Health Objectives for the Nation Public Attitudes Regarding Limits on Public Smoking and Regulation of Tobacco Sales and Advertising --- 10 U.S. Communities, 1989

The national health objectives for the year 2000 emphasize the need for policies and laws that restrict smoking in public places, restrict minors' access to tobacco products, and restrict minors\' exposure to tobacco product advertising and promotion (1). To characterize public attitudes regarding policy issues related to the prevention and control of tobacco use, the National Cancer Institute surveyed communities participating in the Community Intervention Trial for Smoking Cessation (COMMIT) (2). This report describes the results of a baseline COMMIT survey in 10 U.S. communities.*

Data were obtained from a telephone survey conducted from January through April 1989 of stratified random samples of persons aged 25--64 years who were identified in the 1988 COMMIT baseline survey (3). Approximately 113 heavy smokers (greater than or equal to 25 cigarettes per day), 120 light/moderate smokers (1--24 cigarettes per day), 112 smokers who had recently quit (less than or equal to 5 years), and 172 persons who had not smoked in greater than 5 years or who had never smoked were identified in each of the 10 participating communities during the 1988 baseline survey. Of the 5172 persons identified, 3654 (71%) persons participated in the 1989 survey. The data for each community were weighted to reflect variations in smoking status and response rate differences among communities so that overall weighted estimates were derived for each community.

In all 10 communities, respondents supported limiting smoking in a wide range of locations (Table 1, page 351). Although nonsmokers were more likely than smokers to support limiting smoking in various locations, 82%--100% of smokers supported limiting smoking in restaurants, private worksites, government buildings, indoor sports arenas, hospitals, and doctors' offices. In each community, most of the survey population favored efforts to restrict minors' access to cigarettes (Table 2, page 352). In six communities, 50%--56% agreed that tobacco companies should not be allowed to sponsor sporting and cultural events, and in nine communities, 55%--73% agreed that all tobacco advertising should be eliminated. Communities varied considerably in their attitudes toward banning the sale of cigarette products (Table 3, page 352). Reported by: KM Cummings, PhD, R Sciandra, Roswell Park Cancer Institute, Buffalo, New York, and TF Pechacek, PhD, WR Lynn, D Corle, National Cancer Institute, National Institutes of Health, for the Community Intervention Trial for Smoking Cessation Research Group. Epidemiology Br, Office on Smoking and Health, Center for Chronic Disease Prevention and Health Promotion, CDC.

Editorial Note

Editorial Note:

The findings in this report indicate a high level of concordance among these 10 geographically diverse communities for support of regulatory efforts to limit public exposure to environmental tobacco smoke. In addition, these findings are consistent with those in other reports (4,5). As of 1989, approximately 50% of large businesses had promulgated smoking restriction policies for their employees (4). Through March 1991, 46 states** had enacted laws restricting smoking in public places (CDC, unpublished data).

Respondents in each of the 10 communities in this survey strongly supported the enactment and enforcement of laws restricting the sale of tobacco to minors. Although legislation in 45 states** restricting the sale of cigarettes to minors has been in place since 1989 (6), enforcement and compliance have been limited (7). In 1989, the U.S. Inspector General reported only 32 documented violations of sales laws (7); however, in the United States an estimated 1 billion packs of cigarettes are sold annually to persons less than 18 years of age (8).

In 1987 and 1988, surveys on the banning of tobacco advertising indicated that 49%--55% of respondents believed tobacco advertising should not be permitted (4). In many communities, tobacco advertising has been banned in public transit systems.

To target the need for smoking control and prevention, the national health objectives for the year 2000 include: 1) increasing to at least 75% the proportion of worksites with a formal smoking policy that prohibits or severely restricts smoking in the workplace; 2) enacting in all 50 states comprehensive laws on clean indoor air that prohibit or strictly limit smoking in the workplace and enclosed public places; 3) enacting and enforcing laws that prohibit the sale and distribution of tobacco products to persons less than 19 years of age, particularly where age verification is difficult or impossible (such as through vending machines); 4) establishing tobacco-free environments in all elementary, middle, and secondary schools; and 5) eliminating or severely restricting all forms of tobacco product advertising and promotion to which minors are likely to be exposed (1).

References

1. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives. Washington, DC: US Department of Health and Human Services, Public Health Service, 1990; DHHS publication no. (PHS)91-50212.

2. Pechacek TF. A randomized trial for smoking cessation. In: Smoking and health, 1987---proceedings of the sixth World Conference on Smoking and Health. New York: Excerpta Medica, 1988:241--3.

3. Mattson ME, Cummings KM, Lynn WR, Giffen C, Corle D, Pechacek T. Evaluation plan for the community intervention trial for smoking cessation (COMMIT). Int J Community Health Educ (in press).

4. CDC. Reducing the health consequences of smoking: 25 years of progress---a report of the Surgeon General. Washington, DC: US Department of Health and Human Services, Public Health Service, 1989; DHHS publication no. (CDC)89-8411.

5. Gallup G, Newport F. Many Americans favor restrictions on smoking in public places. Gallup Poll Monthly 1990;298:19--27.

6. CDC. State laws restricting minors' access to tobacco. MMWR 1990;39:349--53.

7. Office of Evaluation and Inspections. Youth access to cigarettes. New York: US Department of Health and Human Services, Office of Inspector General, 1990; DHHS publication no. OEI-02-90-02310.

8. Di Franza JR, Tye JB. Who profits from tobacco sales to children? JAMA 1990;263:2784--7. *Four of the 10 communities surveyed are located in the Northeast (Fitchburg/Leominster, Massachusetts; Paterson, New Jersey; Utica, New York; Yonkers, New York); three in the West (Vallejo, California; Medford/Ashland, Oregon; Bellingham, Washington); and one each in the South (Raleigh, North Carolina), Southwest (Santa Fe, New Mexico), and Midwest (Cedar Rapids, Iowa).

**Including the District of Columbia.

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