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California as a model.

D G Bal1, J C Lloyd, A Roeseler

  • 1Cancer Control Branch, California Department of Health Services, Sacramento, CA 94234-7320, USA. dbal@dhs.ca.gov

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
|September 19, 2001
PubMed
Summary
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California's Tobacco Control Program significantly reduced smoking rates and deaths by "denormalizing" tobacco. This public health initiative led to fewer smokers, lower cigarette consumption, and decreased cancer incidence.

Area of Science:

  • Public Health
  • Epidemiology
  • Tobacco Control

Background:

  • Smoking is a leading preventable cause of death, linked to heart disease, cancer, and respiratory illnesses.
  • California established its Tobacco Control Program in 1989 to combat tobacco use and its associated health consequences.
  • The program's core strategy is to "denormalize" tobacco through various interventions.

Purpose of the Study:

  • To evaluate the effectiveness of California's Tobacco Control Program in reducing tobacco use and its impact on public health.
  • To assess changes in smoking prevalence, consumption, and disease incidence following program implementation.

Main Methods:

  • The program focused on countering pro-tobacco influences, reducing environmental tobacco smoke exposure, and limiting access to tobacco products.

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  • Data on adult smoking prevalence, per capita cigarette consumption, and cancer incidence were analyzed.
  • Programmatic activities aimed at "denormalizing" tobacco were implemented statewide.

    • Main Results:

    • Adult smoking prevalence in California decreased significantly, becoming 20% lower than the national average by 1996.
    • Per capita cigarette consumption fell by over 50%, with approximately one million fewer smokers than expected.
    • Exposure to secondhand smoke declined, and California's lung and bronchus cancer incidence is decreasing at a higher rate than the national average.

    Conclusions:

    • California's Tobacco Control Program has been highly effective in reducing tobacco use and improving public health outcomes.
    • Despite program successes, the tobacco industry continues aggressive marketing, necessitating ongoing vigilance from the health community.
    • The program's comprehensive strategy of "denormalization" has demonstrably lowered smoking rates and related diseases.