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AJPH First Look, published online ahead of print Sep 27, 2007
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March 2008, Vol 98, No. 3 | American Journal of Public Health 556-559
© 2008 American Public Health Association
DOI: 10.2105/AJPH.2006.107441

RESEARCH AND PRACTICE

Setting a Challenging Yet Realistic Smoking Prevalence Target for Healthy People 2020: Learning From the California Experience

David Mendez, PhD and Kenneth E. Warner, PhD

The authors are with the Department of Health Management and Policy, University of Michigan, Ann Arbor.

Correspondence: Requests for reprints should be sent to David Mendez, PhD, Department of Health Management and Policy, 109 Observatory Rd, Ann Arbor, MI 48109 (e-mail: dmendez{at}umich.edu).

Objectives. We sought to outline an optimistic yet achievable goal for future US smoking prevalence rates based on empirical evidence reflecting the success of smoking control efforts in California.

Methods. Using a dynamic model and the smoking initiation and cessation rates achieved in California as a guide, we projected US adult smoking prevalence rates through the year 2020.

Results. If smoking initiation and cessation rates for the nation do not change, population dynamics will result in smoking prevalence rates falling to 19.1% in 2010 and 16.8% in 2020. If the country attains California’s initiation and cessation rates by 2010, adult smoking prevalence rates will be 18.5% in 2010 and 14.7% as of 2020.

Conclusions. If California’s smoking initiation and cessation rates are attained nationwide, the US smoking prevalence rate could be 5.9 percentage points lower than the 2005 rate by the year 2020, and there would be 10.2 million fewer smokers than in 2005. A target of 14% smoking prevalence by 2020 is aggressive yet feasible, given that it takes into account the constraints imposed by population demographics.






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