Adult tobacco use levels after intensive tobacco control measures: New York City, 2002-2003.
OBJECTIVE
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.
Frieden
Thomas R
TR
New York City Department of Health and Mental Hygiene, New York 10013, USA. tfrieden@health.nyc.gov
Mostashari
Farzad
F
Kerker
Bonnie D
BD
Miller
Nancy
N
Hajat
Anjum
A
Frankel
Martin
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006293:Health Promotion / Q000331:legislation & jurisprudence*; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D015397:Program Evaluation; D011635:Public Health Administration; D011640:Public Policy; D012307:Risk Factors; D012907:Smoking / Q000191:economics / Q000453:epidemiology* / Q000331:legislation & jurisprudence; D016540:Smoking Cessation; D000074606:Smoking Prevention; D013660:Taxes / Q000331:legislation & jurisprudence; D019460:Tobacco Industry / Q000191:economics / Q000331:legislation & jurisprudence*; D014029:Tobacco Use Disorder / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D014505:Urban Population