Skip to main content
NCBI home page
Tobacco Control logoLink to Tobacco Control
. 2000 Jun;9(2):177–186. doi: 10.1136/tc.9.2.177

Effectiveness of comprehensive tobacco control programmes in reducing teenage smoking in the USA

M Wakefield 1, F Chaloupka 1
PMCID: PMC1748334  PMID: 10841854

Abstract

OBJECTIVE—To describe the extent to which comprehensive statewide tobacco control programmes in the USA have made progress toward reducing teenage smoking.
DATA SOURCES—Literature search of Medline for reviews of effectiveness of programme and policy elements, plus journal articles and personal request for copies of publicly released reports and working papers from evaluation staff in each of the state programmes of California, Massachusetts, Arizona, Oregon, and Florida.
STUDY SELECTION—All studies, reports, and commentaries that provided information on aspects of programme implementation and evaluation.
DATA SYNTHESIS—Statewide comprehensive programmes show high levels of advertising recall and generally positive improvement in smoking related beliefs and attitudes among teenagers. More fully funded programmes lead to increased mass media campaign advertising and community initiatives; a greater capacity to implement school based smoking prevention programmes; and an increase in the passage of local ordinances that create smoke free indoor environments and reduce cigarette sales to youth. The combination of programme activity and increased tobacco tax reduce cigarette consumption more than expected as a result of price increases alone, and these effects seem to apply to adolescents as well as adults. Programmes are associated with a decline in adult smoking prevalence, with these effects observed to date in California, Massachusetts, and Oregon. Arizona and Florida have yet to examine change in adult prevalence associated with programme exposure. California and Massachusetts have demonstrated relative beneficial effects in teenage smoking prevalence, and Florida has reported promising indications of reduced prevalence. Arizona has yet to report follow up data, and Oregon has found no change in teenage smoking, but has only two years of follow up available. One of the most critical factors in programme success is the extent of programme funding, and consequent level of programme implementation, and the degree to which this is undermined by the tobacco industry and other competitors for funding.
CONCLUSIONS—Despite the different strengths and combinations of programme messages and strategies used in these comprehensive programmes, there is evidence that they lead to change in factors that influence teenage smoking, and to reductions in teenage smoking.


