With fewer adults quitting and more youths becoming smokers, the nation won't meet its smoking-related goals for 2000, according to researchers.
"The combined failures of individual, community, and legislative policy efforts made it impossible to meet the 15 percent smoking prevalence mark set for the year 2000," said lead study author C. Tracy Orleans, PhD, of the Robert Wood Johnson Foundation in Princeton, New Jersey.
Approximately 25 percent of U.S. adults currently smoke. Several decades ago approximately 65 percent of Americans smoked, a rate that began to drop steadily following the Surgeon General's 1964 report. The smoking decline slowed in 1990, and youth rates concurrently rose, with over 3,000 youths becoming new smokers daily.
"Research has produced effective strategies for helping smokers quit, including cognitive behavioral and nicotine replacement therapies," said Orleans.
"However, more work needs to be done to reach smokers in low-income and minority populations and to develop effective treatments for adolescents, pregnant women, and highly addicted smokers and for smokeless tobacco users."
Room for improvement also exists with regard to school, worksite, healthcare, and community-based efforts, according to Orleans and co-author K. Michael Cummings, PhD, of the Roswell Park Cancer Institute. Their research appears in the November/December issue of the American Journal of Health Promotion.
School-based prevention programs have succeeded only in delaying tobacco use. Worksite efforts have not succeeded on a large scale and have not impacted blue-collar smokers. Community-based programs have also had disappointing results, and although physician advice has been demonstrated to motivate smoking cessation efforts, many smokers don't receive such advice from their physicians, according to the researchers.
On a more positive note, 50 percent of workplaces now have formal anti-smoking policies; more health plans provide some coverage for state-of-the-art smoking cessation treatments; and the growth of managed care, with its emphasis on illness prevention, is likely to result in the spread of more "quit smoking" messages.
Anti-smoking efforts are most effective in combination with tobacco control legislation and environmental change. For example, school-based preventive programs combined with higher excise taxes, youth access law enforcement, counteradvertising, and antitobacco advocacy have the most potential for success, according to Orleans and Cummings.
Modern research tools must be enlisted to increase what is known about the causes of youth smoking as well as the physiology of addiction, so that more effective treatments can be developed for the 50 million Americans addicted to tobacco.
"The nation has reached a point of unprecedented potential to reduce the social, health, and economic harm caused by tobacco," concluded Orleans.
The American Journal of Health Promotion is a bimonthly peer-reviewed journal dedicated to the field of health promotion. For information about the journal call (248) 682-0707 or visit the journal's website at www.healthpromotionjournal.com .
Posted by the Center for the Advancement of Health < http://www.cfah.org >. For information about the Center, call Petrina Chong, < pchong@cfah.org > (202) 387-2829.
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American Journal of Health Promotion