Dileep G Bal

For those of you who don’t know, in California we had a 25 cent increase in the price of a packet of cigarettes with Proposition 99 in November 1988. Twenty percent of these revenues were earmarked for Health Education, Prevention & Cessation efforts. However, we were unable to get expenditure authority from the legislature for nearly a year. The tobacco industry was very skilful and introduced a whole slew of bills and tied up our smoking legislation so that essentially we got cracking only in late 1989.

Let me just touch on some of the numbers that Gary mentioned and give you the California equivalents. In 1990, the US adult smoking prevalence was 25.5%. In 1991, it was 25.7%, a marginal increase. I think it’s a bit of a blip or artifact. In California in 1988, when the initiative passed, we had an adult smoking prevalence of 26.7%. In 1990 it had decreased to 22.2% and our latest survey, in early-mid 1992, showed it to be 20.0%. The absolute decline since 1988 has been 23.6% in California.

Unlike the 3% increase in the national rates among African-Americans between 1990 and 91, from 26% to 29%, in California African- American rates are actually quite close to non- Hispanic whites.

We’ve got a mix of cessation, prevention and environmental strategies. My own and my colleagues feelings are that the mix varies at different prevalence levels. In other words, without going into the details of the dependency of hard-core smokers, on a somewhat selfish note I’m not unhappy that the national prevalence rate is showing a slight upward blip (even if it is an artifact), because the collective expectation on us is so unrealistic. When the California legislature and the executive branch lean on me, if I should happen to have an upward …