Community Preventive Services -
Changing Risk Behaviors -

Tobacco


Task Force on Community Preventive Services Recommendations:

Strategies for Reducing Exposure to Environmental Tobacco Smoke, Increasing Tobacco-Use Cessation, and Reducing Initiation in Communities and Health-Care Systems

Intervention

Recommendation

Intervention Description

Strategies to reduce exposure to environmental tobacco smoke (ETS)

Smoking bans and restrictions

Strongly recommended

Bans or limits tobacco smoking in workplaces and public areas (policies, regulations, and laws).

Community education to reduce home ETS exposure

Insufficient evidence*

Provides information to persons about reducing ETS exposure in the home.

Strategies to reduce tobacco-use initiation

Increasing the unit price of tobacco products

Strongly recommended

Increases the excise tax on cigarettes (government legislation).

Mass media education to reduce tobacco-use initiation - campaigns

Strongly recommended (when combined with other interventions)

Informs viewers through long-term, high-intensity counter advertising campaigns.

Strategies to increase tobacco-use cessation (for community-wide use)

Increasing the unit price of tobacco products

Strongly recommended

Increases the excise tax on cigarettes (government legislation).

Mass media education to increase tobacco-use cessation -- campaigns

Strongly recommended

Informs viewers through long-term, high-intensity counter advertising campaigns.

Mass media education to increase tobacco-use cessation -- series

Insufficient evidence*

Recruits and motivates tobacco users to quit during the course of a short-term broadcast cessation series.

Mass media education to increase tobacco-use cessation -- contests

Insufficient evidence

Recruits and motivates tobacco users to participate in a targeted cessation date.

Uses short-term mass media messages to promote contest and to recruit participants.

Strategies to increase tobacco-use cessation (for health care systems)

Multicomponent tobacco-use cessation interventions that include telephone support

Strongly recommended

Provides information and motivation to tobacco product users via telephone contact.

Proactive telephones support includes provider-maintained contact.

Reactive telephone support requires patient-initiated contact.

Multicomponent program including provider reminder system plus provider education program with or without patient education

Strongly recommended

Educates and prompts health-care providers to identify, advise, and assist tobacco-using patients in cessation efforts.

Provider reminder systems

Recommended

Informs or prompts providers to determine patient's tobacco-use status and/or deliver brief advice to quit.

Reducing patient out-of-pocket costs for effective cessation therapies

Recommended

Reduces or eliminates patient co-payment for effective cessation therapies.

Provider education only

Insufficient evidence*

Provides information to health-care providers on the importance of cessation for tobacco-using patients.

Provider feedback

Insufficient evidence*

Provides retrospective assessment of provider performance in delivery of tobacco cessation advice or assistance to patients.

Youth access restrictions

Pending

Regulates and enforces bans on the purchase or consumption of tobacco products by children and adolescents (laws).

School-based education

Pending

Provides information and motivation to children and adolescents to diminish the uptake of tobacco product use.

Tobacco industry restrictions

Pending

Regulates tobacco product content, labeling, or industry promotion and advertising (laws).

* A determination that evidence is insufficient should not be seen as evidence of ineffectiveness. A determination of insufficient evidence assists in identifying a) areas of uncertainty regarding effectiveness of an intervention and b) continuing research needs. In contrast, evidence of ineffectiveness leads to a recommendation that the intervention should not be used.