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Journal of Urban Health : Bulletin of the New York Academy of Medicine logoLink to Journal of Urban Health : Bulletin of the New York Academy of Medicine
. 2005 Mar;82(1):58–70. doi: 10.1093/jurban/jti008

Smoking practices in New York City: The use of a population-based survey to guide policy-making and programming

Farzad Mostashari 1,✉, Bonnie D Kerker 1, Anjum Hajat 3, Nancy Miller 4, Thomas R Frieden 2
PMCID: PMC3456623  PMID: 15738335

Abstract

To inform New York City’s (NYC’s) tobacco control program, we identified the neighborhoods with the highest smoking rates, estimated the burden of second-band smoke exposure, assessed the early response to state taxation, and examined cessation practices. We used a stratified random design to conduct a digit-dialed telephone survey in 2002 among 9,674 New York City adults. Our main outcome measures included prevalence of cigarette smoking, exposure to second-hand smoke, the response of smokers to state tax increases, and cessation practices. Even after controlling for sociodemographic factors (age, racelethnicity, income, education, marital status, employment status, and foreign-born status) smoking rates were highest in Central Harlem and in the South Bronx. Sixteen percent of nonsmokers reported frequent exposure to second-hand smoke at home or in a workplace. Among smokers with a child with asthma, only 33% reported having a no-smoking policy in their homes. More than one fifth of smokers reported reducing the number of cigarettes they smoked in response to the state tax increase. Of current smokers who tried to quit, 65% used no cessation aid. These data were used to inform New York City’s smoke-free legislation, taxation, public education, and a free nicotine patch give-away program. In conclusion, large, local surveys can provide essential data to effectively advocate for, plan, implement, and evaluate a comprehensive tobacco control program.

Keywords: Smoking prevalence, Tobacco control, Tobacco use cessation, Community health surveys, Health policy, Taxation

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Footnotes

Dr. Mostashari (the guarantor) made substantial contributions to the conception, design, and supervision of this paper, the analysis and interpretation of data, the drafting of the paper, critical revisions of the paper for important intellectual content, and the acquisition of data and funding for this research. Dr. Kerker made substantial contributions to the analysis and interpretation of data, the drafting of the paper and critical revisions of the paper for important intellectual content. Ms. Hajat made substantial contributions to the acquisition of data and critical revisions of the paper for important intellectual content. Dr. Miller made substantial contributions to the conception of this paper and critical revisions of the paper for important intellectual content. Dr. Frieden made substantial contributions to the conception, design, and supervision of this paper and critical revisions of the paper for important intellectual content.

