Throughout the years, tobacco consumption has remained a significant cause of numerous public health issues in the United States. Presently, tobacco consumption is among the top risk factors linked to escalating cancer, cardiovascular diseases, respiratory illnesses, diabetes, and stroke. According to Paoleti et al. (2012), more than 440,000 people in the United States have lost their lives due to illnesses related to consuming tobacco products, with more than 40% of these deaths resulting from cancer. Considering this health threat, the United States government embarked on mitigating the harm by formulating and implementing various policies and restrictions to curb tobacco use. These policies later emerged as tobacco control laws. Presently, most states in the U.S have various tobacco laws barring the sale and consumption of tobacco to different quarters. This paper examines the efficacy of tobacco control policies in the United States.
History and background on tobacco consumption restrictions
In late 19th century, James Bonsack unveiled an automatic machine that produced 200 cigarettes per minute. Bonsack’s invention stirred up the tobacco industry, causing a massive job loss and increased cigarette consumption in New York. Not so long after, health providers and researchers noticed an increase in Tuberculosis cases and consequently enacted restrictions on spitting to prevent Tuberculosis transmission (Paoleti et al., 2012). During this period, most local and state authorities became increasingly aware of the perils linked with tobacco consumption and therefore enacted laws prohibiting the production, trade, possession, and consumption of cigarettes. Nonetheless, cigarette smoking accelerated once again with World War I. Much later in the 1950s and 1960s, health statistics and reports from the Surgeon General indicated illnesses like lung cancer, bronchitis, heart problems, and other complications like low birth weight were linked to tobacco consumption. Due to this situation, the United States government created several interventions to limit tobacco use. Such included increased taxes on tobacco products, tobacco use regulations, and smoke–free air ordinances.
Various tobacco control policies and their impacts on tobacco use in the U.S
According to Levy et al. (2018), the introduction and implementation of tobacco consumption restrictions in the U.S have significantly reduced tobacco prevalence among the population. For instance, since consumption highly depends on affordability, an increase in tobacco products’ prices across the United States has reduced tobacco use as more people quit because they are unable to afford cigarettes, cigars, or other items. As Paoleti et al. (2012) pointed out, federal, state, and local taxes are imposed on tobacco in the U.S. In this situation, most smokers and especially the youth, are forced to cease smoking since they are more sensitive to pricing than the older generation. From a health perspective, the CDC reports that price increase has reduced tobacco use by 7.4% among adults aged above 30 and 7.2% among people aged between 19 and 30.
Moreover, the price increase has curbed initiation rates and increased cessation rates by 6.5% in adults and 18.6% among young adults. Again, the recent price increases have saved the United States healthcare costs significantly over the years. In tandem with the government’s effort to increase prices, organizations have moved a step further to increase insurance charges for workers who smoke, while others (Paoleti et al., 2012).
Besides increasing prices, the United States government and health organizations have enacted various smoke-free air laws to curb tobacco consumption and exposure. Smoke-free air laws forbid smoking within public areas like parks, restaurants, bars, and subways (Levy et al., 2018). Presently, over 24 states have adopted smoke-free laws, as recent research revealed that passive smoking is among the factor behind the increasing cancer cases among nonsmokers. Like price increase, smoke-free air laws have significantly scaled-down smoking and tobacco use. According to Paoleti et al. (2012), smoke-free air laws have reduced hospital admissions linked to myocardial infarctions and pulmonary embolism by 19%. On the other hand, smoke restrictions have increased the quitting rates and decreased tobacco exposure by 50%. In addition, smoke-free air laws have reduced the amount of cigarettes smoked per day (Levy et al., 2018). Although the state and federal governments enforce smoke-free air laws, individuals, organizations and institutions have also enacted similar policies that have highly influenced public perception and behavior concerning tobacco use (Wang et al., 2018).
In addition to price increase and smoke-free air policies, the United States government has also implemented different tobacco regulation policies like the 2019 law that increased tobacco sales from 18-21. Other regulations aim to reduce nicotine levels in tobacco products (Appelberg et al., 2018). Typically, such regulations aim to reduce initiation rates among the younger generation. According to Levy et al. (2018), state-funded tobacco regulation programs have reduced smoking rates by over 5% and initiation rates by 12% between 2009 and 2018. Such evidence shows that tobacco restrictions are viable measures to curb the massive tobacco use in the country.
Besides the above measures, the United States government presently employs healthcare as one of the most crucial mechanisms to increase tobacco cessation. Since tobacco has a high risk of addiction, current strategies to curb smoking involve using therapies to mitigate nicotine dependence among former users. Although therapies and pharmacological approaches efficiently reduce tobacco consumption, most health practitioners do not assist patients in quitting tobacco (Paoleti et al., 2012). Due to this situation, most former smokers relapse, and thus the whole idea behind reducing tobacco consumption fails.
Additionally, mass education and communication interventions have also reduced tobacco consumption. According to Levy et al. (2018), mass education campaigns are conducted using digital media, radio, television, social media, billboards, etc. Primarily, such campaigns are used to sensitize a massive audience consisting of the younger generation who are ardent consumers of digital media about the health risks associated with tobacco consumption (CDC, 2017). According to an extensive study conducted 2002-2012, mass media campaigns reduced smoking rates in the United States by 5%. Besides, recent studies indicate that increased cessation and initiation rates among young people are linked to mass media campaigns.
Lastly, health warnings have reduced tobacco use in the United States. Health warnings consist of pictures and labels that bear the detrimental effects associated with using tobacco products. According to Levy et al. (2018), health warnings bearing pictures reduce initiation and smoking prevalence by 13% among adults. Nevertheless, the intensity and size of the health warnings matter as bigger pictures and letters are more likely to have a higher effect.
Conclusion
Due to the policies and interventions discussed in this paper, tobacco consumption and related health issues have waned considerably in the United States. Such an outcome depicts that tobacco control laws in the United States have relatively attained their desired objectives. Regardless, various challenges are facing the efforts to reduce tobacco use. Firstly, due to imports, tobacco remains the most used substance in the United States. Besides, the use of smokeless tobacco has increased significantly in recent years. Lastly, there are less evidence-based policies to reduce tobacco prevalence and increase cessation.
Reference
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Levy, D. T., Tam, J., Kuo, C., Fong, G. T., & Chaloupka, F. (2018). Research full report: the impact of implementing tobacco control policies: the 2017 tobacco control policy scorecard. Journal of Public Health Management and Practice, 24(5), 448.
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Wang, T. W., Tynan, M. A., Hallett, C., Walpert, L., Hopkins, M., Konter, D., & King, B. A. (2018). Smoke-Free and tobacco-free policies in colleges and universities―United States and territories, 2017. Morbidity and Mortality Weekly Report, 67(24), 686.
