Adequate and sustained funding for comprehensive tobacco control programs is effective in reducing cigarette smoking.

Successful smoking cessation increased by 25% during the 1990s in the US; comprehensive tobacco-control programs were associated with greater cessation success than were high cigarette prices alone, although both effects were limited to younger adults. Evaluations of comprehensive tobacco programs in California, Massachusetts, Oregon, Arizona, and Florida, provide compelling evidence that these programs significantly reduce tobacco use by reducing smoking prevalence, average consumption, and youth uptake, and increasing adult smoking cessation. For example, in California following the adoption of Proposition 99, which raised the cigarette excise tax and earmarked some of the new revenues for a comprehensive tobacco control program, overall cigarette consumption declined by 62% compared to just 36% for the country as a whole during the period 1987-2002. Moreover, the prevalence of youth smoking fell by 43% in California from 1995 to 1999, while prevalence among high school students nationally was unchanged. Significant reductions in smoking in the other aforementioned states were also observed following the implementation of comprehensive programs. Evidence from national studies conducted in the US also provides powerful evidence that increased state spending on comprehensive tobacco control programs decreases overall cigarette demand, decreases youth smoking prevalence, and decreases average consumption among youth. Overall, there is a positive association between quit attempts among current everyday smokers in the past year and increases in real per capita tobacco control expenditures. One study found that a doubling in real per capita tobacco control program expenditures leads to a 0.5% increase in the likelihood of current everyday smokers making at least one quit attempt in a 12-month period. The small impact of tobacco control expenditures is attributed to the fact that states spent an average of $0.63 per capita on tobacco control programs between 1992 and 1999, well below the $5.98 level recommended in 1999 by the Centers for Disease Control for state expenditures on tobacco control programs. If states were to spend up to the minimum recommended level, that would amount to almost a ten-fold increase and would yield a 3% decrease in prevalence.

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