Anti-Smoking Effort Working, Study Finds : Health: The number of those who light up has dropped 17% in three years; a 75% reduction by the year 2000 now seems possible.
California’s ambitious smoking-control program has reduced the percentage of smokers by 17% in three years, though many of the state’s smokers are thwarted in their efforts to kick the habit, according to a poll by San Diego researchers released Tuesday.
If the trend continues, California will reach its goal of cutting smoking by 75% by the year 2000, said study co-author John Pierce, an associate professor of medicine at UCSD School of Medicine.
“We’re on target to reach what I once called a ridiculously optimistic goal,” said Pierce, who released a report on the campaign at the American Heart Assn.’s annual science writers’ meeting in Galveston, Texas.
But clearly, most smokers are stymied when they try to quit. During the past year, half of all smokers attempted to quit and only 11% were successful, said Dr. John Burns, co-author of the study and a UCSD professor of medicine.
“We are most successful in getting people to try to quit. We need to invest more effort in getting people to stay off cigarettes once they do try,” said Burns, who is also medical director of respiratory therapy at the UCSD Medical Center. “We must reduce smoking at work and reduce tobacco advertising and promotion.”
In a somewhat startling finding, only 40% of smokers who saw their doctors in the last year said they had been advised to quit. But a physician’s advice often prompted a smoker to at least try, Burns said.
In California, Burns said, “the problem we have is not convincing people to quit or try to quit but getting people to stay off.”
The figures were particularly discouraging among black men, who were most likely to try to quit and least likely to succeed. Sixty percent tried, Burns said; 4% succeeded.
The $2.5 million state-funded study, based on a random telephone poll during the past year of 26,815 adults and 7,767 adolescents, also found that smokers overwhelmingly say they want to quit and that a majority of smokers favor bans on cigarette advertising, Pierce said.
The percentage of smokers in California has dropped from 26.8% in 1987 to 22.2% in 1990, a 17% reduction, Pierce said. California is aiming to reduce smoking to 6% of the population by the year 2000, roughly a 75% drop from 1988.
The drop was caused by a high-profile television advertising campaign, education efforts with schools and doctors, and a rise of 25 cents per pack in cigarette taxes, Pierce said. The California campaign is financed with $80 million per year of the $780 million collected from the cigarette tax.
In 1988, when anti-smoking Proposition 99 was passed, it kicked off a “tremendous consciousness-raising about tobacco,” Burns said. This heightened awareness, he said, is reflected in the 17% drop among smokers. The actual anti-smoking media and school campaign began, however, in spring, 1990.
Burns and Pierce give high marks to the campaign. In their study, more than 60% of adults and two-thirds of adolescents said they had seen or heard anti-smoking messages in the seven days before they were surveyed.
Other experts applauded what they saw as California’s success.
“It confirms in part what we already knew, that a vigorous educational campaign combined with a rise in excise taxes can have a dramatic impact on smoking rates,” said Dr. Mona Sarfaty, a consultant to Sen. Edward Kennedy’s Labor and Human Resources Committee.
But industry officials downplayed the success of California’s anti-smoking campaign. Brennan Dawson, a spokeswoman for the Tobacco Institute, the industry’s lobbying organization, said the drop in smoking was due to the rise in the cost of cigarettes because of the additional tax. That produced a sharper decline in California than in the nation as a whole, she said.
The two most important stumbling blocks to further reductions among smokers are teen-agers, who continue to start up the habit, and the high failure rate of smokers who try to quit.
“Kids really respond to advertising,” Burns said. “And kids have ready access to cigarettes. They find no difficulty at all in purchasing cigarettes and vending machines appear to be one source.”
In the survey, adolescents--even those 12 to 14--told researchers that they could readily buy cigarettes from small stores or vending machines. The majority of adolescents, or 73%, also said that they had at least one class in school aimed at discussing the ills of tobacco. Nonetheless, 9% of teens reported that they smoked.
Pierce said health campaigns have been effective in discouraging adults from starting to smoke. “But our message--smoking kills--plays only to mature adults.”
Teen-agers have not responded to it, particularly in the face of tobacco advertising that associates smoking with a desirable self-image, he said.
Though teens have not been won by the anti-smoking message, the California campaign posed a victory for health officials, said the study’s authors. And it may well be an effort that other states duplicate.
Sen. Edward Kennedy, D-Mass., has introduced a bill to create a national program modeled after the California one.
His legislation would establish a center to coordinate tobacco research, create a national education campaign and tighten regulations governing cigarette sales. It also would return to the states the power to regulate tobacco advertising on billboards and public transit--a power that the states lost more than 20 years ago as part of compromise in the legislation that established the cigarette warning labels.
The Associated Press contributed to this report.
