Surveillance and Evaluation Data Resources for Comprehensive Tobacco Control Programs
Surveillance of tobacco use and evaluation of tobacco control programs are two keys to the success in reducing the prevalence of smoking since the U.S. Surgeon General first publicized the adverse consequences of tobacco use in a 1964 report.
In many areas of health promotion and disease prevention, the behavior of populations has been difficult to track. However, trends in tobacco use have been known since the beginning of the 20th century. Tobacco use rose inexorably from 1900 to 1965, declining only during the early years of the great depression and other economic downturns. These declines gave the first clue that pricing and taxing could significantly affect tobacco use. But price is not the only factor that affects tobacco use. The nonsmokers' rights movement and the Surgeon General’s Report on the health hazards associated with secondhand tobacco smoke—as well as a doubling in the federal cigarette tax—all contributed to a decline in tobacco use that began in the mid-1970s.
In recent years, monitoring and evaluation of tobacco control activities in California, Massachusetts, and Oregon have shown that aggressive and comprehensive tobacco control programs are effective in reducing cigarette smoking. For example, California was the first state to implement a comprehensive tobacco control program and is now seeing changes in longterm health outcomes, notably a 4.8% decline in lung cancer rates among men and women from 1988 to 1997, while rates in other regions increased by 13.2%. In Oregon, the smoking prevalence among 8th graders declined for the first time in recent history (from 21% in 1998 to 15% in 1999) after the state implemented a comprehensive tobacco control program that included hard-hitting media messages, innovative cessation programs, and widespread efforts to promote smoke-free workplaces. Massachusetts established a comprehensive tobacco control program in 1993 and saw a 30% decline in per capita cigarette purchases from 1992 to 1998. These and other findings led to the development of CDC’s Best Practices for Comprehensive Tobacco Control Programs, which stipulates that surveillance and evaluation, along with eight other elements are necessary to ensure that tobacco control programs achieve their goals.
Comprehensive tobacco use prevention and control programs use the research data and strategies described in CDC’s Best Practices, the 2000 Surgeon General’s Report Reducing Tobacco Use, and the Task Force on Community Preventive Services' tobacco-related recommendations. Using these three publications in conjunction with data from the sources listed in this publication will create a strong foundation for generating action at the state level and achieving the Healthy People 2010 tobacco objectives within the next decade.
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