The effects of tobacco control policies on smoking rates: a tobacco control scorecard

This article reviews studies of the effect of tobaccocontrol policies on smoking rates with the aim of providingguidance on the importance of different policies. Based on past studies, we estimate the magnitude of effects of major tobacco control policies, how their effects depend on the manner in which the policies are implemented, the relationship between the different policies, and the barriers to implementation. The most successful campaigns have implemented a combination of tobacco control policies. Of those policies, substantial evidence indicates that higher taxes and clean air laws can have a large impact on smoking rates. Evidence also indicates that media campaigns when implemented with other policies are important. Research on greater access to treatment and telephone support hotlines indicates a strong potential to increase quit rates and may be important in affecting heavier smokers. Direct evidence on the effects of advertising bans and health warnings is mixed, but these policies appear to be important in some of the countries that have had success in reducing smoking rates. School education programs and limits on retail sales are not likely to have much impact if implemented alone, but may be more important when combined with other policies. KEY WORDS: smoking, tobacco control policy Smoking is the single most preventable cause of pre-mature mortality. Approximately 440,000 deaths are at-tributable to smoking each year in the United States alone, and considerable medical costs are associated with morbidity.1 Globally, it is estimated that there are currently 4 million tobacco attributable deaths each year, with current trends driving a rise to 10 million deaths per year by the 2030s.