Earlier this month, my colleague Rob Moore wrote a commentary for the Ohio Capital Journal asking what can be done about cigarette use in Ohio. Although it doesn’t get nearly as much attention as other public health crises, smoking is responsible for more deaths annually than HIV, illegal drug use, alcohol use, car crashes, and guns, combined.
Tobacco use is a particular problem in Ohio. According to the CDC, Ohio has the fourth-highest rate of cigarette use in the country. Fortunately for Ohio, there is a lot of research exploring how to reduce cigarette use. The challenge for local policymakers is to figure out what the best evidence based approaches are.
One resource available for local leaders is the Community Guide. The Community Guide is a publication from the Community Preventive Services Task Force, an organization of academics and medical doctors convened by the Department of Health and Human Services.
The Community Preventive Services Task Force reviews the research on areas of public health and makes recommendations for community leaders based on that evidence. One topic they’ve undertaken is evaluating evidence-based ways to decrease tobacco use.
One policy option that there is strong evidence for is text messages targeted towards people who want to quit smoking. A systematic review of text message interventions found that they increased smoking cessation rates by a median of 2.3 percentage points. When combined with other smoking cessation interventions, text messages were able to increase smoking cessation rates by as much as 4.4 percentage points.
Another policy the Community Preventive Services Task Force reviews is internet-based smoking cessation interventions. Unlike text message interventions, the Community Preventive Services Task Force only believes that there is “sufficient evidence” to support these types of interventions, as opposed to the “strong evidence” designation given to text messages . According to appendix five of their methodology page, this means that despite the fact that the research seems to indicate that the outcomes are quite good, the panel members had problems with the methods used by the initial researchers.
Internet-based smoking cessation interventions were slightly less effective than text-based interventions, only increasing smoking cessation rates by 1.2 percentage points. When looking at only the studies conducted in the United States, this increase in smoking cessation rate fell to only 0.1 percentage points.
This is not to say that text message interventions are strictly superior to internet-based interventions. It could be the case that a local government already has the infrastructure in place to provide internet-based smoking cessation interventions, and could introduce this policy change at almost no additional cost.
For local governments with extremely tight budgets, this could be a superior option to building out the capacity for text-message based interventions. No matter what, policymakers need to have access to this kind of information in order to make those decisions.
If Ohio is serious about addressing its smoking problem, looking at the interventions outlined by the Community Preventive Services Task Force would be a great place to start. Hopefully local policymakers can learn from these studies and improve the state’s public health.