References

  • 1.Annual smoking-attributable mortality, years of potential life lost, and economic costs—United States, 1995–1999. MMWR Morb Mortal Wkly Rep. 2002;51:300–303. [PubMed]
  • 2.Hopkins DP, Briss PA, Ricard CJ, et al. Reviews of evidence regarding interventions to reduce tobacco use and exposure to environmental tobacco smoke. Am J Prev Med. 2001;20(suppl 2):16–66. doi: 10.1016/S0749-3797(00)00297-X. [DOI] [PubMed] [Google Scholar]
  • 3.Fichtenberg CM, Glantz SA. Association of the California tobacco control program with declines in cigarette consumption and mortality from heart disease. N Engl J Med. 2000;343:1772–1777. doi: 10.1056/NEJM200012143432406. [DOI] [PubMed] [Google Scholar]
  • 4.Reducing Tobacco Use: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health & Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2000. [Google Scholar]
  • 5.Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys. Ann Arbor, MI: AAPOR; 2000. [Google Scholar]
  • 6.Behavioral Risk Factor Surveillance System Survey Questionnaire. Atlanta, GA: U.S. Department of Health & Human Services, Centers for Disease Control and Prevention; 2002. [Google Scholar]
  • 7.National Health Interview Survey. Atlanta, GA: U.S. Department of Health & Human Services, Centers for Disease Control and Prevention; 2002. [Google Scholar]
  • 8.Community Health Survey. New York, NY: New York City Department of Health and Mental Hygiene; 2002. [Google Scholar]
  • 9.Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC) Atlanta, GA: United States Department of Health & Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2002. [Google Scholar]
  • 10.Frieden TR, Testimony, Thomas R, Frieden, MD, MPH, Commissioner of Health and Mental Hygiene New York City. On Intro 256-A—The Smoke-Free Air Act of 2002. Available at: http://www.nyc.gov/html/doh/html/public/testi/testi20021213.html. Accessed January 19, 2005.
  • 11.New York City Smoke-Free Air Act, chapter 5, title 17 of the New York City Administrative Code as amended by Local Law no. 47, 2003.
  • 12.Law MR, Morris JK, Wald NJ. Environmental tobacco smoke exposure and ischaemic heart disease: an evaluation of the evidence. BMJ. 1997;315:973–980. doi: 10.1136/bmj.315.7114.973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders. Washington, DC: U.S. Environmental Protection Agency; 1992. [Google Scholar]
  • 14.Jaakkola MS, Piipari R, Jaakkola N, Jaakkola JJ. Environmental tobacco smoke and adult-onset asthma: a population-based incident case-control study. Am J Public Health. 2003;93:2055–2060. doi: 10.2105/ajph.93.12.2055. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Blair PS, Fleming PJ, Bensley D, et al. Smoking and the sudden infant death syndrome: Results from 1993–95 case-control study for confidential inquiry into stillbirths and deaths in infancy. BMJ. 1996;313:195–198. doi: 10.1136/bmj.313.7051.195. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Pizacani BA, Martin DP, Stark MJ, Koepsell TD, Thompson B, Dieher P. A prospective study of household smoking bans and subsequent cessation related behavior: the role of stage of change. Tobacco Control. 2003;13:23–28. doi: 10.1136/tc.2003.003038. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Farkas AJ, Gilpin MS, White MM, Pierce JP. Association between household and workplace smoking restrictions and adolescent smoking. JAMA. 2000;284:717–722. doi: 10.1001/jama.284.6.717. [DOI] [PubMed] [Google Scholar]
  • 18.Molyneux A, Lewis S, Leivers U, et al. Clinical trial comparing nicotine replacement therapy (NRT) plus brief counselling, brief counselling alone, and minimal intervention on smoking cessation in hospital inpatients. Thorax. 2003;58:484–488. doi: 10.1136/thorax.58.6.484. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.Miller N, Frieden TR, Liu SY, et al. Effectiveness of a large free nicotine patch distribution program. In press 2005.
  • 20.McGrady GA, Pederson LL. Do sex and ethnic differences in smoking initiation mask similarities in cessation behavior? Am J Public Health. 2002;92:961–965. doi: 10.2105/ajph.92.6.961. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.Biener L, Aseltine RH, Jr, Cohen B, Anderka M. Reactions of adult and teenaged smokers to the Massachusetts tobacco tax. Am J Public Health. 1998;88:1389–1391. doi: 10.2105/ajph.88.9.1389. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22.Chaloupka FJ, Warner KE. The economics of smoking. In: Culyer AJ, Newhouse JP, editors. Handbook of Health Economics. Amsterdam: Elsevier; 2000. pp. 1539–1627. [Google Scholar]
  • 23.Fiore MC, Croyle RT, Curry SJ, et al. Preventing 3 million premature deaths and helping 5 million smokers quit: a national action plan for tobacco cessation. Am J Public Health. 2004;94:205–210. doi: 10.2105/AJPH.94.2.205. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Response to increases in cigarette prices by race/ethnicity, income and age groups —United States, 1976–1993. MMWR Morb Mortal Wkly Rep. 1998;47:605–609. [PubMed]
  • 25.Prevent All Cigarette Trafficking Act (PACT), 108th Congress, 1st Session ed. 2003.
  • 26.Agnew C, Loving T. The role of social desirability in self-reported condom use attitudes and intentions. AIDS Behav. 1998;2:229–239. doi: 10.1023/A:1022189801933. [DOI] [Google Scholar]
  • 27.Nelson DE, Holtaman D, Bolen J, Stanwyck CA. Reliability and validity of measures from the Behavioral Risk Factor Surveillance System (BRFSS) Soz Praventivmed. 2001;46:S3–S42. doi: 10.1007/BF01318790. [DOI] [PubMed] [Google Scholar]
  • 28.Bowlin SJ, Morril BD, Nafziger AN, Jenkins PL, Lewis C, Pearson TA. Validity of cardiovascular disease risk factors assessed by telephone survey: the Behavioral Risk Factor Survey. J Clin Epidemiol. 1993;46:561–571. doi: 10.1016/0895-4356(93)90129-O. [DOI] [PubMed] [Google Scholar]

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