Keywords: comprehensive tobacco control programmes; teenage smoking

Full Text

The Full Text of this article is available as a PDF (150.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aguinaga Bialous S., Glantz S. A. Arizona's tobacco control initiative illustrates the need for continuing oversight by tobacco control advocates. Tob Control. 1999 Summer;8(2):141–151. doi: 10.1136/tc.8.2.141. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bauman K. E., Brown J. D., Bryan E. S., Fisher L. A., Padgett C. A., Sweeney J. M. Three mass media campaigns to prevent adolescent cigarette smoking. Prev Med. 1988 Sep;17(5):510–530. doi: 10.1016/0091-7435(88)90050-3. [DOI] [PubMed] [Google Scholar]
  3. Bauman K. E., LaPrelle J., Brown J. D., Koch G. G., Padgett C. A. The influence of three mass media campaigns on variables related to adolescent cigarette smoking: results of a field experiment. Am J Public Health. 1991 May;81(5):597–604. doi: 10.2105/ajph.81.5.597. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Begay M. E., Glantz S. A. Question 1 tobacco education expenditures in Massachusetts, USA. Tob Control. 1997 Autumn;6(3):213–218. doi: 10.1136/tc.6.3.213. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Biener L., Aseltine R. H., Jr, Cohen B., Anderka M. Reactions of adult and teenaged smokers to the Massachusetts tobacco tax. Am J Public Health. 1998 Sep;88(9):1389–1391. doi: 10.2105/ajph.88.9.1389. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Botvin G. J., Renick N. L., Baker E. The effects of scheduling format and booster sessions on a broad-spectrum psychosocial approach to smoking prevention. J Behav Med. 1983 Dec;6(4):359–379. doi: 10.1007/BF00846324. [DOI] [PubMed] [Google Scholar]
  7. Bruvold W. H. A meta-analysis of adolescent smoking prevention programs. Am J Public Health. 1993 Jun;83(6):872–880. doi: 10.2105/ajph.83.6.872. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Centers for Disease Control and Prevention (CDC) Cigarette smoking among high school students--11 states, 1991-1997. MMWR Morb Mortal Wkly Rep. 1999 Aug 13;48(31):686–692. [PubMed] [Google Scholar]
  9. Chaloupka F. J., Wechsler H. Price, tobacco control policies and smoking among young adults. J Health Econ. 1997 Jun;16(3):359–373. doi: 10.1016/s0167-6296(96)00530-9. [DOI] [PubMed] [Google Scholar]
  10. DiFranza J. R., Richards J. W., Paulman P. M., Wolf-Gillespie N., Fletcher C., Jaffe R. D., Murray D. RJR Nabisco's cartoon camel promotes camel cigarettes to children. JAMA. 1991 Dec 11;266(22):3149–3153. [PubMed] [Google Scholar]
  11. Eckhardt L., Woodruff S. I., Elder J. P. Related effectiveness of continued, lapsed, and delayed smoking prevention intervention in senior high school students. Am J Health Promot. 1997 Jul-Aug;11(6):418–421. doi: 10.4278/0890-1171-11.6.418. [DOI] [PubMed] [Google Scholar]
  12. Elder J. P., Edwards C. C., Conway T. L., Kenney E., Johnson C. A., Bennett E. D. Independent evaluation of the California Tobacco Education Program. Public Health Rep. 1996 Jul-Aug;111(4):353–358. [PMC free article] [PubMed] [Google Scholar]
  13. Evans N., Farkas A., Gilpin E., Berry C., Pierce J. P. Influence of tobacco marketing and exposure to smokers on adolescent susceptibility to smoking. J Natl Cancer Inst. 1995 Oct 18;87(20):1538–1545. doi: 10.1093/jnci/87.20.1538. [DOI] [PubMed] [Google Scholar]
  14. Flay B. R., Koepke D., Thomson S. J., Santi S., Best J. A., Brown K. S. Six-year follow-up of the first Waterloo school smoking prevention trial. Am J Public Health. 1989 Oct;79(10):1371–1376. doi: 10.2105/ajph.79.10.1371. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Flynn B. S., Worden J. K., Secker-Walker R. H., Pirie P. L., Badger G. J., Carpenter J. H., Geller B. M. Mass media and school interventions for cigarette smoking prevention: effects 2 years after completion. Am J Public Health. 1994 Jul;84(7):1148–1150. doi: 10.2105/ajph.84.7.1148. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Forster J. L., Murray D. M., Wolfson M., Blaine T. M., Wagenaar A. C., Hennrikus D. J. The effects of community policies to reduce youth access to tobacco. Am J Public Health. 1998 Aug;88(8):1193–1198. doi: 10.2105/ajph.88.8.1193. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Forster J. L., Wolfson M. Youth access to tobacco: policies and politics. Annu Rev Public Health. 1998;19:203–235. doi: 10.1146/annurev.publhealth.19.1.203. [DOI] [PubMed] [Google Scholar]
  18. Goldman L. K., Glantz S. A. The passage and initial implementation of Oregon's Measure 44. Tob Control. 1999 Autumn;8(3):311–322. doi: 10.1136/tc.8.3.311. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Goldstein A. O., Fischer P. M., Richards J. W., Jr, Creten D. Relationship between high school student smoking and recognition of cigarette advertisements. J Pediatr. 1987 Mar;110(3):488–491. doi: 10.1016/s0022-3476(87)80523-1. [DOI] [PubMed] [Google Scholar]
