“The number of lives that potentially could be saved due to smoking-prevention
initiatives overshadows nearly all other public health measures,” says
Frederick P. Rivara, M.D., M.P.H., of the University of Washington in
Seattle.
The analysis appears in the August issue of the American
Journal of Preventive Medicine.
There were about 4 million 18-year-old Americans in the year 2000, Rivara
and colleagues report. About 27 percent of the men and 23 percent of the
women were smokers at that age. By the time this group turns 85, Rivara
estimates, more than 412,000 will die of smoking-related diseases. That
translates to an estimated 6 million years of life lost.
“This would be repeated each year, as each successive cohort of
individuals ages,” he says. Aggressive anti-smoking campaigns could
save thousands of lives, he adds, but current anti-smoking efforts have
produced only mixed results.
“School-based programs are unable to decrease the long-term smoking
prevalence among adolescents,” Rivara says. Smoking bans and restricting
sales to minors haven’t helped either.
However, previous research shows that raising cigarette prices and disseminating
multimedia antismoking campaigns do reduce adolescent smoking.
“A 10 percent increase in price would result in a 6 percent decrease
in smoking prevalence,” Rivara says. Large, statewide multimedia
campaigns in Massachusetts and California cut smoking rates by 6 percent
to 12 percent.
Combining these two approaches could sharply cut smoking and the ensuing
illness and death. There would be 26 percent fewer smokers by age 18 and
a similar decline in current and former smokers at age 35, he says.
“In the population of people aged 18 years in 2000, 108,466 lives
and 1.6 million years of potential life lost would be saved by preventing
26 percent of smoking-attributable mortality,” Rivara says.
This double-barreled approach would pay for itself, he
says: “The
increased revenue generated from higher excise taxes on tobacco would
fund the large-scale multimedia campaign.”
The antismoking campaign would still have to compete with tobacco company
marketing muscle, he adds. The companies might cut cigarette prices or
use special promotions to get around the tax increases, diminishing their
effect.
Reducing adolescent smoking won’t cut smoking-related
death rates for decades, but the size of the effect is great enough to
make the attempt,
he says.
The study was supported by a grant from the Robert Wood Johnson Foundation.
