Calif. Leads Nation in Quitting Smoking; Anti-Tobacco Policies Credited

Researchers have found that when it comes to quitting smoking, Californians have done better than people from the rest of the nation, probably because of stricter tobacco control policies, The Los Angeles Times reported March 16.

The research team reviewed smoking data between 1965 and 2007, and compared how smoking patterns changed over time and by age. According to the study abstract, they analyzed data from the National Health Interview Surveys, 1965-1994, and from the Current Population Survey Tobacco Supplements, 1992-2007.

Overall, the researchers compared 139,176 Californians with 1,662,353 respondents from other states. They divided smokers into three categories: high-intensity, consuming 20 or more cigarettes a day; moderate-to-high-intensity, smoking 10-19 cigarettes a day; and low-intensity, smoking 0-9 a day.

Smoking rates in the low-intensity cohort did not change significantly in either California or the United States: California started at 7.1 percent in 1965, the rest of the U.S. started at 7.0 percent — and both fell to 5.3 percent by 2007.

High-intensity smoking rates told a different story. By 2007, California's high-intensity smoking rate dropped to just over one-tenth of its 1965 rate, whereas high-intensity smoking rates in the United States only fell to about one-third of their 1965 level. Nearly a quarter of California's adults (23.2 percent) smoked 20 or more cigarettes a day in 1965, compared with 22.9 percent in the rest of the nation. As of 2007, only 2.6 percent of adults in California smoked 20 or more a day, while 7.2 percent of the remainder of the U.S. did.

The same trend was visible among moderate-to-high-intensity smokers. Between 1965 and 2007, the mid-range smoking rate in California plunged from 11.1 percent to 3.4 percent, but dropped less steeply in the rest of the country, from 10.5 percent to 5.4 percent.

How did California do it? The researchers said the difference was due to over forty years of investment in tobacco control and aggressive anti-tobacco policies, including cigarette taxes and anti-smoking ordinances.

“In 1968, California was the first state to aggressively raise its cigarette tax … [and] the first state to introduce an ongoing, well-funded comprehensive tobacco control program, which has been in place since 1989,” the authors of the study wrote.

“Ordinances restricting cigarette smoking in the workplace were first introduced in California in 1976 and increased rapidly throughout the 1980s.”

California residents appear to be reaping the rewards. The researchers say that lung cancer now claims fewer lives in that state than elsewhere in the U.S. After reaching a high of 109 deaths for every 100,000 people in 1987, California's lung cancer rates dropped to 77 per 100,000 people by 2007, while they remained at 102 deaths per 100,000 in the remainder of the country.

The study, “Prevalence of Heavy Smoking in California and the United States, 1965-2007,” was published in the March 16, 2011 issue of The Journal of the American Medical Association.

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