The role of public policies in reducing smoking prevalence in California: Results from the California Tobacco Policy Simulation Model

Abstract

SummaryTobacco control policies are examined utilizing a simulation model for California, the state with the longest running comprehensive program. We assess the impact of the California Tobacco Control Program (CTCP) and surrounding price changes on smoking prevalence and smoking-attributable deaths. Modeling begins in 1988 and progresses chronologically to 2004, and considers four types of policies (taxes, mass media, clean air laws, and youth access policies) independently and as a package.The model is validated against existing smoking prevalence estimates. The difference in trends between predicted smoking rates from the model and other commonly used estimates of smoking prevalence for the overall period were generally small. The model also predicted some important changes in trend, which occurred with changes in policy.The California SimSmoke model estimates that tobacco control policies reduced smoking rates in California by an additional 25% relative to the level that they would have been if policies were kept at their 1988 level. By 2004, the model attributes over 60% of the reduction to price increases, over 25% of the overall effect to media policies, 10% to clean air laws, and only a small percent to youth access policies. The model estimates that over 5,000 lives will be saved in the year 2010 alone as a result of the CTCP and industry-initiated price increases, and that over 50,000 lives were saved over the period 1988-2010. Tobacco control policies implemented as comprehensive tobacco control strategies have significantly impacted smoking rates. Further tax increases should lead to additional lives saved, and additional

The public health impacts of a fat tax

“…Experience in reducing the prevalence of smoking also points to an approach which does not rely entirely on price increases. (Levy et al;2007) nd that 59% of the reduction in the prevalence of smoking in California is attributable to increases in price whilst 28% is attributable to media policies. Whilst fat taxes have the potential to e ect marginal changes in the diets of large numbers of people, and thus have a signi cant impact on the incidence of disease across the population, more complex polices which target di erent levels in society are likely to be more e ective in addressing the severe chronic dietary disease which a ects some groups.…”

Can a National Lung Cancer Screening Program in Combination with Smoking Cessation Policies Cause an Early Decrease in Tobacco Deaths in Italy?

“…In comparison with the SimSmoke model developed for United States (18), this model is informed with Italian figures on population and smoking habits (prevalence, initiation rates, stratification of former smokers by time since quitting). Moreover, this model produced estimates of Italian quit rates (5,6).…”

“…We used the SimSmoke model's tax module for the "20% tax increase" scenario (Levy and colleagues; submitted; ref. 18). In fact, price elasticity for Italy was comparable with that recorded in the United States (25,26).…”

“…The number of smoking attributable deaths (SAD) was estimated by smoking prevalence and age-and sex-specific relative risks of smokers and former smokers relative to nonsmokers (18). Specifically, the number of smokers at each age is multiplied by the difference between the death rates of smokers and never-smokers.…”

Associations Between Residential Segregation and Smoking During Pregnancy Among Urban African-American Women

“…53 The proportion of families with income below the federal poverty level in 1999 was included to control for SES at the MSA-level of analysis. Finally, because higher state-level tobacco taxes may be associated with reduced smoking prevalence, [54][55][56] we included a measure of cigarette taxes (tax in dollars per pack of 20 cigarettes imposed by the state exclusive of any local taxes) 35 to control for potential confounding by variation in state-level tobacco control policies. The MSA population and the cigarette tax variable were log-transformed to correct skewness.…”