Policy Factsheet

Comprehensive Tobacco Control Programs

Reasons for Policy

  • Cigarette smoking is the leading cause of preventable morbidity and mortality in the United States.1
  • Half of all long-term smokers die prematurely from smoking-related disease.1
  • The direct medical costs of tobacco use range from $50 billion to $73 billion per year.2

Community Groups

  • Local Government
  • Public Health Departments
  • State Government

Policy Components

A combination of the following elements:

  • Public education media campaigns
  • Policies to prevent youth access to tobacco
  • Tobacco-free environments (smoking bans and restrictions in the workplace)
  • Restrictions on tobacco advertising
  • Price increases in tobacco products (excise taxes)
  • School based prevention programs
  • Tobacco use cessation services
  • Funding and grants for research and prevention

Desired Outcomes

  • Decreased population smoking prevalence
  • Reduced smoking among youths
  • Decreased aggregate cigarette consumption
  • Reduced exposure to environmental tobacco smoke (secondhand smoke)

Level of Evidence Available to Evaluate Effectiveness of Policy

For all policies we describe on this website, we have applied the Standards of Evidence as defined by Flay et al. (2005) in the Standards of Evidence document published by Prevention Science.

The effectiveness level of this policy is 1: Evidence-Based Policies Meeting Criteria for Effectiveness.

The levels of effectiveness as noted are:

  1. meets criteria for policy effectiveness (consistent, positive outcomes from at least two high-quality experimental or quasi-experimental trials using a comparison group or interrupted time series design);
  2. consistent evidence available linking policy with positive outcomes from high-quality observational studies only;
  3. insufficient evidence available for policy or policy components.

Achievable Results

On average, mass media campaigns can achieve:

  • An 8% decrease in tobacco use prevalence in adolescents when combined with other interventions.2

On average, increasing the price of tobacco products can achieve:

  • A 10% increase in price may result in a 2-3% decrease in consumption among both adolescents and young adults.2

On average, smoking bans and restrictions can achieve:

  • Large reductions (60-70%) in exposure to environmental tobacco smoke in the workplace.2

Community Examples

Los Angeles, California, Los Angeles County Department of Public Health Tobacco Control and Prevention Program is the largest local agency in California to lead and implement a tobacco control program.

Vermont’s Comprehensive Tobacco Control Program, program includes seven components recommended by the Centers for Disease Control and Prevention (CDC)

Links to Policy Examples

California, Tobacco Tax and Health Promotion Act, statewide comprehensive tobacco control program, also Health and Safety Code, D. 103, Pt 3, Ch.1 Tobacco Control, Art. 1 § 104350, and Los Angeles Municipal Code Section § 41.50(B)(18)(b), outdoor dining no-smoking ordinance.

Vermont, 18 V.S.A § 9503, Vermont tobacco prevention and treatment

Be sure to check with your state, county, and municipal governments regarding potential existing laws that may impede any new policy development.

Local governments and organizations may check existing state and federal statutes and administrative codes for the authority to implement local policies


1 US Department of Health and Human Services (2004). The Health Consequences of Smoking: A Report of the Surgeon General. US Department of Health and Human Services, CDC, Available at <a href=http://www.cdc.gov/tobacco/data_statistics/sgr/2004/index.htm.</a>

2 Hopkins DP, et al. (2001). Reviews of Evidence Regarding Interventions to Reduce Tobacco Use and Exposure to Environmental Tobacco Smoke American Journal of Preventive Medicine, 20(2S), 16-66.

3 Flay, BR, Biglan, A, Boruch, RF, Ganzalez Castro, F, Gottfredson, D, Kellam, S, Moscicki, EK, Schinke, S, Valentine, JC, & Ji, P (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6(3), 151-175.

**See also: Centers for Disease Control and Prevention (2007). Best Practices for Comprehensive Tobacco Control Programs-2007. US Department of Health and Human Services, CDC, Available at <a href=http://www.cdc.gov/tobacco/tobacco_control_programs/stateandcommunity/best_practices/</a>.