Impact Data - California Tobacco Control Programme
Date
Launched in 1990, the California Tobacco Control Program (TCP) works to create a social milieu and legal climate in which tobacco use is regarded as unacceptable. The programme was implemented through statewide public health and education networks and supported by a research component. When the state legislature passed its anti-tobacco bill in 1989, TCP set the goal of reducing tobacco use by 75% by the end of 1999. This massive campaign involves almost every type of social communication and education method and medium, including television ads, posters, billboards, websites, telephone hotlines, counseling programmes, specific educational curriculum for both primary and secondary school students, and increased enforcement and monitoring of tobacco controls.
There are several evaluations of this overall campaign; the total amount of data collected is too numerous to provide an extensive overview. In addition to the evaluation of changes in knowledge, attitudes, and behaviours, this evaluation provided an extensive examination of the changing nature and role of tobacco-advertising techniques and strategies and ways to combat these new methods.
Methodologies
The Independent Evaluation is a multi-method study with a repeated cross-section design that includes three waves of data collection separated by 18-month intervals. The baseline wave was conducted from October 1996 to February 1997, and focussed on tobacco control activities in 1995 and 1996. The second wave of data collection took place from March to July 1998, and focussed on tobacco control activities during 1997 and 1998. The third wave of data collection was conducted from October 1999 to February 2000, and focussed on tobacco control activities during 1998 and 1999. This series of data collection was part of a review of California smoking practices that has been ongoing since 1990.
Data on program outcomes was derived from 8 different sources, including:
Data on program outcomes was derived from 8 different sources, including:
- Adult Computer-Assisted Telephone Interviews (N=6,916)
- School-Based Youth Surveys (N=26,479)
- Opinion Leader Computer-Assisted Telephone Interviews (CATIs) were conducted with individuals in 17 positions of leadership within the following 5 categories: government officials, law enforcement officials, education officials, media representatives, and business representatives (N=1116)
- Enforcement Agency Surveys, Tobacco Industry Monitoring Data, Local Policy Data, STAKE Act 1-800 Phone Call Data, and some data for 1993-1999 from the California Adult Tobacco Survey (CATS) and California Youth Tobacco Survey (CYTS)
Knowledge Shifts
Between 1996 and 2000 there were significant changes in tobacco knowledge, defined as the mean percent correct on knowledge tests. 8th graders' knowledge increased from 55.1% to 60.1%, while 10th graders' knowledge improved from 59.3% to 65.5%.
Between 1996 and 2000, there was a significant decrease in the percentage of young people who thought cigarettes were easy to obtain for 8th graders, from 67% to 62%, and 10th graders from 89% to 82%. Local TCP efforts to reduce the availability of cigarettes to youth were not found to be associated with these changes. There was also a significant decrease in the 10th graders' perceptions of the frequency of violations of tobacco-free policies in their high schools.
Close to half the adult smokers (46%) had thought about quitting as a result of seeing the television ads, and almost one-third (31%) had thought about quitting as a result of seeing the billboard ads. Among non-smokers, over half (54%) had thought about asking others not to smoke as a result of the television ads, while 33% did so after the billboard ads.
Between 1996 and 2000, there was a significant decrease in the percentage of young people who thought cigarettes were easy to obtain for 8th graders, from 67% to 62%, and 10th graders from 89% to 82%. Local TCP efforts to reduce the availability of cigarettes to youth were not found to be associated with these changes. There was also a significant decrease in the 10th graders' perceptions of the frequency of violations of tobacco-free policies in their high schools.
Close to half the adult smokers (46%) had thought about quitting as a result of seeing the television ads, and almost one-third (31%) had thought about quitting as a result of seeing the billboard ads. Among non-smokers, over half (54%) had thought about asking others not to smoke as a result of the television ads, while 33% did so after the billboard ads.
Practices
From 1996 to 2000, the prevalence of 30-day cigarette smoking decreased significantly among
Similarly, lifetime smoking rates were down as well over the time period, from
Furthermore, from 1996 to 2000 the number of 10th graders who had tried to quit in the last year increased from 46% to 68%.
Between 1998 and 2000, local TCP efforts were related to decreases in adults' ETS exposure at work, but not to decreases in ETS exposure at home.
- 5th graders: from 5% to 1.9%
- 8th graders: from 16.9% to 11.7%
- 10th graders: from 27.8% to 19.5%.
Similarly, lifetime smoking rates were down as well over the time period, from
- 11.9% to 5.4% for 5th graders
- 45.3% to 37.2% for 8th graders
- 62.9% to 54.1% for 10th graders.
Furthermore, from 1996 to 2000 the number of 10th graders who had tried to quit in the last year increased from 46% to 68%.
Between 1998 and 2000, local TCP efforts were related to decreases in adults' ETS exposure at work, but not to decreases in ETS exposure at home.
Attitudes
Perceived norms of both prevalence and social acceptance were both changed within youth populations from 1996 to 2000. Belief in the acceptance of smoking declined from 70.9% to 65.3% for 8th graders, and from 84% to 79.5% for 10th graders. Young people also believed that fewer of their peers were smoking, and there were definitive increases in young people's refusal skills (percentage who believe that it would be easy to say no to a friend's cigarette offer), shifting from 76% to 84.7% for 8th graders and 87.4% to 90.3% for 10th graders.
On the environmental tobacco front (also known as "second-hand smoke"), in 2000 the majority of Californians believed that smoking was unacceptable:
Furthermore, during 2000, exposure to the media campaign was associated with the following outcomes:
On the environmental tobacco front (also known as "second-hand smoke"), in 2000 the majority of Californians believed that smoking was unacceptable:
- In bus shelters: 76%
- Close to building entrances: 72%
- In public places such as the zoo: 65%
- At outdoor restaurants: 62%
- At outdoor community events: 57%
Furthermore, during 2000, exposure to the media campaign was associated with the following outcomes:
- More negative attitudes toward the tobacco industry.
- Among youth, greater support for policies that would restrict tobacco marketing.
- Among youth and adults, greater likelihood of belief that Environmental Tobacco Smoke (ETS) causes cancer.
- Among adults, greater likelihood of asking others not to smoke.
- Among adults, better understanding of the reason for the restrictions on smoking in bars, preference for smoke-free bars, and belief that the law on smoking in bars should not be overturned.
Access
Opportunity for exposure to the California campaign is broad, using multiple platforms for message delivery and addressing a wide array of social groups and constituencies. For instance, campaigns have been directed at specific ethnic groups, young people, parents, and business and restaurant owners. 4.2 million schoolchildren received tobacco use prevention awareness services; 914,000 parents received tobacco use prevention awareness services; and approximately 1 million community members received written materials about tobacco use prevention.
Most Californians were exposed to some form of tobacco control messages through at least 2 different components (media, community, and/or school), including 76% of 8th graders, 85% of 10th graders, and 79% of adults. Only 5% of 8th graders, 4% of 10th graders, and 1% of adults did not report exposure to any programmes.
Most Californians were exposed to some form of tobacco control messages through at least 2 different components (media, community, and/or school), including 76% of 8th graders, 85% of 10th graders, and 79% of adults. Only 5% of 8th graders, 4% of 10th graders, and 1% of adults did not report exposure to any programmes.
Source
Independent Evaluation Consortium: Final Report. Independent Evaluation of the California Tobacco Control Prevention and Education Program: Waves 1, 2, and 3 (1996-2000)." Rockville: Maryland: The Gallup Organization, 2002; and Tobacco Education and Research Oversight Committee: "Toward a Tobacco-Free California: Strategies for the 21st Century", January 2000.
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