Adult tobacco use levels after intensive tobacco control measures: New York City, 2002-2003

Abstract

Objectives: We sought to determine the impact of comprehensive tobacco control measures in New York City.

Methods: In 2002, New York City implemented a tobacco control strategy of (1) increased cigarette excise taxes; (2) legal action that made virtually all work-places, including bars and restaurants, smoke free; (3) increased cessation services, including a large-scale free nicotine-patch program; (4) education; and (5) evaluation. The health department also began annual surveys on a broad array of health measures, including smoking.

Results: From 2002 to 2003, smoking prevalence among New York City adults decreased by 11% (from 21.6% to 19.2%, approximately 140000 fewer smokers). Smoking declined among all age groups, race/ethnicities, and education levels; in both genders; among both US-born and foreign-born persons; and in all 5 boroughs. Increased taxation appeared to account for the largest proportion of the decrease; however, between 2002 and 2003 the proportion of cigarettes purchased outside New York City doubled, reducing the effective price increase by a third.

Conclusions: Concerted local action can sharply reduce smoking prevalence. However, further progress will require national action, particularly to increase cigarette taxes, reduce cigarette tax evasion, expand education and cessation services, and limit tobacco marketing.

FIGURE 1—

Smoking prevalence among New York City adults, 1993–2003, with key tobacco control initiatives and dates of implementation. Note. Smoking prevalence among adults decreased by 11%. Width of bars is proportional to sample size. Space between bars is proportional to time interval between surveys.

FIGURE 2—

Odds ratios for smoking in 2003 vs 2002, by sociodemographic group, with 95% confidence intervals. Note. Logarithmic scale. All data are age adjusted (except for age).