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Trends in Smoking Behavior & Lung Cancer in California

Institution: University of California, San Diego
Investigator(s): John Pierce, Ph.D.
Award Cycle: 2015 (Cycle 24) Grant #: 24ST-0050 Award: $61,992
Subject Area: Public Health, Public Policy, and Economics
Award Type: Special Projects

Initial Award Abstract
In 2010, we published a peer reviewed manuscript that reported forty year (1962-2002) trends in smoking prevalence and per capita consumption in California compared to the rest of the nation. This study also reported the lung cancer rates over the same period. In the 1960s, California had a higher smoking prevalence as well as higher per capita cigarette consumption. However, on these measures, it dropped below the rest of the nation by 1971. The lung cancer rate in the state was also higher than the rest of the nation throughout the 1960s and 70s. However, lung cancer rate became lower than the rate for the rest of the nation in 1987, a lag of 16 years after the inversion of per capita cigarette consumption. These findings demonstrated strong support for the early tobacco control interventions in California. In this paper, we also noted that the implementation of the California Tobacco Control Program in 1989 was associated with per capita consumption declining at a much faster rate in California than the rest of the nation; indeed there was a doubling of the annual size of the gap in per capita consumption. However, while California has maintained its Tobacco Control program (albeit at lower per capita expenditure levels than earlier), and social norms against tobacco in the state appear to have remained particularly high, California is an anomaly when it comes to arguably one of the most important tobacco control strategies, the regular increase of state excise taxes. From 2000 to 2015, California was one of only three states not to increase taxes while, in the same period, 27 states increased their tax rate by over $1. In this update to the 2010 paper, we will test whether the more rapid declines in smoking behaviors in California continued through the first 14 years of the new millennium. Our analysis will differ from our previous paper as, after 2002, taxed sales data no longer provided a good estimate of per capita consumption in the United States as many smokers (particularly in the rest of the nation) sought out non-state-taxed sources for their cigarettes. Therefore, we will substitute estimated per capita consumption from large national survey data and test its validity. We will then update the per capita cigarette consumption data from the 2010 paper through 2014 (or most recent survey available). We will also update the comparison in the trends in lung cancer rates between California and the rest of the nation.