Can strategies used by statewide tobacco control programs help smokers make progress in quitting?

Abstract

Many states have recently adopted programs to encourage smokers to quit. Here, we seek evidence that strategies generally used by these programs have the potential to influence smoking cessation. In California, 1,736 smokers from a population-based telephone survey were interviewed in 1990 and 1992. We examined the association of demographic and program-related variables (reporting of work area smoking bans; belief in the harmfulness of environmental tobacco smoke, including in-home smoking restrictions; and quitting assistance) with quitting progress. Smokers were categorized into levels in a previously developed Quitting Continuum, which considers their addiction level and quitting history. Smokers in each higher continuum category had an increased likelihood of future successful cessation. Smokers progressed if they were at a higher continuum level in 1992 than in 1990. College graduates showed 2.3 times more progress than did high school dropouts. Smokers reporting work area smoking bans showed 1.6 times more progress than did workers not reporting such restrictions. Smokers with the strongest beliefs (home smoking restrictions) regarding the harmfulness of environmental tobacco smoke showed 3.4 times more progress than smokers with no belief. Smokers who reported having some form of cessation assistance showed 3.0 times more progress. The more program-related factors were reported, the higher the rate of progress was: 13.1% for those reporting no factors, 23.4% for one factor, and 40.6% for two or more. These results suggest but do not prove that strategies promoted by statewide tobacco control programs can potentially be effective and that these efforts should be continued and expanded.