American Journal of Epidemiology, Vol 152, Issue 8 727-738, Copyright © 2000 by Oxford University Press
EA Gilpin, FA Stillman, AM Hartman, JT Gibson and JP Pierce
Public health tobacco control efforts have increasingly targeted
communities in addition to individuals. Before population smoking
decreases, effectiveness might be detected from initial outcomes reflecting
these efforts, such as higher cigarette prices or more workplace and home
smoking restrictions. Presumably, these initial outcomes will eventually
influence smoking behavior. State-specific estimates of percentages of the
population working or living under smoking bans are available from the
1992-1993 tobacco use supplement to the Current Population Survey,
conducted annually by the US Bureau of the Census. In addition, the tobacco
industry reports the average state cigarette price yearly. The authors
constructed a tobacco control initial outcomes index (IOI) by using values
of these variables for each state and correlated it with state-specific
adult (aged > or =25 years) and youth (aged 15-24 years) smoking
prevalence computed from the Current Population Survey and per capita
cigarette consumption data computed from sales and Census Bureau data. Both
adult smoking prevalence (r = -0.70) and per capita consumption (r = -0.73)
were significantly correlated with the IOI; youth smoking prevalence
correlated less well (r = -0.34). Although the analysis is not definitive,
deseasonalized 1983-1997 consumption trends for IOI-based tertile groups
were divergent beginning in 1993, with the high IOI group showing the
greatest decrease. A high relative IOI index may be predictive of future
smoking decreases and should be considered when tobacco control efforts are
evaluated.
Index for US state tobacco control initial outcomes [In Process Citation]
Cancer Prevention and Control Program, University of California, San Diego, Cancer Center, La Jolla 92037-0645, USA.
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