Trends in adult cigarette smoking in California compared with the rest of the United States, 1978-1994

Objectives. This study compared trends in adult cigarette smoking prevalence in California and the remainder of the United States between 1978 and 1994. Methods. We used data from National Health Interview Surveys and Behavioral Risk Factor Surveillance System surveys to compare trends in smoking prevalence among persons 18 years and older. Results. In both California and the remainder of the United States, the estimated annual rate of decline in adult smoking prevalence accelerated significantly from 1985 to 1990: to -1.22 percentage points per year (95% confidence interval [CI]= -1.51, -0.93) in California and to -0.93 percentage points per year (95% CI= -1.13, -0.73) in the remainder of the nation. The rate of decline slowed significantly from 1990 to 1994: to -0.39 percentage points per year (95% CI= -0.34, 0.24) in the remainder of the United States. Conclusions. The presence of an aggressive tobacco control intervention has supported a significant decline in adult smoking prevalence in California from 1985 to 1990 and a slower but still significant decline from 1990 to 1994, a period in which there was no significant decline in the remainder of the nation. To restore nationwide progress in reducing smoking prevalence, other states should consider similar interventions.