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Trends in Cigarette Smoking -- Wisconsin, 1950-1988

To assess progress in reducing cigarette smoking in Wisconsin, the Division of Health, Wisconsin Department of Health and Social Services, analyzed trends in cigarette sales from 1950 to 1988 (1). In Wisconsin, cigarette taxes are levied as an excise tax at the time cigarettes are shipped from tobacco distribution centers rather than as sales tax at the time consumers purchase them. To compensate for the time lag between shipment and sale, a 2-year moving average* of per capita cigarette sales (2) was calculated. In this report, per capita sales are the total number of cigarettes for which Wisconsin state excise tax was paid in a given year divided by the number of Wisconsin adults (i.e., residents greater than or equal to 18 years old).

In 1951, 105 packs of cigarettes (20 cigarettes per pack) were sold for every adult in the state (Figure 1). Per capita cigarette sales peaked in 1981 at 118 packs per Wisconsin adult. Four periods had sustained (greater than or equal to 3 years) declines in tobacco sales: 1954-1956, 1962-1966, 1969-1971, and 1982-1984. The greatest decline (10%) occurred from 1982 to 1983. Adapted from: Wisconsin Medical Journal 1989;88(11):40-2, and reported by: PL Remington, MD, HA Anderson, MD, Div of Health, Wisconsin Dept of Health and Social Svcs. Div of Field Svcs, Epidemiology Program Office; Office on Smoking and Health, Center for Chronic Disease Prevention and Health Promotion, CDC.

Editorial Note

Editorial Note: Since the 1950s, when studies linking lung cancer with cigarette smoking were first published, efforts to discourage smoking have increased substantially (3). These efforts have included mandatory warning labels on cigarette packs, physicians' advice to quit, antismoking advertising, worksite smoking-cessation programs, increased restriction on places to smoke, reduced insurance premiums for nonsmokers, and increased taxes on cigarettes.

In Wisconsin, the first three periods of decline in per capita sales might have been related to major national smoking and health "events" (4). The 1954-1956 decline coincided with the first major publicity on adverse effects of smoking on health, a 1952 national magazine article linking cancer and cigarettes (4); the 1962-1966 decline, with the release of additional information about adverse effects, especially the first Surgeon General's report on smoking and health in 1964; and the 1969-1971 decline, with the television broadcast of antismoking public service announcements during 1967-1970 required by the Federal Communications Commission's Fairness Doctrine (4).

The largest decrease in cigarette sales occurred during 1982-1984, concurrent with the largest cigarette tax increases: Wisconsin tax, from 16 cents to 25 cents per pack in 1981-1982 and federal tax, from 8 cents to 16 cents per pack in 1983. This decrease in cigarette sales in Wisconsin is unlikely to be due to the purchase of cigarettes by Wisconsin residents in neighboring states. Even though the price of cigarettes was 5 cents-10 cents lower per pack in Illinois and Minnesota, Wisconsin netted a 40% increase in cigarette tax collections from 1981 to 1983. In addition, cigarette sales did not increase in Wisconsin in 1986, when Illinois and Minnesota imposed higher cigarette taxes and the interstate price differential disappeared. The decrease in cigarette sales also coincided with the enactment of Wisconsin's Clear Indoor Air Act in 1983 (Figure 1) (5). This act mandated smoking restrictions in government worksites and public places to reduce the exposure of nonsmokers to environmental tobacco smoke.

Despite the limitations inherent in ecologic correlations such as this, the Wisconsin data suggest that three key antismoking publicity events (in 1952, 1964, and 1967-1970) helped to reduce cigarette sales. Nonetheless, each of these periods of reduced sales was followed by an increase in cigarette sales. Only the fourth period of reduction in cigarette sales (1982-1984) has been sustained--probably because of continuing interventions, including taxes and clean indoor air acts. This study suggests that, because of their continuous nature, public policy changes such as increased taxes and clean indoor air acts are important in achieving sustained reductions in tobacco sales.

References

  1. Peterson DE, Remington PL. Publicity, policy, and trends in cigarette smoking: Wisconsin 1950-1988. Wis Med J 1989;88(11):40-2.

  2. Tobacco Institute. The tax burden on tobacco: historical compilation. Washington, DC: The Tobacco Institute 1988;23.

  3. CDC. Reducing the health consequences of smoking: 25 years of progress--a report of the Surgeon General, 1989. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, 1989; DHHS publication no. (CDC)89-8411.

  4. Warner KE. Cigarette advertising and media coverage of smoking and health. N Engl J Med 1985;12:384-8.

  5. Wisconsin Statutes Section 101.123 (1987-88). *Incorporates data from the previous and the following year to calculate the value for a given year.



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