Independent evaluation of the massachusetts tobacco control program

For the general population, MTCP has supported restricting environmental tobacco smoke and promoting clean air in public places. In , the state legislature first passed a clean indoor air law requiring restaurants of 75 or more seats to set aside square feet 16 seats for non-smoking sections.

Since then, smoking has been banned in many public venues around the state, including the grounds of all public schools , airports , state buildings , and major sports stadiums, including the Boston Red Sox's Fenway Park To move toward the goal of a statewide smokefree environment, MTCP has funded local boards of health to promote clean indoor air policies.

In this issue, Bartosch and Pope 20 find that highly restrictive restaurant smoking policies do not have a statistically significant effect on business as measured by Massachusetts meals and alcohol tax revenue. A major focus for MTCP has been to build on the strong Massachusetts history of tobacco product regulation as a public health priority.

In , Massachusetts was the first state in the country to require health warnings on oral snuff, an action that ultimately triggered passage of the federal law requiring a uniform label nationwide. Furthermore, in , Massachusetts passed a first in the nation Tobacco Product Disclosure Law that required tobacco manufacturers to report: 1 cigarette nicotine yields under average smoking conditions, and 2 additives in all brands by descending order of weight.

For this action, MDPH was sued by the major cigarette and smokeless tobacco manufacturers. While a federal court subsequently ruled that the ingredient disclosure provision was unconstitutional, 23 that ruling has recently been appealed by the state.

The federal appeals court reversed a lower court ruling affirming the department's authority to require tobacco manufacturers to disclose tobacco product additives by brand and level. That decision has been appealed by the tobacco industry. In a related activity, in , the MDPH proposed regulations requiring manufacturers to test for the major toxins in cigarette smoke of 75 brands.

Legislation is pending which would address the legal issues of the court case and allow MDPH to regulate the levels of nicotine, additives, and smoke constituents.

In this issue, Slade and his colleagues address product testing and health claims made about alternative tobacco products. Of national importance, in , the US Supreme Court heard a lawsuit whereby the tobacco industry challenged youth access and advertising restrictions drafted by the Massachusetts attorney general under the state Consumer Protection Act. The regulation, derived from the unsuccessful proposed Food and Drug Administration rule, prohibited tobacco advertisements within feet of schools and playgrounds.

The regulation was driven by an MDPH survey 27 of storefronts that showed a greater likelihood of tobacco advertising in storefronts within feet of schools, compared to those further away.

In June , the Supreme Court ruled against Massachusetts, stating that the tobacco companies' first amendment rights had been violated. In addition, the court also concluded that the state illegally preempted the federal Cigarette Labeling and Advertising Act of which bars states from restricting tobacco advertising.

The tobacco industry will continue to push its product in creative ways. Marketing to youth by the tobacco industry shifted after the Master Settlement Agreement, by redirecting resources previously aimed at billboard advertising to magazine advertising.

With this monograph, we are honoured to add to the growing body of successful interventions in tobacco control. A comprehensive environmental tobacco smoke campaign helped to educate public opinion leaders to pass smoke-free ordinances. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Skip to main content. Log in via OpenAthens. Log in using your username and password For personal accounts OR managers of institutional accounts. Forgot your log in details? Register a new account? Forgot your user name or password? Search for this keyword. Advanced search. Latest content Current issue Archive Authors About. Log in via Institution.

Email alerts. Article Text. Article menu. Accomplishments of the Massachusetts Tobacco Control Program. Statistics from Altmetric. Massachusetts Tobacco Control Program advertising environmental tobacco smoke In less than a decade, the Massachusetts Tobacco Control Program MTCP has evolved into one of the leading public health initiatives of our time. Cancer prevention: preventing tobacco-related cancers. Cancer: principles and practice of oncology , 6th ed. Philadelphia: Lippincott, Williams and Wilkins, — Impact of the Massachusetts tobacco control programme: population based trend analysis.

BMJ ; : —4. This model should be useful to other states as they develop their tobacco control programmes. Launched in , a telephone quitline set up by Massachusetts and staffed by trained quit counsellors has helped thousands of smokers to quit. You will be able to get a quick price and instant permission to reuse the content in many different ways. Skip to main content. Log in via OpenAthens. Log in using your username and password For personal accounts OR managers of institutional accounts.

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Advanced search. Latest content Current issue Archive Authors About. Log in via Institution. You are here Home Archive Volume 11, Issue suppl 2 Adult smoking intervention programmes in Massachusetts: a comprehensive approach with promising results. Email alerts. Article Text. Article menu. Smoking intervention programme.

