Focus Area 27: Tobacco Use: Modifications to Objectives and Subobjectives

As a result of the Healthy People 2010 Midcourse Review, changes were made to the Healthy People 2010 objectives and subobjectives. These changes are specific to the following situations:

Changes in the wording of an objective to more accurately describe what is being measured.
Changes to reflect a different data source or new science.
Changes resulting from the establishment of a baseline and a target (that is, when a formerly developmental objective or subobjective became measurable).
Deletion of an objective or subobjective that lacked a data source.
Correction of errors and omissions in Healthy People 2010.

Revised baselines and targets for measurable objectives and subobjectives do not fall into any of the above categories and, thus, are not considered a midcourse review change.¹

When changes were made to an objective, three sections are displayed:

In the Original Objective section, the objective as published in Healthy People 2010 in 2000 is shown.
In the Objective With Revisions section, strikethrough indicates text deleted, and underlining is used to show new text.
In the Revised Objective section, the objective appears as revised as a result of the midcourse review.

Details of the objectives and subobjectives in this focus area, including any changes made at the midcourse, appear on the following pages.

¹See Technical Appendix for more information on baseline and target revisions.

Tobacco Use in Population Groups

ORIGINAL OBJECTIVE

27-1.

Reduce tobacco use by adults.

Target and baseline:

Objective	Reduction in Tobacco Use by Adults Aged 18 Years and Older	1998 Baseline* Percent	2010 Target Percent
27-1a.	Cigarette smoking	24	12
27-1b.	Spit tobacco	2.6	0.4
27-1c.	Cigars	2.5	1.2
27-1d.	Other products	Developmental	Developmental

*Age adjusted to the year 2000 standard population.

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

OBJECTIVE WITH REVISIONS
(Including subobjective deleted)

27-1.

Reduce tobacco use by adults.

Target and baseline:

Objective*	Reduction in Tobacco Use by Adults Aged 18 Years and Older	1998 Baseline^† Percent	2010 Target Percent
27-1a.	Cigarette smoking	24	12
27-1b.	Spit tobacco	~~2.6~~ 2.5¹	0.4
27-1c.	Cigars	~~2.5~~ 2.4²	1.2
~~27-1d.~~	(Subobjective deleted due to unreliable data source)* ~~Other products~~	~~Developmental~~	~~Developmental~~

* For data control purposes, subobjectives are not renumbered.
^† Age adjusted to the year 2000 standard population.

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

¹ Baseline revised from 2.6 after November 2000 publication.
² Baseline revised from 2.5 after November 2000 publication.

REVISED OBJECTIVE

27-1.

Reduce tobacco use by adults.

Target and baseline:

Objective*	Reduction in Tobacco Use by Adults Aged 18 Years and Older	1998 Baseline^† Percent	2010 Target Percent
27-1a.	Cigarette smoking	24	12
27-1b.	Spit tobacco	2.5¹	0.4
27-1c.	Cigars	2.4²	1.2

* For data control purposes, subobjectives are not renumbered.
^†Age adjusted to the year 2000 standard population.

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

¹Baseline revised from 2.6 after November 2000 publication.
² Baseline revised from 2.5 after November 2000 publication.

ORIGINAL OBJECTIVE

27-2.

Reduce tobacco use by adolescents.

Target and baseline:

Objective	Reduction in Tobacco Use by Students in Grades 9 Through 12	1999 Baseline Percent	2010 Target Percent
27-2a.	Tobacco products (past month)	40	21
27-2b.	Cigarettes (past month)	35	16
27-2c.	Spit tobacco (past month)	8	1
27-2d.	Cigars (past month)	18	8

Target setting method: Better than the best.

Data source: Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP.

OBJECTIVE WITH REVISIONS

27-2.

Reduce tobacco use by adolescents.

Target and baseline:

Objective	Reduction in Tobacco Use by Students in Grades 9 Through 12	1999 Baseline (unless noted) Percent	2010 Target Percent
27-2a.	Tobacco products (past month)	40	21
27-2b.	Cigarettes (past month)	35	16
27-2c.	Spit tobacco (past month)	8	1
27-2d.	Cigars (past month)	18	8
27-2e.	Bidis (past month)	4 (2000)	2

Target setting method: Better than the best.

