Reducing tobacco use: what works in the population?

One-half of those who have ever smoked cigarettes are currently former smokers. This cessation coincided with a forty-year effort to educate and inform smokers about the risks of smoking. This paper examines the effects of several tobacco control interventions for smokers in the general population using population-based survey data. States with large media-led tobacco control programs have higher rates of smoking cessation, suggesting that these comprehensive approaches can alter smoking behavior. This paper also presents evidence supporting effects on smoking cessation for restrictions on where people can smoke, increases in the cost of cigarettes, provision of physician advice to quit coupled with cessation assistance, pharmacological assistance, and telephone hotlines. It also provides evidence that many of these interventions are being implemented in the general population in ways that are less effective than expected based on clinical trials. Increasing the effectiveness of these interventions and linking multiple interventions to provide synergy offer great opportunities to improve rates of population-based cessation.