Adult smoking intervention programmes in Massachusetts: a comprehensive approach with promising results. Abstract This paper provides a brief overview of the history of Massachusetts' opposition to smoking. Statistics from Altmetric. The tobacco problem. Boston: DeWolfe, Fiske and Company, Massachusetts Department of Public Health. The Massachusetts plan for non-smoking and health, report and recommendations of the Advisory Committee on Smoking and Health of the Office for Non-smoking and Health.

Boston: Massachusetts Department of Public Health, l Wynder EL , Graham E. Tobacco smoking as a possible etiological factor in bronchiogenic carcinoma: a study of proven cases. JAMA : : — OpenUrl Web of Science. Connolly G , Robbins H. Designing an effective statewide tobacco control program-Massachusetts.

Cancer ; 83 suppl : —7. Koh HK. An analysis of the successful Massachusetts tobacco tax initiative. Tobacco Control ; 5 : —5. OpenUrl Abstract. Biener L , Roman AM. Abt Associates. Independent evaluation of the Massachusetts Tobacco Control Program: sixth annual report. Cambridge, Massachusetts: Abt Associates, l Telephone counselling for smoking cessation: effects of single-session and multi-session intervention. Journal of Counselling and Clinical Psychology ; 64 : — Miller WR , Rollnick S.

Treating tobacco use and dependence. The following databases were searched for English-language papers that evaluated tobacco control interventions:. The literature search covered all tobacco control interventions. For the review on comprehensive tobacco control programs, Community Guide staff screened search results twice to identify papers specific to this intervention. Search strategies were adjusted to each database, based on controlled and uncontrolled vocabularies and search software.

Following are the search strategies used in PubMed. Centers for Disease Control and Prevention. Atlanta: U. The following considerations are drawn from studies included in the evidence review, the broader literature, and expert opinion. Create an Account. You are here Home » Systematic Review. In the United States, programs are typically organized and funded at the state level to provide a platform for effective implementation of the following components: Assistance to community-based organizations and coalitions to pursue local programs and policies to reduce tobacco use and secondhand smoke exposure Partnerships at local and state levels to engage health systems and providers, businesses, and public and private agencies and organizations, in an effort to broaden the reach and impact of tobacco control interventions Mass-reach health communication interventions to inform individual and public attitudes about tobacco use and secondhand smoke Cessation services, such as quitlines, to help tobacco users in their efforts to quit Information and technical assistance to support the diffusion and adoption of evidence-based practices e.

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement [PDF - KB] Included studies consistently showed that comprehensive tobacco control programs reduce the prevalence of tobacco use among adults and young people, reduce tobacco product consumption, increase quitting, and contribute to reductions in tobacco-related diseases and deaths.

Prevalence of Tobacco Use among Adults 22 studies Overall median decrease of 3. Studies from U. Over time, the difference between state and national declines narrowed 2 studies. A county comprehensive tobacco control program in the U. Self-reported exposure to multiple components of a U. Cessation 8 studies A country with a national comprehensive program saw an increased quit rate following program implementation 1 study. States and localities with comprehensive tobacco control programs saw greater increases in cessation rates in before-after comparisons 2 studies, 1 U.

In three studies, U. In one study, self-reported exposure to multiple components of a U. Initiation 3 studies Comprehensive tobacco control programs reduced initiation among adolescents years old; 3 studies but had little or no impact on initiation among young adults years old; 2 studies. In four studies, U. Individual Daily Consumption number of cigarettes consumed per day; 10 studies Overall median decrease of Prevalence of Smoke-Free Homes 3 studies U.

Mortality 6 studies U. Reducing secondhand smoke exposure 1 study. Stratified Analyses by Education 4 studies Comprehensive tobacco control programs were effective across groups with different levels of educational attainment for the following outcomes: Reducing tobacco use prevalence among adults 2 studies.

Reducing individual daily consumption 1 study. Increasing cessation 2 studies. A national program reduced the odds of being a smoker for all groups, but groups with the lowest education attainment had the highest odds of being a smoker 1 study.

A national program reduced smoking prevalence and increased cessation across all SES groups; the lowest SES group experienced the greatest increase in cessation 1 study.

Impact Due to Changes in Program Funding or Strength 18 studies In 16 studies, changes in tobacco use outcomes were evaluated in relationship to changes in comprehensive tobacco control program funding levels some studies assessed more than one outcome In 13 of 16 studies, increased program funding was associated with increased program impact, including: Decreased tobacco use prevalence among adults 3 studies ; no impact in 2 studies.

