Old Habits Up in Smoke, Study Finds

    It’s a familiar, repeatedly preached message to most young adults: Smoking is unhealthy. This presents the question – are they listening?

    According to a series of studies released by UCSD’s Moores Cancer Center, the answer is yes. Since the California Tobacco Control Program was introduced in 1989, a greater number of young adults in California are quitting smoking than ever before, and older smokers are significantly cutting back on cigarette consumption.

    The findings, detailed in three papers, evaluate data from the U.S. Census Bureau to assess the first 12 years of the state’s anti-smoking campaign, and its influence on smoking cessation rates, daily cigarette consumption levels and smoking within the black community.

    The first paper compares smoking cessation rates among young, middle-aged and older smokers a decade before the campaign was introduced, and in the decade following its implementation. Researchers discovered a general increase in long-term cessation rates across all age groups, observing the highest rate of quitting among the youngest group of smokers studied, aged 20 to 34.

    This points to the Tobacco Control Program’s success in widening public understanding of the addictive properties and health consequences of cigarettes, according to Karen Messer, the director of biostatistics at the UCSD Rebecca and John Moores Cancer Center and study co-author.

    “”Today’s young adults in California grew up in the era of tobacco control,”” Messer said in an e-mail. “”Smoking restrictions at work and at home are now the norm.””

    Thurgood Marshall College freshman Lawrence Lu described his own attempts to quit smoking as influenced by the negative social values and health risks linked to smoking, an awareness more acute among today’s youth than in previous generations.

    “”People definitely smoke less now than back then, probably because of media campaigns,”” Lu said. “”Attitudes about smoking are different. More people think it’s unhealthy and gross.””

    Messer attributes the Master Settlement Agreement in 1998 ­- a compact struck between major tobacco companies and attorney generals in 46 states – with a decline in tobacco marketing aimed specifically at children and adolescents. Additionally, California’s innovative 1994 Smokefree Workplace Law and its laws concerning the enforcement of sales to minors aided in lowering cessation rates among youth.

    “”As a result [of these measures], young Californians were less likely to start smoking, and if they started, they were more likely to smoke socially as opposed to having a pack-a-day addiction,”” said John P. Pierce, director of the Cancer Prevention and Control Program at the Moores Cancer Center, in an e-mail. “”Less addiction in young people means more successful quitting.””

    The first paper also compared California with national data from two other groups of states. The New York/New Jersey group, with a similar population and comparable tobacco prices, but no measures to “”de-normalize”” smoking, showed considerably lower cessation rates than California. Furthermore, young adults in tobacco-growing states, which have no comprehensive tobacco control programs and low cigarette prices, saw the lowest cessation rates.

    “”California leads the nation in effective strategies to counter tobacco industry promotion of cigarette smoking,”” Messer said. “”These strategies are increasingly being adopted by other states and in national campaigns, and smoking rates are dropping nationwide.””

    The second paper showed that, while smokers in California over the age of 35 were quitting in numbers comparable to older smokers in the New York/New Jersey group, they were smoking fewer cigarettes than in the past.

    “”The older generations, who have been smoking for many years and are maybe more addicted and less able to quit, have actually declined their smoking levels,”” said Wael K. Al-Delaimy, professor of family and preventative medicine and director of the tobacco surveys at Moores Cancer Center, in an e-mail. “”This translates to lower risks of lung cancer and tobacco-related diseases.””

    The third paper specifically detailed rates of smoking among blacks. Though smoking prevalence rates have been historically higher in black communities, this gap has since closed. Whereas prevalence among white smokers dropped most notably in California, rates for blacks showed dramatic decreases regardless of location.

    “”There was this period of time in the late 1970s to early 1980s where the social desirability and even the social acceptability of smoking began to decrease in the African-American community,”” said Dennis Trinidad, assistant professor of medicine at Moores Cancer Center and study co-author, in an e-mail. “”Compare this with strong parental disapproval and, over time, as African-American youth became adults, smaller numbers took up smoking.””

    Al-Delaimy viewed the combination of lower overall consumption levels, along with higher cessation rates, as positive indicators for the future of Californians’ health.

    “”Tobacco use is the single most preventable factor causing diseases in the U.S. and worldwide,”” Al-Delaimy said. “”Ninety percent of lung cancer is caused by tobacco smoke, and close to 90 percent of those diagnosed with lung cancer die within nine months. If we prevent tobacco use, we are preventing many illnesses and significantly improving the health of people as a whole.””

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