Reducing harm from tobacco, which is responsible for more than
440,000 deaths in the United States each year, with a special emphasis on advancing and sustaining policy changes that help prevent and reduce
tobacco use and exposure.

Click here for more on RWJF's work in this area.

ESPITE SUBSTANTIAL DECLINES IN tobacco use, tobacco-related diseases remain America’s leading cause of preventable death. The Robert Wood Johnson Foundation has been committed to reducing the prevalence of tobacco use for more than a decade, supporting research to determine the most effective policies and programs, and promoting policies that prevent people from starting to smoke and help current smokers quit. We know, for example, that tobacco tax increases and clean indoor air policies drive down smoking rates by encouraging smokers to quit and preventing young people from starting tobacco use. State and local officials across the country are enacting these measures, which not only reduce smoking and hazardous secondhand smoke exposure, but also minimize the fiscal and health burden on governments and raise needed public revenue.

While much progress has been made, more must be done to protect the tobacco policy change infrastructure and sustain the advances made in reducing tobacco use and exposure. Toward this end, in 2004 RWJF launched Tobacco Policy Change: A Collaborative for Healthier Communities and States. Created to support state and local partnerships working toward specific tobacco policy advances, this program focuses especially on populations that suffer disproportionately from tobacco exposure and related disease. In its initial year, Tobacco Policy Change provided 25 grants to organizations and coalitions whose proposals ranged from supporting comprehensive statewide smoke-free policies, to expanding tobacco control policies on college campuses, to reducing commercial tobacco use on Native American reservations while respecting its cultural and traditional place of honor. Grantees will help achieve new policies that reduce smoking and promote health and, in some communities and states, will prevent attempts to derail or weaken hard-fought tobacco control gains.

Several important research findings in 2004 provided evidence to support the work of tobacco control advocates, scholars and policy-makers. A study found that, while 76 percent of white-collar employees are protected by smoke-free workplace policies, only 43 percent of food preparation and service employees (cooks, food counter workers, waiters/waitresses) enjoy this same benefit. Among bartenders, that figure drops to 10 percent. This study builds on research that shows that food service workers are at higher risk of lung cancer than workers in other professions. This disparity helps bolster the case that restaurants and bars should be smoke-free.

Foundation-supported research in 2004 also revealed that smokers of light and ultra-light cigarettes incorrectly believe that such products are less harmful than higher-tar, full-flavored cigarettes. For example, the researchers found that nearly nine out of ten Marlboro Light cigarette smokers surveyed in the study did not know that “light” cigarettes deliver about as much tar as regular cigarettes.

In the cessation arena, the results and experience of Foundation grantees provided critical input to a set of tobacco control recommendations provided to the Interagency Committee on Tobacco Use chaired by the U.S. Surgeon General. Recommendations included establishing a national hotline through which smokers could obtain cessation medication and counseling; launching a national paid media campaign encouraging cessation; increasing the federal cigarette tax by $2 per pack and using at least half the revenue for smoking cessation initiatives; providing coverage for smoking cessation counseling and FDA-approved medicines under federally-funded health care programs including Medicare and Medicaid; increasing investment in research to improve smoking cessation therapies; and providing training for health care providers in treating tobacco dependence.

Following on those recommendations the U.S. Department of Health and Human Services announced the establishment of a toll-free national access line (1-800-Quit-Now). The Centers for Medicare & Medicaid Services will also provide new coverage for Medicare beneficiaries who smoke to receive counseling services to help them quit.