Increased sustained cessation among pregnant women after delivery but no impact on cessation during pregnancy 1 study. Decreased tobacco use prevalence among young people 2 studies ; no impact in 1 study. Decreased tobacco use initiation 2 studies. Increased cessation among young people 1 study.

Decreased cigarette pack sales 6 studies ; no impact in 1 study. Decreased individual daily consumption 1 study. In two studies, changes in tobacco use outcomes were evaluated in relationship to program strength presence or extent of implemented interventions and policies Increased program strength were associated with the following outcomes 2 studies : Decreased adult smoking prevalence 1 study ; program strength measured as composite score of program funding, staff capacity, and policy and environment change as a result of the program.

Increased cessation 1 study ; program strength measured as composite score of 6 tobacco control policies and interventions. Healthcare costs averted 10 studies Estimates of healthcare costs averted varied substantially, mainly due to variations in the examined programs and differences in modeling practices used by researchers. Cost-benefit estimates 9 studies Median benefit-to-cost ratio of IQI: to Based on results for different settings and populations, findings are applicable to the following: U.

More research is needed to examine longitudinal associations between comprehensive tobacco control programs and changes in the presence and strength of tobacco control policies. It would also be useful to understand the relationships between specific comprehensive program components and policy changes. Funding levels vary widely for overall tobacco control programs and the specific components within them. More information is needed about the relationships between funding levels for specific components and overall comprehensive program effectiveness.

In the U. More research is needed to examine how these differences modify overall program effectiveness. Research is needed to examine the effects of comprehensive tobacco control programs on use of combustible tobacco products other than cigarettes e.

Studies could also examine the effects of comprehensive tobacco control programs on product substitution i. Continued research is needed on the effectiveness of comprehensive tobacco control programs among subpopulations with high rates of tobacco use. It would also be useful to know more about the independent effectiveness of specific program components among these subpopulations. Continued economic research is needed to examine cost-effectiveness of comprehensive tobacco control programs.

Studies could also examine cost-effectiveness for specific program components. Future economic research should assess changes in worker productivity such as averted productivity losses attributable to reductions in tobacco use.

Included studies assessed comprehensive tobacco control programs in the United States 55 studies , Australia 2 studies , Canada 1 study , France 1 study , Ireland 1 study and nations within the European Union 1 study. Most of the U. Economic Review No content is available for this section. Effectiveness Review Sixty-one studies were included in this review, and 5 papers provided more information about included studies.

Decline in smoking prevalence-New York City, MMWR ;56 24 Decrease in smoking prevalence-Minnesota, MMWR 5 Tobacco control programs and tobacco consumption. Cato Journal ; Declines in lung cancer rates--California, MMWR ;49 47 Considerations for Implementation The following considerations are drawn from studies included in the evidence review, the broader literature, and expert opinion. Evidence indicates comprehensive tobacco control programs are effective independent of increases in tobacco product prices or adoption of smoke-free policies.

All of these interventions are effective, important, and complementary elements of an overall strategy to reduce tobacco use and secondhand smoke exposure. Increases in program funding are associated with increases in program effectiveness, with the greatest impact seen if programs are funded at CDC-recommended levels. Comprehensive tobacco control programs are effective in U. Comprehensive tobacco control programs are effective across diverse racial, ethnic, educational, and SES groups.

CDC's Best Practices for Comprehensive Tobacco Control Programs suggests program options to address population groups that have experienced persistently high rates of tobacco use and secondhand smoke exposure. Community Preventive Services Task Force's recommendations for program components can be found for quitlines and mass-reach health communication interventions.

The Task Force recommends additional programs and policies to reduce tobacco use and secondhand smoke exposure. A number of national organizations provide resources on program implementation and evaluation. Tobacco, Objective 1 TU-1 : Reduce tobacco use by adults Tobacco, Objective 2 TU-2 : Reduce tobacco use by adolescents Tobacco, Objective 3 TU-3 : Reduce the initiation of tobacco use among children, adolescents, and young adults Tobacco, Objective 11 TU : Reduce the proportion of nonsmokers exposed to secondhand smoke Tobacco, Objective 20 TU : Increase the number of States and the District of Columbia, Territories, and Tribes with sustainable and comprehensive evidence-based tobacco control programs.

Tobacco Control Interventions.