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Surveillance and Evaluation Data Resources for Comprehensive Tobacco Control Programs
Preface
Surveillance of tobacco use and evaluation of tobacco
control programs are two keys to the success in reducing the
prevalence of smoking since the U.S. Surgeon General first
publicized the adverse consequences of tobacco use in a
1964 report.
In many areas of health promotion and disease prevention, the
behavior of populations has been difficult to track. However,
trends in tobacco use have been known since the beginning
of the 20th century. Tobacco use rose inexorably from 1900
to 1965, declining only during the early years of the great
depression and other economic downturns. These declines
gave the first clue that pricing and taxing could significantly
affect tobacco use. But price is not the only factor that affects
tobacco use. The nonsmokers' rights movement and the
Surgeon General's Report on the health hazards associated
with secondhand tobacco smoke—as well as a doubling in
the federal cigarette tax—all contributed to a decline in
tobacco use that began in the mid-1970s.
In recent years, monitoring and evaluation of tobacco control
activities in California, Massachusetts, and Oregon have shown
that aggressive and comprehensive tobacco control programs
are effective in reducing cigarette smoking. For example,
California was the first state to implement a comprehensive
tobacco control program and is now seeing changes in longterm
health outcomes, notably a 4.8% decline in lung cancer
rates among men and women from 1988 to 1997, while rates
in other regions increased by 13.2%. In Oregon, the smoking
prevalence among 8th graders declined for the first time in
recent history (from 21% in 1998 to 15% in 1999) after the
state implemented a comprehensive tobacco control program
that included hard-hitting media messages, innovative cessation
programs, and widespread efforts to promote smoke-free
workplaces. Massachusetts established a comprehensive tobacco
control program in 1993 and saw a 30% decline in per capita
cigarette purchases from 1992 to 1998. These and other
findings led to the development of CDC's Best Practices for
Comprehensive Tobacco Control Programs, which stipulates
that surveillance and evaluation, along with eight other elements
are necessary to ensure that tobacco control programs achieve
their goals.
Comprehensive tobacco use prevention and control programs
use the research data and strategies described in CDC's Best
Practices, the 2000 Surgeon General's Report Reducing Tobacco
Use, and the Task Force on Community Preventive Services'
tobacco-related recommendations. Using these three
publications in conjunction with data from the sources
listed in this publication will create a strong foundation for
generating action at the state level and achieving the Healthy
People 2010 tobacco objectives within the next decade.
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