TOBACCO: Researchers Criticize State Efforts

      "In a report disputed by the state agency that commissioned it," University of California-San Diego "researchers conclude that California weakened its successful anti-smoking program by depriving it of funds," the San Diego Union-Tribune reports. Since the program started losing its effectiveness, the tobacco industry "outspent" the state ten to one on advertising and promotions (Duerksen, 9/9). But this wasn't always the case. In fact, California's Tobacco Control Program got off to a roaring start in 1989, reducing per capita consumption from 9.7 packs a month to 6.5 packs a month by 1993. But after 1993, the program seemed to lose its initial effectiveness, only reducing the average Californian's consumption to 6 packs a month by 1996. According to a study in today's Journal of the American Medical Association, that first period was associated with a rate of decline 52% greater than the rest of the U.S., while the second period saw smoking decline only about half as much -- 28% as much as the rest of the country. In addition, the researchers found that during the second period, teen smoking actually increased from 9% to 11%. Discussing reasons why the program "clearly lost its positive effect on reducing smoking" around 1993, researchers at UC-San Diego, led by Dr. John Pierce, note that at that time the program "failed to introduce new and innovative approaches to interest the public." Similarly, tobacco industry "political counterstrategies" of lowering prices and increasing advertising efforts were stepped up and the state lowered funding for the program (Pierce et al, 8/9 issue). Click tobacco control to view an abstract of the study.

Wilson's Fault?
      The Los Angeles Times reports that the "researchers emphasize cuts in the program's funding," which dropped from $3.35 per person prior to 1993 to $2.08 per person afterward. "Taking the money out of the budget crippled the program," said Pierce, associate director of UC-San Diego's cancer prevention and control program (Monmaney, 9/9). Stanton Glantz, a UC-San Francisco researcher involved with the state program, said that by cutting funding, Gov. Pete Wilson (R) "delivered for the tobacco industry." But Donald Lyman, who, as chief of the state's Division of Chronic Diseases and Injury Control oversees the program, said the "program cut its own funding as its success in curbing tobacco use grew." He continued, "The bottom line is that the program works" and is more successful than "any other program in the country" (Schwartz, Washington Post, 9/9).

Biting The Hand That Feeds...
      The San Francisco Chronicle reports, however, that Pierce and his colleagues "paid a price for the latest critique" of the program -- the state health department cut funding for the UC-San Diego researchers' work. "We were terminated," said Pierce. Pierce's "latest report shows the [Wilson] administration has succeeded in wrecking the program. His reward for that is a bullet through his head," said Glantz. But Lyman said the decision to terminate the study came from concerns over the "timeliness" and "abusive language" of the report. "If you hire a guy to paint the house, and he shows up late and insults the wife, are you going to hire him again?" asked Lyman. In addition, the state "differed" with Pierce and colleagues "on several technical issues and only released the report this summer after a panel of experts reviewed the work and concluded that Pierce's approach was valid." Now there are two versions of the report -- the official state version and the version appearing in today's JAMA. Pierce said the JAMA study "couches the findings in less diplomatic language" than the state's version. "We are basically saying, 'You've lost it.' The programs have lost their effectiveness in discouraging smoking in California" (Russell, 9/9). However, the study does note that the smoking rate in California is much lower than the national average -- 18% compared to 22.4% in 1996 (JAMA, 9/9 issue).

Another Y2K Problem
      The national smoking rate is not low enough "to meet a long-standing goal of reducing smokers to 15% of the adult population by 2000," according to a study in this month's American Journal of Public Health. The goal was set in 1987 as part of the Healthy People 2000 initiative, "which set health and fitness objectives for the American public." Researchers at UC-Irvine found that currently 24% of American adults smoke and "that about 21% of adults in the United States will still be smoking on Jan. 1, 2000." UC-Irvine marketing professor Cornelia Pechmann, lead author of the study, said, "I feel it's a shame that we haven't done more to help adult smokers to quit." The Los Angeles Times reports that Pechmann's study "singled out the success of California, a state that spends five times the national average on anti-smoking programs and has one of the lowest smoking rates in the country" (Garvey, 9/9).