Data sources: Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP; National Youth Tobacco Survey (NYTS), American Legacy Foundation and CDC.

REVISED OBJECTIVE

27-2.

Reduce tobacco use by adolescents.

Target and baseline:

Objective	Reduction in Tobacco Use by Students in Grades 9 Through 12	1999 Baseline (unless noted) Percent	2010 Target Percent
27-2a.	Tobacco products (past month)	40	21
27-2b.	Cigarettes (past month)	35	16
27-2c.	Spit tobacco (past month)	8	1
27-2d.	Cigars (past month)	18	8
27-2e.	Bidis (past month)	4 (2000)	2

ORIGINAL OBJECTIVE

27-3.

(Developmental) Reduce the initiation of tobacco use among children and adolescents.

Potential data source: National Household Survey on Drug Abuse (NHSDA), SAMHSA.

OBJECTIVE WITH REVISIONS

27-3.

~~(Developmental)~~ Reduce the initiation of tobacco use among children, ~~and~~ adolescents, and young adults.

Target and baseline:

Objective	Reduction in Cigarette Initiation	2002 Baseline Rate per 1,000 Person-Years Exposure	2010 Target Rate per 1,000 Person-Years Exposure
27-3a.	Children and adolescents aged 12 to 17 years	100.1	81.2
27-3b.	Young adults aged 18 to 25 years	59.6	48.1

Target setting method: Better than the best.

~~Potential d~~Data source: National ~~Household~~ Survey on Drug Use and Health~~Abuse~~ (NHSDUHDA), SAMHSA.

REVISED OBJECTIVE

27-3.

Reduce the initiation of tobacco use among children, adolescents, and young adults.

Target and baseline:

Objective	Reduction in Cigarette Initiation	2002 Baseline Rate per 1,000 Person-Years Exposure	2010 Target Rate per 1,000 Person-Years Exposure
27-3a.	Children and adolescents aged 12 to 17 years	100.1	81.2
27-3b.	Young adults aged 18 to 25 years	59.6	48.1

Target setting method: Better than the best.

Data source: National Survey on Drug Use and Health (NSDUH), SAMHSA.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

27-4.

Increase the average age of first use of tobacco products by adolescents and young adults.

Target and baseline:

Objective	Increase in Average Age of First Tobacco Use	2002¹ Baseline Average Age of First Cigarette Use, in Years	2010 Target Average Age of First Cigarette Use, in Years
27-4a.	Adolescents aged 12 to 17 years	12	14
27-4b.	Young adults aged 18 to 25 years	14²	16³

Target setting method: Better than the best.

Data source: National Survey on Drug Use and Health (NSDUH), SAMHSA.

¹ Baseline year revised from 1997 after November 2000 publication.
² Baseline revised from 15 after November 2000 publication.
³Target revised from 17 because of baseline revision after November 2000 publication.

Cessation and Treatment

NO CHANGE IN OBJECTIVE
27-5.	Increase smoking cessation attempts by adult smokers. Target: 75 percent. Baseline: 41 percent of adult smokers aged 18 years and older stopped smoking for 1 day or longer because they were trying to quit in 1998 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.

NO CHANGE IN OBJECTIVE
27-6.	Increase smoking cessation during pregnancy. Target: 30 percent. Baseline: 14 percent of females aged 18 to 49 years stopped smoking during the first trimester of their pregnancy in 1998. Target setting method: Better than the best. Data source: National Health Interview Survey (NHIS), CDC, NCHS.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

27-7.

Increase tobacco use cessation attempts by adolescent smokers.

Target: 64¹ percent.

Baseline: 61² percent of smokers in grades 9 through 12 who ever smoked at least one cigarette every day for 30 days tried to quit smoking in 2001.²

Target setting method: Better than the best.

Data source: Youth Risk Behavior Surveillance System (YRBSS), CDC, NCCDPHP.

