The Department of Public Health's tobacco-control efforts included an aggressive anti-smoking television ad campaign.


Globe Staff / July 31, 2008


Nearly 8 percent fewer Massachusetts adults smoked in 2007 than the year before, the steepest decline in cigarette use in more than a decade, state health authorities reported yesterday.

The drop coincided with the revival of the state's tobacco-control program, which was slashed under the administrations of Jane Swift and Mitt Romney.


The Department of Public Health, for example, in boosting its spending by 50 percent, resurrected in-your-face television ads starring former smokers whose health was affected by cigarettes.

At the same time, the state's quest to insure nearly every resident, which has extended coverage to more than 350,000 adults, may have contributed to the decline.

"When we looked at studies about who influenced decisions about ending smoking, the primary-care doctor was at the top of the list," said John Auerbach, the state's public health commissioner.

The law establishing near-universal coverage also ordered the state's medical program that insures the poor to pay for smoking cessation counseling and nicotine replacement patches.

Even as the state's smoking rate reached a historic low of 16.4 percent in 2007, there are strong hints that the decline is accelerating this year. When cigarette taxes increased by $1 a pack at the start of this month, it spawned a flurry of calls to the state hotline that helps smokers.

In a typical month, that service gets 400 or 500 calls. By yesterday, more than 7,000 people had called this month, compelling the state to extend a nicotine replacement patch giveaway through August to meet demand.

That two-month campaign is costing $500,000. Overall, the state spent close to $13 million on tobacco control in the budget year that just ended. At its high point, in 2001, spending stood at $50.5 million; within a few years, it had plunged to $2.5 million.



Tobacco-control specialists not connected with the state cautioned that it can be risky to draw too many conclusions from one year's worth of data. But they also acknowledged that Massachusetts' smoking rates have been plunging for two decades.

Nearly 30 years ago, 4 in 10 men in Massachusetts smoked regularly, said Gregory Connolly, a Harvard School of Public Health professor.

"If you think back to that time, it's amazing," said Connolly, former director of the state's Tobacco Control Program. "But then we fundamentally changed the social norms around smoking in Massachusetts."

Fewer than 2 in 10 men currently smoke. Within a few years, Connolly said, smoking rates may hover near 10 percent, leaving only the most "hardcore" smokers. "Then what do we do?" he said. "Do we treat tobacco like cocaine or opium? Do we ban it?"

Smoking is blamed for 400,000 deaths a year, making it the leading cause of preventable death in the United States, according to the Centers for Disease Control and Prevention.

The one-year decline in smoking has been even more pronounced among adolescents, previously released figures showed. In 2007, 17.7 percent of adolescents said they smoked regularly, down from 20.5 percent the year before.

The adult smoking rates emerged from an annual survey conducted by the state that asks thousands of residents about behaviors related to their health. Only California, Connecticut, and Utah have lower smoking rates.

The decline has not been noticed only by those who oppose tobacco: Big tobacco has felt the drop acutely.

"The decline in the US cigarette market is one that continues year on year," said David Sutton, a spokesman for the nation's largest cigarette maker, Philip Morris USA. "We expect that to continue."

The company lost one more customer yesterday: Joanne Lynn, a Marlboro devotee for 35 years.

Her husband had pressured her relentlessly to quit. Then there was that cigarette odor that fouled her clothing. "And we'll be taking a walk, and we're approaching a hill, and I say, 'Oh, my, we have to do the hill,' " said Lynn, 49, who sometimes wasn't sure her lungs could take the climb.

So she finally decided to quit, in no small part because she and other colleagues received an e-mail from their boss telling them about the state's nicotine patch giveaway.

Her boss: Auerbach, the Department of Public Health commissioner.

Now, she said, she won't have to play a daily game of hide-and-seek.

"I used to sneak out of the building, run down the street, and hope the commissioner or somebody didn't catch me smoking my cigarette," said Lynn, of Saugus, who works in the agency's graphic design department. "I didn't want to smoke in front of the building with the big DPH sign there."