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California's Tobacco Control Program and Tobacco-Use Trends

Institution: University of California, San Diego
Investigator(s): Karen Messer, Ph.D.
Award Cycle: 2009 (Cycle 18) Grant #: 18CA-0134 Award: $419,901
Subject Area: Public Health, Public Policy, and Economics
Award Type: California Research Award
Abstracts

Initial Award Abstract
We propose to build on our existing program of research using the California Tobacco Survey and other large state and national surveys to assess population trends in tobacco use in California. In particular we will study the association of the California Tobacco Control Program with population increases in smoking cessation and decreases in adolescent smoking initiation, as well as other trends in tobacco use such as increased adoption of smoke-free homes among California smokers. These studies will add to the scientific evidence base supporting public health efforts to reduce tobacco use in California. We are currently funded by TRDRP to do similar work, and during the current three year funding period we have published twenty research papers which investigate patterns of tobacco use as they relate to effective strategies for tobacco control. All have appeared in major research journals and several have been widely reported in the news media, helping to disseminate understanding of effective tobacco control strategies at the population level.

Under the existing TRDRP grant we have shown that smoking cessation increased during the 1990’s in the US, especially among young adult smokers. Among non-Hispanic white young adults, cessation increased more in California than in comparison states with no comprehensive tobacco control program. Among African-Americans, we found a national decline in smoking that appeared to from decreased adolescent uptake, independent of state-level tobacco control programs. Among younger smokers, there was a national trend towards lighter consumption, while for those 35 years of age and older, non-Hispanic white smokers in California smoked significantly less. We also showed that recent young adult smokers in the US quit at higher rates than older smokers, in part because more of them try to quit, and in part because they are more likely to be lighter smokers and live in smoke-free homes. Young adults were much less likely than older adults to use pharmaceutical cessation aids. Analysis of a national longitudinal sample confirmed that smokers who live in smoke-free homes are much more likely to try to quit smoking, and also to quit smoking successfully (90 + days) if they do try to quit.

In this grant we plan a series of projects to investigate recent trends in smoking behavior in California. There is evidence that the California tobacco control program has reduced adolescent experimentation with cigarettes. However, our preliminary work indicates that recent tobacco industry marketing in California may be associated with increased teen-aged experimentation, and we will attempt to confirm this finding. An important question is whether this increase in teen experimentation appears to be carrying through to young adult smoking. We will compare the experience in California to that of other states with comprehensive tobacco control programs and with the remainder of the US. We will also look at these questions separately for different race-ethnic groups (e.g. African-American, non-Hispanic white, Hispanic).

Tobacco industry marketing is known to target “pre-quitters”, and we will investigate whether recent tobacco industry marketing in California appears to be associated with reduced young adult smoking cessation. Previously, we and others have shown that African-American adult smokers quit at lower rates than their non-Hispanic white counterparts. We will investigate whether this remains true for recent cohorts of young adults, and whether these disparities appear to be less in California than in other US states.

California smokers have historically had higher rates of smoke-free-homes than in other states, and we will test whether this is still true, and whether it remains true among those with a high-school level education, and among different race-ethnic groups. We will assess how strongly a smoke-free home is associated with increased quitting and with reduced smoking uptake among children in the home.
Publications

Electronic recording, self-report, and bias in measuring cigarette consumption (commentary)
Periodical: Health Psychology Index Medicus:
Authors: Pierce JP. ART
Yr: 2009 Vol: 28 Nbr: Abs: Pg: 527-28

Changes in age trajectories of smoking experimentation during the California Tobacco Control Program
Periodical: American Journal of Public Health Index Medicus:
Authors: Messer, K, Pierce JP. ART
Yr: 2009 Vol: Nbr: Abs: Pg:

Camel No. 9 cigarette marketing campaign targeted young teenage girls
Periodical: Pediatrics Index Medicus:
Authors: Pierce JP, Messer K, James LE, White MM, Kealey S, Vallone DM, Healton CG ART
Yr: 2010 Vol: Nbr: Abs: Pg: