UC Merced, UCSF to examine effectiveness of state and local antismoking programs

Researchers with the University of California, San Francisco, and UC Merced will examine the effectiveness of state and local antismoking programs across the United States in an effort to make sure health authorities are able to use their increasingly limited resources to support and defend the most effective approaches.

Stanton A. Glantz, UCSF professor of medicine, James Lightwood, UCSF assistant professor of clinical pharmacy, and Anna V. Song, UC Merced assistant professor of psychology, were awarded a five-year, $2.6 million grant on Sept. 1 from the National Institutes of Health to study which anti-smoking programs are working best and how the tobacco industry works to prevent states from pursuing the most effective tobacco control policies and programs.

Tobacco use remains the leading preventable cause of death in California and the nation. Not all programs are equally effective in reducing smoking or bringing down health care costs. Understanding which programs are best can help inform government policy decisions and make sure money is spent on effective programs.

"California's tobacco control program has already saved California taxpayers and businesses well over $86 billion in direct health costs," Glantz said. "With this research, we hope to inform policy makers and public health professionals how we can essentially eliminate tobacco as a public health problem in California in the next few years."

• The first is to document and analyze the variations in tobacco control policymaking and in how programs are run. The results will serve as the basis for recommendations to create the most effective and efficient tobacco control strategies and policies.
• The second goal is to define the relationships between spending on state tobacco control programs, smoking, and health care expenditures, and then use these relationships to quantify the effects of program intensity and quality.
• Third, the researchers will quantify the effects of tobacco control policies — such as the clean indoor air laws California pioneered — on smoking initiation, progression and cessation, and health disparities.

"We are combining modern understanding of adolescent and young adult psychology with mathematical models to understand the spread and decline in tobacco use," Song said. "It's similar to the way epidemiologists understand the spread of infectious diseases, with the tobacco companies playing the role of mosquitoes spreading disease."

The field of tobacco control has remained dynamic with new legislation and advocacy programs.

For example, the Family Smoking Prevention and Tobacco Control Act of 2009 granted the U.S. Food and Drug Administration authority over tobacco products. It also repealed federal preemption of state and local actions to regulate the time, nature and place of tobacco advertising and promotion, creating new opportunities for state and local tobacco control policymaking. California is also considering strengthening its own clean indoor air law to close loopholes that remain from the 1990s, when the current law was enacted.

Last year, the Centers for Disease Control and Prevention increased the visibility of tobacco control through several American Recovery and Reinvestment Act programs, including funding for tobacco control media campaigns in all states. It also has the Communities Putting Prevention to Work program, which is funding 21 state, local and tribal programs to implement policy-oriented tobacco control strategies.