¹ Target revised from 84 because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 76 and 1999 after November 2000 publication.

ORIGINAL OBJECTIVE

27-8.

Increase insurance coverage of evidence-based treatment for nicotine dependency.

Target and baseline:

Objective	Increase in Insurance Coverage of Evidence-Based Treatment for Nicotine Dependency	1998 Baseline (unless noted) Percent	2010 Target Percent
27-8a.	Managed care organizations	75 (1997–98)	100
		Number	Number
27-8b.	Medicaid programs in States and the District of Columbia	24	51
27-8c.	All insurance	Developmental	Developmental

Target setting method: Total coverage of FDA-approved pharmacotherapies and behavioral therapies.

Data sources: Addressing Tobacco in Managed Care Survey, Robert Wood Johnson Foundation; (Medicaid data) Health Policy Tracking Service, National Conference of State Legislators.

OBJECTIVE WITH REVISIONS
(Including subobjective deleted)

27-8.

Increase insurance coverage of evidence-based treatment for nicotine dependency.

Target and baseline:

Objective*	Increase in Insurance Coverage of Evidence-Based Treatment for Nicotine Dependency	1998 Baseline (unless noted) Percent	2010 Target Percent
27-8a.	Managed care organizations	75 (1997–98)	100
		Number	Number
27-8b.	Medicaid programs in States and the District of Columbia	24	51
~~27-8c.~~	(Subobjective deleted due to unreliable data source)^† ~~All insurance~~	~~Developmental~~	~~Developmental~~

* For data control purposes, subobjectives are not renumbered.

Target setting method: Total coverage of FDA-approved pharmacotherapies and behavioral therapies.

Data sources: Addressing Tobacco in Managed Care Survey (managed care data), Robert Wood Johnson Foundation; ~~(Medicaid data)~~ Health Policy Tracking Service (Medicaid data), National Conference of State Legislators.

REVISED OBJECTIVE

27-8.

Increase insurance coverage of evidence-based treatment for nicotine dependency.

Target and baseline:

Objective*	Increase in Insurance Coverage of Evidence-Based Treatment for Nicotine Dependency	1998 Baseline (unless noted) Percent	2010 Target Percent
27-8a.	Managed care organizations	75 (1997–98)	100
		Number	Number
27-8b.	Medicaid programs in States and the District of Columbia	24	51

* For data control purposes, subobjectives are not renumbered.

Target setting method: Total coverage of FDA-approved pharmacotherapies and behavioral therapies.

Data sources: Addressing Tobacco in Managed Care Survey (managed care data), Robert Wood Johnson Foundation; Health Policy Tracking Service (Medicaid data), National Conference of State Legislators.

Exposure to Secondhand Smoke

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

27-9.

Reduce the proportion of children who are regularly exposed to tobacco smoke at home.

Target: 6¹ percent.

Baseline: 20² percent of children aged 6 years and under lived in a household where someone smoked inside the house at least 4 days per week in 1998.²

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

¹ Target revised from 10 because of baseline revision after November 2000 publication.
² Baseline and baseline year revised from 27 and 1994 after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

27-10.

Reduce the proportion of nonsmokers exposed to environmental tobacco smoke.

Target: 63¹ percent.

Baseline: 88² percent of nonsmokers aged 4 years and older had a serum cotinine level above 0.10 ng/mL in 1988–94 (age adjusted to the year 2000 standard population).

Target setting method: Better than the best.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

¹ Target revised from 45 because of baseline revision after November 2000 publication.
² Baseline revised from 65 after November 2000 publication.

NO CHANGE IN OBJECTIVE

27-11.

Increase smoke-free and tobacco-free environments in schools, including all school facilities, property, vehicles, and school events.

Target: 100 percent.

Baseline: 37 percent of middle, junior high, and senior high schools were smoke-free and tobacco-free in 1994.

Target setting method: Retain year 2000 target.

Data source: School Health Policies and Programs Study (SHPPS), CDC, NCCDPHP.

