|
By the late 1990s, the California Tobacco Control Program (CTCP) had successfully decreased susceptibility to smoking among 15-17-year-old adolescents. However, as the age at which smoking is initiated extends from age 12 until age 24 years, it is possible that the CTCP effect was only to delay rather than prevent initiation. There is evidence that, around the year 2000, the tobacco industry increased their targeted promotion and marketing programs aimed at young adults. The CTCP effect on susceptibility to smoke during adolescence may have translated into a reduction in the proportion of the birth cohort who became adult smokers; the CTCP may also have impacted the level of daily cigarette consumption among those who did become smokers and this in turn may have led smokers in these birth cohorts to be more successful in their quit attempts as young adults. All of these smoking behaviors will be important to the future rates of smoking related diseases and if major reductions are observed, then we would hypothesize that the rates of early onset lung cancer will be much lower for these birth cohorts than comparison birth cohorts. The proposed research project aims to examine the long-term reduction in cigarette smoking behavior (starting smoking, amount smoked, quitting smoking) among the California birth cohorts identified as having lower rates of susceptibility to smoking as adolescents. In order to do this, birth cohorts of people who were adolescents in California post-implementation of the Tobacco Control Program (i.e. in 1990 or later) will be compared to previous Californian birth cohorts. In addition, to control for trends in tobacco use across the United States, we will compare the smoking behavior of these California birth cohorts with the same birth cohorts from the rest of the nation. The specific hypotheses to be examined include: H1) California birth cohorts who were adolescents in 1990 or later will have lower age-specific ever smoking, consumption patterns, and lifetime cigarette consumption and higher rates of early quitting compared to previous birth cohorts (adolescents in late 1970s and 1980s) and H2) California birth cohorts who were adolescents in 1990 or later will have lower age-specific ever smoking, consumption patterns, and lifetime cigarette consumption compared to adolescents in similar age birth cohorts from the rest of the United States, including States that later implemented tobacco control programs. In this project, we will use two large nationally representative population surveys: The Tobacco Use Supplement of the Current Population Survey and the National Health Interview Survey. We will also consider data from the state-run Behavioral Risk Factor Surveillance System that has every state represented. We propose to estimate the impacts of the California Tobacco Control Program on ever smoking, lifetime cigarette consumption reduction, and early quitting. The proposed research will use these repeated cross-sectional surveys to provide multiple estimates of smoking behavior in birth cohorts who became adolescents in the mid-1990s (i.e. those born after 1976) until they are in at least their late 20s or early 30s (the oldest would be in their mid-thirties at the time of the most recently available national smoking survey). This research will report on the magnitude of reduction on lifetime smoking behavior that occurred following CTCPs successful reduction in the proportion of teens who become susceptible to smoke. This analysis will test the justification for recommendations to focus on social norms as a prime target for tobacco control programs and hence will have a high impact on tobacco control policies. |
