Tobacco Use and the ASSIST program

Study Shows Tobacco Control Programs May Decrease Smoking

WASHINGTON, D.C. — December 5, 2003 — The American Stop Smoking Intervention Study (ASSIST), an 8–year project funded by the National Cancer Institute, showed that state tobacco control programs can reduce smoking rates, according to a recent report (J Natl Cancer Inst. 2003 Nov 19; 95(22): 1681–91). The ASSIST program provided funding to 17 states to promote smoke–free places, counter tobacco advertising, limit tobacco access, and increase tobacco prices through excise taxes.

The researchers compared changes in smoking prevalence (the number of people who smoke), per capita cigarette consumption (the amount of cigarettes smoked per person), and tobacco control policies between the 17 ASSIST states and the 33 non–ASSIST states and the District of Columbia. The ASSIST states were: Colorado, Indiana, Maine, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New Mexico, New York, North Carolina, Rhode Island, South Carolina,Virginia, West Virginia, Washington, Wisconsin.

They found that ASSIST states had a greater reduction in the prevalence of adult smoking than did non–ASSIST states. ASSIST states also had lower per capita cigarette consumption than non–ASSIST states, although the difference was not statistically significant. States that emphasized tobacco control programs had larger decreases in per capita cigarette consumption, implying that changes in tobacco control policies could help reduce cigarette smoking.

The study authors estimated that the reduction in adult smoking prevalence associated with ASSIST could have translated into about 278,700 fewer smokers nationwide if all states had implemented ASSIST. “Our research emphasizes the importance of strong tobacco control programs and effective policies,” said Dr. Frances Stillman, the primary author of the study and director of the ASSIST evaluation (National Cancer Institute, Press Release, November 9, 2003). “States can reduce smoking prevalence and the enormous health and economic burden of smoking if they put in place proven programs and policies.”

Tobacco Use and Health Risks

Smoking cigarettes causes lung cancer, emphysema, heart attacks and strokes. Nearly one in every five deaths in the United States is smoking–related, and tobacco use results in annual medical costs of more than $75 billion (Centers for Disease Control, Tobacco Information and Prevention Source). (For more statistics about tobacco use, see Targeting Tobacco Use).

Unfortunately, cigarette marketing has increased about 67% in recent years, according to a Federal Trade Commission report. The ASSIST study authors pointed out that during the ASSIST evaluation period, tobacco companies opposed tobacco control policies and spent $47 billion to market cigarettes and other tobacco products. They believe that the impact of this tobacco spending may have reduced the potential impact of the ASSIST program somewhat. They also noted that the flow of tobacco information between states was not restricted, and could have had some influence on the study results. “Even given these factors,” Stillman said, “the results of this ASSIST evaluation add to the body of research documenting that strong policy–focused interventions can have a significant effect on smoking behavior.”