Minority Health and Health Equity Archive

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Tobacco Use: Prevention, Cessation, and Control
(AHRQ Publication, 2006) Ranney, Leah; Melvin, Cathy; Lux, Linda; McClain, Erin; Morgan, Laura; Lohr, Kathleen N.
Practice Center (RTI-UNC EPC) systematically reviewed the evidence on (a) the effectiveness of community- and population-based interventions to prevent tobacco use and to increase consumer demand for and implementation of effective cessation interventions; (b) the impacts of smokeless tobacco marketing on smoking, use of those products, and population harm; and (c) the directions for future research. Data Sources: We searched MEDLINE®, Cumulative Index to Nursing and Applied Health (CINAHL), Cochrane libraries, Cochrane Clinical Trials Register, Psychological Abstracts, and Sociological Abstracts from January 1980 through June 10, 2005. We included English-language randomized controlled trials, other trials, and observational studies, with sample size and followup restrictions. We used 15 Cochrane Collaboration systematic reviews, 5 prior systematic reviews, and 2 meta-analyses as the foundation for this report. Review Methods: Trained reviewers abstracted detailed data from included articles into evidence tables and completed quality assessments; other senior reviewers confirmed accuracy and resolved disagreements. Results: We identified 1,288 unique abstracts; 642 did not meet inclusion criteria, 156 overlapped with prior reviews, and 2 were not published articles. Of 488 full-text articles retrieved and reviewed, we excluded 298 for several reasons, marked 88 as background, and retained 102. Evidence (consistent with previous reviews) showed that (a) school-based prevention interventions have short-term (but not long-term) effects on adolescents; (b) multicomponent approaches, including telephone counseling, increase the number of users who attempt to quit; (c) self-help strategies alone are ineffective, but counseling and pharmacotherapy used either alone or in combination can improve success rates of quit attempts; and (d) provide training and academic detailing improve provider delivery of cessation treatments, but evidence is insufficient to show that these approaches yield higher quit rates. Recent evidence on the following topics was insufficient to change prior review findings: (a) effectiveness of population-based prevention interventions; (b) effectiveness of providerbased interventions to reduce tobacco initiation; (c) effectiveness of community- and providerbased interventions to increase use of proven cessation strategies; (d) effectiveness of marketing campaigns to switch tobacco users from smoking to smokeless tobacco products; and (e) effectiveness of interventions in populations with comorbidities and risk behaviors (e.g., depression, substance and alcohol abuse). No evidence was available on the way in which smokeless tobacco product marketing affects population harm. Conclusions: The evidence base has notable gaps and numerous study deficiencies. We found little information to address some of the issues that previous authoritative reviews had not covered, some information to substantiate earlier conclusions and recommendations from those reviews, and no evidence that would overturn any previous recommendations.
FACTSHEET: Changes in Nicotine Yield: 1998-2004
(Massachusetts Tobacco Control Program, Massachusetts Department of Public Health, 2004) Keithly, Lois; Cullen, Doris; Land, Thomas
The Massachusetts Tobacco Control Program has analyzed data from 1998-2004 and has found that the amount of nicotine inhaled by the average smoker has increased 10% over the seven year period. Although per capita consumption of cigarettes has declined, the amount of nicotine consumed per cigarette has increased. Concurrently, the amount of nicotine present in second-hand smoke has also increased.
REPORT:MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH CHANGE IN NICOTINE YIELDS 1998 - 2004,DATA SUBMITTED IN ACCORDANCE WITH MASSACHUSETTS GENERAL LAWS CHAPTER 94: Section 307B, 105 CMR 660.000
(Massachusetts Tobacco Control Program, Massachusetts Department of Public Health, 2004) Keithly, Lois; Cullen, Doris; Land, Thomas
SUMMARY Since 1997, cigarette manufacturers have delivered nicotine reporting information using testing methods established by the Massachusetts Department of Public Health (MDPH). Massachusetts General Law chapter 94 section 307B and Department of Public Health Regulations 105 CMR 660.000 mandate that cigarette companies report each year to the Department the nicotine yield ratings for all cigarette brands with a U.S. market share of greater than 1.5%. Nicotine Yield Testing • For all brands tested in both 1998 and 2004 (N = 116), the total amount of nicotine delivered to the smoker has increased significantly: 1.72 mg in 1998 compared to 1.89 mg in 2004. These data were also evaluated by manufacturer. For each of the major manufacturers (i.e.,Brown & Williamson, Lorillard, Phillip Morris, and RJ Reynolds), the increases in nicotine delivered were significant. • Each manufacturer markets many brands of cigarettes and this data was analyzed by brand. Once again, the increases in nicotine delivered were significant. With the exception of Winston cigarettes, all brands that were tested in both 1998 and 2004 had significant increases in nicotine delivered to the smoker. This includes Basic, Camel, Doral, Kool, Marlboro, and Newport cigarettes. • Cigarette brand families (e.g. Marlboro) with a U.S. market share of greater than 1.5% were required to submit nicotine yield information. In 2004, a total of 179 brands were tested from the four major cigarette manufacturers – Brown & Williamson (now owned by RJ Reynolds),Lorillard, Philip Morris, and RJ Reynolds.
AMOUNT OF NICOTINE IN CIGARETTES INCREASED SIGNIFICANTLY SINCE 1998
(Massachusetts Tobacco Control Program, Massachusetts Department of Public Health, 2002) UNSPECIFIED
PRESS RELEASE: AMOUNT OF NICOTINE IN CIGARETTES INCREASED SIGNIFICANTLY SINCE 1998 The amount of nicotine a smoker gets from smoking a cigarette has increased steadily over the past seven years, according to a new report released by the Massachusetts Department of Public Health (DPH). The study found that, regardless of brand, the amount of nicotine that is actually delivered to the smoker’s lungs has increased significantly. The data was collected from reports submitted to DPH from 1998 to 2004 by all tobacco companies that sell cigarettes in the state, as required by Massachusetts General Law Chapter 307B and Department of Public Health Regulations CMR 660.000. Massachusetts is one of only three states in the country to require tobacco companies to submit this information annually.

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