In 17 states that participated in a $128 million government program to discourage tobacco, the prevalence of smoking dropped nearly a percentage point faster than in the rest of the country, a study found.
If the anti-tobacco program was used in all states and the District of Columbia it could reduce the number of smokers by about 278,700, said Frances A. Stillman, the first author of the study appearing Wednesday in the Journal of the National Cancer Institute.
The study evaluated the effect of an eight-year demonstration project called American Stop Smoking Intervention Study, or ASSIST, that was sponsored by NCI.
The anti-smoking project trained local advocacy groups to lobby for passage of higher cigarette excise taxes and to promote regulations for smoke-free environments. The program also mounted a public relations effort to counter an estimated $47 billion spent by industry to market tobacco products during the study period and included efforts to limit underage access to tobacco.
States included in the study were Colorado, Indiana, Maine, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New Mexico, New York, North Carolina, Rhode Island, South Carolina, Virginia, West Virginia, Washington and Wisconsin.
‘A real bargain'
At $128 million, the program spent about $1,200 for each smoker who kicked the habit. Elizabeth A. Gillian, a University of California, San Diego, researcher and a co-author of the study, called that cost “a real bargain.”
Studies by the Centers for Disease Control and Prevention suggest that cigarette smoking is responsible for more that 440,000 deaths a year in the United States. Smoking has been linked to heart disease, emphysema and other respiratory system diseases, stroke and a number of different types of cancer.
To evaluate the impact of ASSIST, researchers used industry sales figures and surveys that showed that smoking decreased nationally by 2.41 percentage points during the eight-year period.
In the 17 states where the ASSIST program was in action, the percentage of smokers dropped by 3.02 percentage points during the eight years, compared to a decline of only 2.11 percentage points in the other 33 states and the District of Columbia.
During the eight years of the ASSIST program, smoking among all the U.S. population dropped from 24.67 percent to 22.26 percent; in the 17 states, it dropped from 25.19 percent to 22.17 percent; and in the rest of the country, it declined from 24.41 percent to 22.30 percent.
Stillman said the 17 states included some that already had strong anti-smoking programs and some that didn’t.
She said the results showed that “states can reduce smoking prevalence and the enormous health and economic burden of smoking if they put in place proven programs and policies.”
The impact of the program may have been blunted somewhat by the tobacco industry. Stillman said the Federal Trade Commission estimates that the industry spent about $47 billion promoting tobacco products nationally during the period of the ASSIST program.
Jennifer Golisch, a spokeswoman for Philip Morris USA, Inc., the nation’s largest tobacco company, would not comment on the study. She said her company now spends $100 million a year to discourage underage smoking. Starting in 1999, she said, the company reduced its cigarette ads in magazines by 50 percent. Golisch said Philip Morris also supports regulation of smoking in public places and favors regulation of the tobacco industry by the Food and Drug Administration.