Changes in Smoking Prevalence and Number of Cigarettes Smoked Per Day Following the Implementation of a Comprehensive Tobacco Control Plan in New York City

Abstract

The New York City (NYC) Health Department has implemented a comprehensive tobacco control plan since 2002, and there was a 27% decline in adult smoking prevalence in NYC from 2002 to 2008. There are conflicting reports in the literature on whether residual smoker populations have a larger or smaller share of "hardcore" smokers. Changes in daily consumption and daily and nondaily smoking prevalence, common components used to define hardcore smokers, were evaluated in the context of the smoking prevalence decline. Using the NYC Community Health Survey, an annual random digit dial, cross-sectional survey that samples approximately 10,000 adults, the prevalence of current heavy daily, light daily, and nondaily smokers among NYC adults was compared between 2002 and 2008. A five-level categorical cigarettes per day (CPD) variable was also used to compare the population of smokers between the 2 years. From 2002 to 2008, significant declines were seen in the prevalence of daily smoking, heavy daily smoking, and nondaily smoking. Among daily smokers, there is also evidence of population declines in all but the lowest smoking category (one to five CPD). The mean CPD among daily smokers declined significantly, from 14.6 to 12.5. After an overall decline in smoking since 2002, the remaining smokers may be less nicotine dependent, based on changes in daily consumption and daily and nondaily smoking prevalence. These findings suggest the need to increase media and cessation efforts targeted towards lighter smokers.

Six Components Necessary for Effective Public Health Program Implementation

“…7 The state of California and the city of New York each invested in sustained implementation of comprehensive tobacco control technical packages that helped establish the MPOWER strategy and have recorded steady, long-term declines in smoking prevalence. 8,9 In Uruguay, which implemented most elements of the MPOWER strategy sooner than any other country, smoking prevalence fell by a quarter in just 3 years, perhaps the fastest decline ever recorded. 10,11 A technical package of surveillance and vaccination has brought the world to the brink of polio eradication.…”

Lessons Learned From the Implementation of a Time-Limited, Large-Scale Nicotine Replacement Therapy Giveaway Program in New York City

“…However, because these guidelines rely on findings from clinical trials that exclude light smokers, published evidence about the effectiveness of cessation interventions for light smokers is limited (Fiore et al, 2008). as proportions of light smokers within the smoking population continue to grow, and as heavy smoking declines (Coady et al, 2012), treating light smokers will become increasingly important as a strategy to decrease smoking prevalence. light smokers who are ready to quit should be offered access to NRT unless contraindicated (The Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff, and Consortium Representatives, 2000).…”

Learning From New York City

“…Evaluations of these initiatives illustrate that they have been effective in meeting their goals. [39][40][41][42][43][44][45][46][47] Two of their important strategies can be borrowed by other places fairly easily: using the existing full range of administrative authority of an agency and remobilization of the existing workforce.…”