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reduce consumption among continuing smokers.
Raising excise taxes on tobacco products can reduce tobacco use while increasing state revenues.
Tobacco addiction is treatable, and treatment programs are cost effective.
The enforcement of youth access laws will not achieve its full potential impact until merchant compliance rates are high.
To ensure accountability and enable future improvements in tobacco control programs, state tobacco control programs must be evaluated and have explicit goals coupled to performance measures.
Notes
1.
The Institute of Medicine (IOM) examined state tobacco control efforts in Growing Up Tobacco Free: Preventing Nicotine Addiction in Children and Youths, B.S.Lynch and R.J.Bonnie, eds., Washington, D.C.: National Academy Press, 1994 (www.nap.edu/catalog/4757.html), as did the National Cancer Policy Board in Taking Action to Reduce Tobacco Use, Washington, D.C.: National Academy Press, 1998 (www.nap.edu/catalog/6060.html).
2.
Health and cost statistics are from the Office of Smoking and Health, Centers for Disease Control and Prevention (CDC) web site, www.cdc.gov/tobacco. The Master Settlement Agreement is available through the National Association of Attorneys General at www.naag.org/tob2.htm.
3.
Wingo P.A., Ries L.A.G., Giovino G.A., et al. Annual report to the nation on the status of cancer, 1973–1996, with a special section on lung cancer and tobacco smoking. Journal of the National Cancer Institute 91:675–690, 1999.
4.
Centers for Disease Control and Prevention. Incidence of initiation of cigarette smoking—United States, 1965–1995. Morbidity and Mortality Weekly Report 47(39):837–840, 1998.
5.
Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs. Atlanta: CDC, 1999 (www.cdc.gov/tobacco/bestprac.htm).
Campaign for Tobacco-Free Kids, “Statewide Programs,” (www.tobaccofreekids.org/html/statewide_programs.html), 1999; Coalition for a Tobacco-Free Pennsylvania and Governor Tom Ridge, press release, 1999; The Gallup Organization, Final Technical Report: Independent Evaluation of the California Tobacco Control Prevention and Education Program, Methods and Procedures, Wave I Data, 1996–1997, and Final Technical Report: Independent Evaluation of the California Tobacco Control Prevention and Education Program, Wave I Data, 1996–1997, Rockville, Md.: Author, 1998; Centers for Disease Control and Prevention, Best Practices…, op. cit.; Centers for Disease Control and Prevention, Office of Smoking and Health, “State and National Tobacco Control Highlights” (www.cdc.gov/tobacco/statehi/statehi.htm), 1999; State of Arizona, Office of the Auditor General, Performance Audit: Department of Health Services’ Tobacco Education and Prevention Program, Phoenix, 1999; Minnesota Health Improvement Partnership Tobacco Work Group, Tobacco Use
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