  20. Hu T. W., Sung H. Y., Keeler T. E. Reducing cigarette consumption in California: tobacco taxes vs an anti-smoking media campaign. Am J Public Health. 1995 Sep;85(9):1218–1222. doi: 10.2105/ajph.85.9.1218. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Hu T. W., Sung H. Y., Keeler T. E. The state antismoking campaign and the industry response: the effects of advertising on cigarette consumption in California. Am Econ Rev. 1995 May;85(2):85–90. [PubMed] [Google Scholar]
  22. Lewit E. M., Hyland A., Kerrebrock N., Cummings K. M. Price, public policy, and smoking in young people. Tob Control. 1997;6 (Suppl 2):S17–S24. doi: 10.1136/tc.6.suppl_2.s17. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Manley M., Lynn W., Payne Epps R., Grande D., Glynn T., Shopland D. The American Stop Smoking Intervention Study for cancer prevention: an overview. Tob Control. 1997;6 (Suppl 2):S5–11. doi: 10.1136/tc.6.suppl_2.s5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. McKinlay J. B. More appropriate evaluation methods for community-level health interventions. Introduction to the special issue. Eval Rev. 1996 Jun;20(3):237–243. doi: 10.1177/0193841X9602000301. [DOI] [PubMed] [Google Scholar]
  26. Pentz M. A., Dwyer J. H., MacKinnon D. P., Flay B. R., Hansen W. B., Wang E. Y., Johnson C. A. A multicommunity trial for primary prevention of adolescent drug abuse. Effects on drug use prevalence. JAMA. 1989 Jun 9;261(22):3259–3266. [PubMed] [Google Scholar]
  27. Perry C. L., Kelder S. H., Murray D. M., Klepp K. I. Communitywide smoking prevention: long-term outcomes of the Minnesota Heart Health Program and the Class of 1989 Study. Am J Public Health. 1992 Sep;82(9):1210–1216. doi: 10.2105/ajph.82.9.1210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Perry C. L., Klepp K. I., Shultz J. M. Primary prevention of cardiovascular disease: communitywide strategies for youth. J Consult Clin Psychol. 1988 Jun;56(3):358–364. doi: 10.1037//0022-006x.56.3.358. [DOI] [PubMed] [Google Scholar]
  29. Pierce J. P., Choi W. S., Gilpin E. A., Farkas A. J., Berry C. C. Tobacco industry promotion of cigarettes and adolescent smoking. JAMA. 1998 Feb 18;279(7):511–515. doi: 10.1001/jama.279.7.511. [DOI] [PubMed] [Google Scholar]
  30. Pierce J. P., Dwyer T., Frape G., Chapman S., Chamberlain A., Burke N. Evaluation of the Sydney "Quit. For Life" anti-smoking campaign. Part 1. Achievement of intermediate goals. Med J Aust. 1986 Mar 31;144(7):341–344. [PubMed] [Google Scholar]
  31. Pierce J. P., Gilpin E. A., Emery S. L., White M. M., Rosbrook B., Berry C. C., Farkas A. J. Has the California tobacco control program reduced smoking? JAMA. 1998 Sep 9;280(10):893–899. doi: 10.1001/jama.280.10.893. [DOI] [PubMed] [Google Scholar]
  32. Pierce J. P., Macaskill P., Hill D. Long-term effectiveness of mass media led antismoking campaigns in Australia. Am J Public Health. 1990 May;80(5):565–569. doi: 10.2105/ajph.80.5.565. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Popham W. J., Potter L. D., Hetrick M. A., Muthén L. K., Duerr J. M., Johnson M. D. Effectiveness of the California 1990-1991 tobacco education media campaign. Am J Prev Med. 1994 Nov-Dec;10(6):319–326. [PubMed] [Google Scholar]
  34. Rigotti N. A., DiFranza J. R., Chang Y., Tisdale T., Kemp B., Singer D. E. The effect of enforcing tobacco-sales laws on adolescents' access to tobacco and smoking behavior. N Engl J Med. 1997 Oct 9;337(15):1044–1051. doi: 10.1056/NEJM199710093371505. [DOI] [PubMed] [Google Scholar]
  35. Shopland D. R. Smoking control in the 1990s: a national cancer institute model for change. Am J Public Health. 1993 Sep;83(9):1208–1210. doi: 10.2105/ajph.83.9.1208. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Stillman F., Hartman A., Graubard B., Gilpin E., Chavis D., Garcia J., Wun L. M., Lynn L., Manley M. The American Stop Smoking Intervention Study. Conceptual framework and evaluation design. Eval Rev. 1999 Jun;23(3):259–280. doi: 10.1177/0193841X9902300301. [DOI] [PubMed] [Google Scholar]
  37. Tobler N. S. Drug prevention programs can work: research findings. J Addict Dis. 1992;11(3):1–28. doi: 10.1300/J069v11n03_01. [DOI] [PubMed] [Google Scholar]
  38. Wakefield M. A., Chaloupka F. J. Improving the measurement and use of tobacco control "inputs". Tob Control. 1998 Winter;7(4):333–335. doi: 10.1136/tc.7.4.333. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Tobacco Control are provided here courtesy of BMJ Publishing Group

RESOURCES