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How have New York and New Jersey reduced smoking?

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From 1992-2002 cigarette smoking prevalence in New York City remained relatively stable, with around 21-22% of adults being smokers. However, in 2002 the city began to implement a comprehensive five-point tobacco control plan, as follows:
1. Increased city cigarette tax from 8c to $1.50 per pack.
2. Implement comprehensive smoke-free workplace legislation (including bars and restaurants).
3. Educate healthcare providers to provide treatment for smokers.
4. Provide free nicotine patches via the quitline.
5. Implement a comprehensive TV-based anti-smoking media campaign designed to motivate quit attempts.

The New York City effort was also helped by wider national tobacco control activities, New York state media activities, and steeper increases in cigarette taxes in near-bye New Jersey, which served to reduce options for cross-border purchasing.

The result was a decrease in adult smoking prevalence from 21.5% in 2002 to 17.5% in 2006, amounting to 240,000 fewer smokers in the city. Youth smoking also decreased from 14.8% to 11.2% from 2003-2005 in New York City.

The state-wide ban on smoking in workplaces or public places, implemented in 2003, resulted in an 8% drop in hospital admissions for myocardial infarctions, and a direct healthcare cost saving of $56 million in one year.

In addition to the direct benefits to the health of the people of New York, these policies have improved health among future generations by reducing youth smoking onset, improved the state’s and city’s budget by bringing in additional cigarette tax revenues, allowed the people of New York to go out in greater numbers to enjoy the excellent bars and restaurants without having to inhale carcinogens or stink of tobacco, and increased the income to those establishments as more people started to use them after they went smoke-free.

It is hard to imagine better, more cost-effective public policy, other than by boosting the return on investment by investing even more heavily in tobacco control policy implementation (as New York State recently decided to do). Other cities and states would do well to observe the lessons and implement similar policies designed to reduce smoking.

Meanwhile, in my home state of New Jersey, we have also had considerable success in reducing adult cigarette smoking prevalence from around 21% in the 1990s to 17.4% in 2005. In 2004 the average adult in the US consumed 69 packs of cigarettes per year, whereas the average adult in New Jersey consumed 43 packs. Among high-schoolers, the prevalence of monthly cigarette smoking also reduced from 21% in 2001 to 16% in 2006.

New Jersey has also implemented a comprehensive tobacco control program including the highest state cigarette tax in the country, comprehensive smoking cessation services, youth-led tobacco control activities, age-of-sale increased to 19 years, and then implementation of comprehensive smoke-free workplace legislation in 2006.
Data and information on changes in tobacco use in New Jersey can be found at: http://www.state.nj.us/health/as/ctcp/research.htm

Further details about changes in smoking in New York City can be found at:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5624a4.htm

A summary of reductions in heart attacks in New York can be found at:
http://www.ajph.org/cgi/content/abstract/97/11/2035
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About the Author


MA, MAppSci, PhD

Dr. Jonathan Foulds is an expert in the field of tobacco addiction.

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