Predicting progress toward cessation in California smokers
Initial Award Abstract
The main aim of this application will be to write a new proposal that will use the questionnaire developed as part of the present project to evaluate the degree to which five tobacco control strategies facilitate and/or inhibit cessation, progress-toward-cessation and relapse among California. The purpose of the questionnaire will be to evaluate the relative effectiveness of several tobacco control strategies in the encouragement of cessation, progress-toward-cessation, and prevention of relapse in current and/or former California smokers. This research extends previous evaluations of the California Tobacco Control Program. Data from the 1990-1992 longitudinal panel of the California Tobacco Survey demonstrated that three major strategies promoted by the Tobacco Control Program in California appeared to reduce smoking prevalence and consumption. Smokers who worked in smokefree workplaces, who lived in a household where smoking was generally or completely banned, or who received assistance with quitting on their most recent quit attempt were significantly more likely to quit or make progress-toward-cessation than smokers who lacked these characteristics. While these results were encouraging, they were based on retrospective, rather than prospective, data and did not prove that these policies were causally related to quitting and progress-toward cessation.
A comprehensive evaluation of the California Tobacco Control Program, besides being prospective, needs to address a broader range of tobacco control strategies and tobacco industry activities which also potentially influence cessation, progress-toward-cessation, and relapse. Other strategies include excise tax increases, the encouragement of health care providers to advise smokers to quit, and media campaigns to educate the public about the negative effects of smoking and side stream smoke. With the passage of Proposition 10 in November 1998, California will impose a 50-cent tax on a pack of cigarettes starting in January 1999, and in late 1998, the Tobacco industry reached a settlement of state suits to recover smoking-related medical costs. The industry will pass along at least some of these costs to smokers by raising cigarette prices.
The proposed follow-on study that will result from this project will use longitudinal data from a representative sample of California smokers to assess program effects. The strategies that will be evaluated by the questionnaire will include price and tax effects, workplace and household smoking restrictions, doctor’s advice and referral, as well as pro and anti-tobacco advertising. We anticipate that the findings of this study will provide valuable information on ways to enhance the effectiveness of the California Tobacco Control Program. |