Index for US state tobacco control initial outcomes

Public health tobacco control efforts have increasingly targeted communitie s in addition to individuals. Before population smoking decreases, effectiv eness might be detected from initial outcomes reflecting these efforts, suc h as higher cigarette prices or more workplace and home smoking restriction s. Presumably, these initial outcomes will eventually influence smoking beh avior. State-specific estimates of percentages of the population working or living under smoking bans are available from the 1992-1993 tobacco use sup plement to the Current Population Survey, conducted annually by the US Bure au of the Census. In addition, the tobacco industry reports the average sta te cigarette price yearly. The authors constructed a tobacco control initia l outcomes index (IOI) by using values of these variables for each state an d correlated it with state-specific adult (aged greater than or equal to 25 years) and youth (aged 15-24 years) smoking prevalence computed from the C urrent Population Survey and per capita cigarette consumption data computed from sales and Census Bureau data. Both adult smoking prevalence (r = -0.7 0) and per capita consumption (r = -0.73) were significantly correlated wit h the IOI; youth smoking prevalence correlated less well (r = -0.34). Altho ugh the analysis is not definitive, deseasonalized 1983-1997 consumption tr ends for IOI-based tertile groups were divergent beginning in 1993, with th e high IOI group showing the greatest decrease. A high relative IOI index m ay be predictive of future smoking decreases and should be considered when tobacco control efforts are evaluated.