TOBACCO PREVENTION AND CESSATION PROGRAMS

Tobacco control programs play a crucial role in the prevention of many chronic conditions such as cancer, heart disease, and respiratory illness. Comprehensive tobacco prevention and cessation programs prevent kids from starting to smoke, help adult smokers quit, educate the public, the media and policymakers about policies that reduce tobacco use, address disparities, and serve as a counter to the
ever-present tobacco industry.
Recommendations for state tobacco prevention and cessation programs are best summarized in the Center for Disease Control and Prevention’s Best Practices for Comprehensive Tobacco Control Programs. In this guidance document, CDC recommends that states establish tobacco control programs that are comprehensive, sustainable, and accountable and include state and community interventions, public education interventions, cessation programs, surveillance and evaluation and administration and management.
The empirical evidence regarding the effectiveness of comprehensive tobacco prevention and cessation
programs is vast and growing. There is more evidence than ever before that tobacco prevention and
cessation programs work to reduce smoking, save lives and save money. In 2007, the Institute of
Medicine and the President’s Cancer Panel all issued landmark reports that concluded there is
overwhelming evidence that state comprehensive state tobacco control programs substantially reduce
tobacco use and recommended that every state fund such programs at CDC-recommended levels.2
Data from numerous states that have implemented programs consistent with CDC guidelines show
significant reductions in youth and adult smoking. The most powerful evidence, however, comes from
national studies that look across states and control for as many of the relevant confounding factors as
possible. These rigorous studies consistently show effects of tobacco prevention and cessation programs.
A recent study published in the American Journal of Public Health, examined state tobacco prevention
and cessation funding levels from 1995 to 2003 and found that the more states spent on these programs,
the larger the declines they achieved in adult smoking, even when controlling for other factors such as
increased tobacco prices. The researchers also calculated that if every state had funded their programs
at the levels recommended by the U.S. Centers for Disease Control (CDC) during that period, there would
have been between 2.2 million and 7.1 million fewer smokers in the United States by 2003. The
Campaign for Tobacco-Free Kids estimates that such smoking declines would have saved between
700,000 and 2.2 million lives as well as between $20 billion and $67 billion in health care costs.
The study described above adds to earlier research, using similar methods, which demonstrated the
same type of relationship between program spending and youth smoking declines. A 2005 study
concluded that if every state had spent the minimum amount recommended by the CDC for tobacco
prevention, youth smoking rates nationally would have been between three and 14 percent lower during
the study period, from 1991 to 2000. Further, if every state funded tobacco prevention at CDC minimum
levels, states would prevent nearly two million kids alive today from becoming smokers, save more than

600,000 of them from premature, smoking-caused deaths, and save $23.4 billion in long-term, smokingrelated
health care costs.
A 2003 study published in the Journal of Health Economics found that states with the best funded and
most sustained tobacco prevention programs during the 1990s – Arizona, California, Massachusetts and
Oregon – reduced cigarette sales more than twice as much as the country as a whole (43 percent
compared to 20 percent). This study, the first to compare cigarette sales data from all the states and to
isolate the impact of tobacco control program expenditures from other factors that affect cigarette sales,
demonstrates that the more states spend on tobacco prevention, the greater the reductions in smoking,
and the longer states invest in such programs, the larger the impact. The study concludes that cigarette
sales would have declined by 18 percent instead of nine percent between 1994 and 2000 had all states
fully funded tobacco prevention programs.
A 2006 study published in the American Journal of Health Promotion provides further evidence of the
effectiveness of comprehensive tobacco control programs and tobacco control policies. The study’s
findings suggest that well-funded tobacco control programs combined with strong tobacco control policies
increase cessation rates. Quit rates in communities that experienced both policy and programmatic
interventions were higher than quit rates in communities that had only experienced policy interventions
(excise tax increases or secondhand smoke regulations). This finding supports the claim that state-based
tobacco control programs can accelerate adult cessation rates in the population and have an effect
beyond that predicted by tobacco-control policies alone.
Data from numerous states provide additional evidence of the effectiveness of comprehensive tobacco
prevention and cessation programs. States that have implemented comprehensive programs have
achieved significant reductions in tobacco use among both adults and youth. The experiences in states
from around the country who have invested in comprehensive prevention programs establish the
following key points:
· When adequately funded, comprehensive state tobacco prevention programs quickly and
substantially reduce tobacco use, save lives, and cut smoking-caused costs.
· State tobacco prevention programs must be insulated against the inevitable attempts by the tobacco
industry to reduce program funding and otherwise interfere with the programs’ successful operation.
· The programs’ funding must be sustained over time both to protect initial tobacco use reductions and
to achieve further cuts.
· When program funding is cut, progress in reducing tobacco use erodes, and the state suffers from
higher levels of smoking and more smoking-caused deaths, disease, and costs.
Unfortunately, many states faced with budget difficulties have recently made the penny-wise but poundfoolish
decision to slash the funding of even the most effective tobacco control programs, which will cost
lives and money

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