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States between 1989 and 1993 (Gilpin et al. 2001). The National Cancer Policy Board (a joint program of the IOM and the National Research Council) examined the evidence on the effectiveness of state programs and concluded in a 2000 report that, “multi-faceted state tobacco control programs are effective in reducing tobacco use” (IOM/NRC 2000). The evidence on the effects of the state programs is reviewed in Chapter 5.

A growing number of states, localities, and workplaces have become smoke-free. Nine states—California, Connecticut, Delaware, Maine, New York, Massachusetts, Rhode Island, Vermont, and Washington—have comprehensive, statewide smoke-free laws (ALA 2005, 2006). The laws in Florida, Idaho, and Utah exempt only stand-alone bars. Studies and economic data show that fears that restaurants and bars would suffer economically from smoking bans have not generally been borne out. Some of the strongest evidence of the impact of secondhand smoke policies comes from New York City, where a comprehensive smoking ban took effect on March 30, 2003. In the year after the law took effect, business receipts for restaurants and bars increased, the rate of employment rose, and the number of liquor licenses increased. Virtually all establishments are complying with the law, which has the support of most New Yorkers (Tobacco Free Kids 2006). According to a 2005 report, 18.4 percent of adults in New York City smoke, a decline from 19.2 percent a year earlier and a decline from 21.6 percent from 2 years earlier. These declines are significantly steeper than those for the nation overall (Perez-Pena 2005).

A substantial increase in cigarette prices has also occurred over the past decade. The federal excise taxes on cigarettes rose from 24 cents to 39 cents per pack between 1993 and 2002, many states raised their cigarette taxes, and the major manufacturers increased prices by about a dollar per pack, including 45 cents a pack to cover the cost of the MSA (Capehart 2001). In 1997, premium brands cost about $1.90 per pack, and by 2003 the cost had increased to about $3.60 a pack, with higher prices in states with higher taxes (Derthick 2004).

The exposure of the tobacco companies’ deceptive marketing practices not only resulted in widespread criticism of the industry but also created a new justification for legal action and regulation. A dramatic measure of how much had changed was the new corporate stance of the country’s largest cigarette company, Philip Morris USA. In the fall of 1999, Philip Morris acknowledged in a public statement that smoking causes cancer and that nicotine is addictive (Meier 1999). A few months later, Philip Morris officially took the position that cigarettes should be regulated (AP 2000). Only a few years earlier, the company’s chief executive officer (who had since left the company), along with the chief executive officers of other major tobacco companies, testified before a congressional committee (under oath) that he did not believe that nicotine is addictive (Waxman 1994).



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