Study Finds that Money Spent on Tobacco Control Efforts Decreases Cigarette Sales

A new paper published by Tobacconomics researchers in collaboration with Centers for Disease Control and Prevention (CDC) published in the journal PLoS ONE finds that overall state spending on tobacco control has a significant negative impact on tax paid cigarette sales.

Tobacconomics researchers John Tauras, Frank Chaloupka, and Jidong Huang in conjunction with researchers from the CDC including Xin Xu, Brian King, S. Rene Lavinghouze, and Karla Sneegas examined the effect of state-level tobacco control spending in each of the CDC’s Best Practices categories on cigarette sales. The research is the first nationally representative study to use actual state level tobacco control spending data and not just state level tobacco control appropriations data. Moreover, the study is the first to examine the effects of tobacco control spending in each of the CDC’s Best Practices categories on cigarette sales.

The researchers found overall state spending on tobacco control to have a significant negative impact on cigarette sales. Moreover, spending in the areas of cessation interventions, health communication interventions, and state and community interventions were found to have a negative impact on cigarette sales in all the models that were estimated whereas spending in the areas of surveillance and evaluation, and administration and management were found to have negative effects on cigarette sales in only some models. The models estimated by the researchers predict that states could spend up to seven times their current levels and still see significant reductions in cigarette sales.

In 1989, California became the first state in the United States to create a comprehensive state-wide tobacco control program. The year before that, California voters passed Proposition 99, which raised the cigarette excise tax by 25 cents per pack. A portion of the revenue generated from the excise tax increase was earmarked for tobacco control purposes. California used funds from the tax increase to support anti-tobacco initiatives including a media campaign, community education programs, school education programs, research funding, surveillance and evaluation activities, and other initiatives. Following California’s lead, other states began creating comprehensive tobacco control programs funded by the revenue generated from tobacco taxes. While some states used ballot initiatives to pass tobacco excise tax increases, other states were successful in using the legislative process to increase tobacco taxes. A number of state tobacco control programs were also funded by state settlements with cigarette manufacturers or by the funds states receive through the Master Settlement Agreement with the tobacco industry. Additional funding for state tobacco control programs have come from private organizations, such as the American Cancer Society and the American Lung Association, private foundations, such as the Robert Wood Johnson Foundation, and various Federal programs.

Evaluations of major individual state programs provide compelling evidence that these programs are correlated with reduced tobacco use. Using evidence from the scientific literature, the CDC issued its first Best Practices for Comprehensive Tobacco Control Programs in 1999, which provided guidance on key components of comprehensive state tobacco control programs and included recommendations for funding of these programs. In 2007, based on additional new evidence in the scientific literature, the CDC revised its Best Practice guidelines and updated its funding recommendations for states.  The revised guidelines detailed five central components for comprehensive tobacco control programs using evidence of the effects of state tobacco control programs found in the scientific literature. The five components included: state and community interventions; health communication interventions; cessation interventions; surveillance and evaluation; and administration and management. The most recent revision to the Best Practices for Comprehensive Tobacco Control Programs was released in 2014. The 2014 Best Practices updates the guidance provided in 2007 to reflect additional state evidence and experiences, new scientific literature, and changes in state populations, inflation, and the national tobacco control landscape since its previous release. The recommended funding level outlined in the report represents the annual level of investment for ensuring a fully funded and sustained comprehensive tobacco control program with resources sufficient to most effectively reduce tobacco use.