Interventions that have the greatest chance of reducing tobacco use in the population are those that reach the most smokers repeatedly and make tobacco use less appealing, such as increasing tobacco taxes, restricting tobacco product marketing, implementing smoke-free policies, sponsoring hard hitting anti-tobacco media campaigns, and changing policies to dramatically increase access to cessation support.
Numerous studies by SAPRP investigators and others have found that various policies that make tobacco use less affordable, convenient and attractive can increase quit rates. The impact of such policies on reducing tobacco use appears to be enhanced when they are implemented simultaneously.
The effectiveness of such an approach was demonstrated in New York City after implementation of a comprehensive tobacco control plan that included increasing the cigarette excise tax; legal action that made virtually all work-places, including bars and restaurants, smoke free; a paid public education campaign about the risks of smoking; and improved access to cessation services, including a large-scale free nicotine-patch program.
Simulation models have also been used by SAPRP investigators to estimate how different tobacco control policies might impact smoking rates in the population. Using a dynamic simulation model of smoking trends, known as SimSmoke, it was found that by 2010, the aging of older population groups and the impact of policies implemented in years prior to 2004 would produce smoking rates of approximately 18.4%, which is substantially short of the national 2010 goal of 12%. According to SimSmoke, if policies such as higher taxes and clean air laws are implemented, smoking rates would be substantially reduced and come closer to reaching the 2010 goal.
In August 2002, the Subcommittee on Cessation of the federal Interagency Committee on Smoking and Health (ICSH) was charged with developing recommendations to substantially increase rates of tobacco cessation in the United States. The subcommittee's report, A National Action Plan for Tobacco Cessation, outlined 10 recommendations for reducing premature morbidity and mortality by helping millions of Americans stop using tobacco.
The plan includes various strategies designed to promote cessation, such as establishment of a national "quitline" network and a $2 per pack excise tax increase to pay for a Smokers' Health Fund.
The main elements of the ICSH plan also were reiterated and expanded upon in a 2007 report by the Institute of Medicine (IOM), which also outlined a national plan for reducing tobacco use. The IOM report describes a strategy that includes strengthening and fully implementing existing tobacco control measures known to be effective in discouraging tobacco use and expanding the regulatory framework for tobacco to limit the marketing of addictive products.
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