title: Comprehensive tobacco control policies in West Virginia--going from intersection to integration.
abstract: BACKGROUND
  Currently, there exists a sufficient robust evidence base for effective tobacco control interventions. Yet, despite this progress, we as a nation and state are not currently on track to achieve the Healthy People 2020 objective to reduce cigarette smoking among adults to 12 percent or less by the year 2020. We examine state selected specific data and make recommendations on initiating an approach to policy that may lead us to further integrate tobacco control programs in West Virginia at a community level.
  
  
  METHODS
  We utilized the publicly available data to compare the historical performance of West Virginia with its select neighboring states (Ohio, Kentucky, Tennessee, Virginia, and Pennsylvania) in the areas of daily adult smoking rates, productivity losses, smoking-attributable mortality and per pack state cigarette taxes.
  
  
  RESULTS
  West Virginia's adult daily smoking rates have not declined in proportion when compared with the rest of the nation or even surrounding states. We have suffered more dollars in productivity lost per person, and higher smoking-attributable mortality while having one of the lowest state taxes on a pack of cigarettes.
  
  
  CONCLUSIONS
  Whereas research has well documented the effectiveness of laws and policies in a comprehensive tobacco control effort to protect the public from smoking related morbidity and mortality, as a state, we must begin to understand that the individual components of the comprehensive program are most effective when they work together at community levels to produce the synergistic effects. Therefore we strongly recommend our state legislature and policy makers consider tobacco control funding mechanisms that promote such integrated strategies at the local community level.
authors.forename: Monika
authors.initials: M
authors.lastname: Sawhney
authors.forename: Nasandra
authors.initials: N
authors.lastname: Wright
authors.forename: Rahul
authors.initials: R
authors.lastname: Gupta
mesh_terms: D017281:Cost of Illness; D006291:Health Policy; D006801:Humans; D012907:Smoking / Q000191:economics / Q000453:epidemiology* / Q000331:legislation & jurisprudence*; D013660:Taxes; D014029:Tobacco Use Disorder / Q000191:economics / Q000453:epidemiology*; D014903:West Virginia