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In 1989, California became the first US state to establish a Comprehensive Tobacco Control Program, with a primary goal to reduce tobacco use throughout the state. Funded by a voter-introduced increase in the tobacco tax (a tax increase which itself has been shown to reduce tobacco use), the program includes funding for research into “the prevention, causes, and treatment of tobacco-related diseases.” This includes research into effective Tobacco Control policies which reduce initiation of smoking among adolescents, which help existing smokers to quit smoking, and which help protect non-smokers from secondhand tobacco smoke. As part of program evaluation, since 1990 the California Department of Health Services has contracted with the UCSD Tobacco Control group to conduct the California Tobacco Survey, a large population survey of attitudes, behaviors, and media exposure regarding smoking and tobacco use. This survey interviews a random sample of twenty thousand to thirty thousand California adolescents and adults every three years, and is a primary source of information about trends in smoking in California. However, the contract to conduct the surveys does not fund research.
In this continuation grant, we plan to complete several ongoing projects and initiate new projects which build on our existing history of research using the California Tobacco Survey and other large population surveys on tobacco use. Our research has focused on population trends and influences on tobacco-use behavior, adding to the scientific knowledge base about effective actions to reduce tobacco use. During the current three year funding period we have published thirty five research papers which investigate patterns of tobacco use and what works in tobacco control.
For example, under the existing TRDRP grant our recent work has shown that adolescent receptivity to tobacco advertising (having a favorite cigarette ad or a tobacco promotional item) predicts future adult smoking, and that the strength of this relationship did not abate after the Master Settlement Agreement in 1998. However, on the positive side, our work also shows that the proportion of California adolescents who are receptive to such advertising has diminished, and that adolescent smoking rates are down sharply in California.
In the present grant we plan to continue this work under three main topics. First, we will compare the population effectiveness of differing tobacco control policies among US states which have widely varying approaches to tobacco control, including among diverse subpopulations. For example, a proposed project investigates whether the California program was associated specifically with decreased smoking uptake, increased quitting and/or reduced smoking intensity among Mexican-American Californians. As a comparison group, we propose to use the significant populations of Mexican Americans in other states, such as Texas, that have not had a well-funded tobacco control program.
We will also investigate evidence for an association of tobacco industry activity with increases in harmful tobacco-use behaviors. For example, marketing activity by the tobacco industry targeting young adults has recently increased, especially in bars and clubs, including over 20,000 “bar nights” sponsored by the tobacco industry in California in 2004 alone. We will explore whether there is an association between attendance at bars and clubs, willingness to use a tobacco promotional item, and initiation of smoking in young adulthood (ages 18-24 years).
Finally, we will draw inferences about changing patterns and predictors of smoking behavior which have implications for future tobacco control action. For example, we have shown that there was a major decline in experimentation with cigarettes in young California teens starting in 1996. We will investigate to what extend this carried through to reduced smoking rates in adulthood, and to what extent smoking uptake patterns may have changed towards older ages. |
