Statewide comprehensive tobacco programs

Statewide comprehensive tobacco control programs coordinate state and community-level cessation and prevention interventions and provide information on the dangers of tobacco via educational, regulatory, clinical, social, and economic strategies (CDC-King 2014), such as restrictions on tobacco product marketing and availability, mass media campaigns, cessation services, or smoke-free policies. Programs often provide assistance to community-based organizations and coalitions that implement local tobacco control programs and policies. Statewide programs also conduct surveillance, evaluation, and program monitoring (CG-Tobacco use).

Expected Beneficial Outcomes (Rated)

  • Reduced number of tobacco users

  • Reduced youth smoking

  • Improved health outcomes

  • Reduced tobacco use

  • Increased quit rates

  • Reduced exposure to secondhand smoke

  • Reduced health care costs

Evidence of Effectiveness

There is strong evidence that statewide comprehensive tobacco control programs reduce the number of tobacco users and amount of tobacco used, increase quit rates, reduce exposure to secondhand smoke (SHS), improve health outcomes, and reduce health care costs (CG-Tobacco use).

Statewide comprehensive tobacco control programs reduce long-term smoking by adults and youth. States with programs have greater reductions in youth smoking, smoking initiation among adolescents (ages 11 to 17), and higher quit rates for adult smokers than states without programs. Statewide programs reduce SHS exposure in homes and workplaces, and residents of states with programs are more likely to adopt home smoking bans than those in states without programs. Comprehensive tobacco control programs can reduce smoking-related cancers, deaths, and hospitalizations (CG-Tobacco use).

In the long-term, states with comprehensive tobacco control programs have greater reductions in daily tobacco use and reduced cigarette pack sales than states without programs (CG-Tobacco use).

Statewide programs reduce tobacco use and SHS exposure similarly across racial and ethnic groups, as well as education and income levels (CG-Tobacco use). A study of Oklahoma’s statewide comprehensive tobacco control program suggests that such programs can be more effective in rural than urban areas ().

Statewide comprehensive tobacco control programs are cost effective; savings from averted health care costs exceed program costs. Programs funded at Centers for Disease Control and Prevention (CDC) recommended levels are more effective than programs funded at lower levels (CG-Tobacco use).

Impact on Disparities

No impact on disparities likely

Implementation Examples

The Centers for Disease Control and Prevention (CDC) prepared recommended funding levels for each state’s and Washington DC’s comprehensive tobacco control programs (CDC-King 2014). The Campaign for Tobacco-Free Kids lists the projected spending on an annual basis. States’ spending projections range from 0% to 89.4% of the CDC recommendation in fiscal year 2019; Connecticut, Tennessee, and West Virginia are projected to spend 0% and Alaska to spend 89.4% (CTFK-Tobacco settlement, CTFK-State spending). Cumulatively, states will spend 19.8% of the total funding the CDC recommends spending on tobacco control programs in 2019 (CTFK-State spending).

The California Tobacco Control Branch leads statewide and local health programs in promoting a tobacco free environment; it also provides information about tobacco control policies, community resources, media tools, and research and evaluation results (CDPH-CTCB). The New York State Tobacco Control Program includes community programs and partnerships, health communications, the New York State Smokers’ Quitline, and surveillance, evaluation, and research efforts (NYS TCP).

Implementation Resources

CTFK-TFR - Campaign for Tobacco-Free Kids (CTFK), Tobacco Free Retailers (TFR). You can shop tobacco-free: find stores that don't sell tobacco products.

CDC-King 2014 - Centers for Disease Control and Prevention (CDC). Best practices for comprehensive tobacco control programs - 2014. Atlanta: US Department of Health and Human Services (US DHHS); 2014.

CDPH-CTCB - California Department of Public Health (CDPH). California Tobacco Control Program (CTCP). 2018.

CTFK-Issues - US state and local issues. Prevention and cessation programs: Reducing smoking, saving lives, saving money. Campaign for Tobacco-Free Kids. 2018.

CTFK-Tobacco settlement - Broken promises to our children: A state-by-state look at the 1998 tobacco settlement 19 years later. Campaign for Tobacco-Free Kids. 2018.

Citations - Evidence

* Journal subscription may be required for access.

CG-Tobacco use - The Guide to Community Preventive Services (The Community Guide). Tobacco.

Rhoades 2015* - Rhoades RR, Beebe LA, Boeckman LM, Williams MB. Communities of excellence in tobacco control: Changes in local policy and key outcomes. American Journal of Preventive Medicine. 2015;48(1):S21-S28.

Citations - Implementation Examples

* Journal subscription may be required for access.

CTFK-State spending - Campaign for Tobacco-Free Kids (CTFK). History of spending for state tobacco prevention programs FY2000 - FY2019.

CDC-King 2014 - Centers for Disease Control and Prevention (CDC). Best practices for comprehensive tobacco control programs - 2014. Atlanta: US Department of Health and Human Services (US DHHS); 2014.

NYS TCP - New York State Department of Public Health. New York State Tobacco Control Program (NYS TCP). 2018.

CDPH-CTCB - California Department of Public Health (CDPH). California Tobacco Control Program (CTCP). 2018.

CTFK-Tobacco settlement - Broken promises to our children: A state-by-state look at the 1998 tobacco settlement 19 years later. Campaign for Tobacco-Free Kids. 2018.

Date Last Updated

Jan 29, 2019