 th ) 6.Georgia
$133m$0.37 (41 st ) Tobacco and the Economy
Slide 11
1993 (rank) 2005 (rank) New York$0.80 (3 rd ) $1.50 (8 th ) New
Jersey$0.64 (12 th ) $2.40 (2 nd ) Tobacco control program states
Massachusetts$0.75 (5 th ) $1.51 (6 th ) California$0.59 (17 th )
$0.87 (21 st ) Large Population States with High Excise Taxes on
Cigarettes
Slide 12
Trends in Affordability (% Disposable Income) of a Pack of
Cigarettes,1988-2002 MSA No major difference between states on
cigarette affordability No change in affordability between 1992 and
1998 All state groups had a major decrease in affordability
starting in 1999
Slide 13
California NY/NJ Tobacco States Per Capita Expenditure on
Tobacco Control in Selected US States Recommended
Slide 14
Data Sources Current Population Surveys (age 15+) Ongoing
State-specific surveys of 45,000 households/month conducted by
Bureau of Census includes 4 month follow-back to estimate labor
force participation Tobacco Use Supplements in specific months in
1955, 1985, 1989, 1992-3, 1995-6, 1998-9, 2002-3 Since 1992, NCI
coordinated additional telephone follow-up to increase % who
self-report tobacco use California Tobacco Surveys (age 12+)
Telephone surveys of 34,000 CA households in 1990, 1993, 1996,
1999, 2002.
Slide 15
Smoking Behaviors That We Considered Among Non-Hispanic White
Population Consumption level among current smokers Wael Al-Delaimy
Quitting activity Karen Messer Differences in smoking behavior in
African Americans across these states Dennis Trinidad California
effect on smoking initiation Hao Tang