Impact of tobacco control on adult per capita cigarette consumption in the United States.
OBJECTIVE
We assessed the impact of tobacco control on adult per capita cigarette consumption in the United States from 1964 to 2011.


METHODS
We used logit regression to model the diffusion of smoking from 1900 to 2011. We also projected hypothetical cigarette consumption after 1963 in the absence of tobacco control. Model predictors included historical events such as wars, specific tobacco control interventions, and other influences.


RESULTS
Per capita consumption increased rapidly through 1963, consistent with S-shaped (sigmoid) diffusion. The course reversed beginning in 1964, the year of publication of the first surgeon general's report on smoking and health. Subsequent tobacco control policy interventions significantly reduced consumption. Had the tobacco control movement never occurred, per capita consumption would have been nearly 5 times higher than it actually was in 2011.


CONCLUSIONS
Tobacco control has been one of the most successful public health endeavors of the past half century. Still, the remaining burden of smoking in the United States augurs hundreds of thousands of deaths annually for decades to come. Reinvigorating the tobacco control movement will require novel interventions as well as stronger application of existing evidence-based policies.
Kenneth E. Warner and Donald W. Sexton are with the Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor. Brenda W. Gillespie is with the Department of Biostatistics, School of Public Health, University of Michigan. David T. Levy is with the Department of Oncology, School of Medicine, Georgetown University, Washington, DC. Frank J. Chaloupka is with the Department of Economics, University of Illinois at Chicago.
Kenneth E
KE
Warner
Donald W
DW
Sexton
Brenda W
BW
Gillespie
David T
DT
Levy
Frank J
FJ
Chaloupka
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical; D011634:Public Health; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation; D000074606:Smoking Prevention; D014481:United States / Q000453:epidemiology