ORIGINAL OBJECTIVE
27-12.	Increase the proportion of worksites with formal smoking policies that prohibit smoking or limit it to separately ventilated areas. Target: 100 percent. Baseline: 79 percent of worksites with 50 or more employees had formal smoking policies that prohibited or limited smoking to separately ventilated areas in 1998–99. Target setting method: Retain year 2000 target. Data source: National Worksite Health Promotion Survey, Association for Worksite Health Promotion (AWHP).
OBJECTIVE WITH REVISIONS
27-12.	Increase the proportion of ~~worksites with formal smoking policies that prohibit~~ ~~smoking or limit it to separately ventilated areas~~ persons covered by indoor worksite policies that prohibit smoking. Target: 100 percent. Baseline: 7969 percent of persons were covered by~~worksites with 50 or more~~ ~~employees had formal~~ indoor worksite smoking policies that prohibited ~~or limited~~ smoking ~~to separately ventilated areas~~ in 1998–99. Target setting method: ~~Retain year 2000 target~~ Total coverage. Data source: ~~National Worksite Health Promotion Survey, Association for Worksite~~ ~~Health Promotion (AWHP)~~Current Population Survey (CPS), U.S. Bureau of the Census and U.S. Bureau of Labor Statistics.
REVISED OBJECTIVE
27-12.	Increase the proportion of persons covered by indoor worksite policies that prohibit smoking. Target: 100 percent. Baseline: 69 percent of persons were covered by indoor worksite smoking policies that prohibited smoking in 1998–99. Target setting method: Total coverage. Data source: Current Population Survey (CPS), U.S. Bureau of the Census and U.S. Bureau of Labor Statistics.

ORIGINAL OBJECTIVE

27-13.

Establish laws on smoke-free indoor air that prohibit smoking or limit it to separately ventilated areas in public places and worksites.

Target and baseline:

Objective	Jurisdictions With Laws on Smoke-Free Air	1998 Baseline Number	2010 Target Number
	States and the District of Columbia
27-13a.	Private workplaces	1	51
27-13b.	Public workplaces	13	51
27-13c.	Restaurants	3	51
27-13d.	Public transportation	16	51
27-13e.	Day care centers	22	51
27-13f.	Retail stores	4	51
27-13g.	Tribes	Developmental	Developmental
27-13h.	Territories	Developmental	Developmental

Target setting method: Retain year 2000 target.

Data source: State Tobacco Activities Tracking and Evaluation System (STATE System), CDC, NCCDPHP, OSH.

OBJECTIVE WITH REVISIONS

27-13.

Establish laws on smoke-free indoor air that prohibit smoking ~~or limit it to~~ ~~separately ventilated areas~~ in public places and worksites.

Target and baseline:

Objective*	Jurisdictions With Laws on Smoke-Free Air	1998 Baseline Number	2010 Target Number
	States and the District of Columbia
27-13a.	Private workplaces	1	51
27-13b.	Public workplaces	13	51
27-13c.	Restaurants	3	51
27-13d.	Public transportation	16	51
27-13e.	Day care centers	22	51
27-13f.	Retail stores	4	51
27-13g.	Tribes	Developmental	Developmental
27-13h.	Territories	Developmental	Developmental
27-13i.*	Bars	0	51

* For data control purposes, subobjectives are not renumbered.

Target setting method: ~~Retain year 2000 target~~Total coverage.

Data source: State Tobacco Activities Tracking and Evaluation System (STATE System), CDC, NCCDPHP, OSH.

REVISED OBJECTIVE

27-13.

Establish laws on smoke-free indoor air that prohibit smoking in public places and worksites.

Target and baseline:

Objective*	Jurisdictions With Laws on Smoke-Free Air	1998 Baseline Number	2010 Target Number
	States and the District of Columbia
27-13a.	Private workplaces	1	51
27-13b.	Public workplaces	10	51
27-13c.	Restaurants	2	51
27-13d.	Public transportation	15	51
27-13e.	Day care centers	22	51
27-13f.	Retail stores	16	51
27-13g.	Tribes	Developmental	Developmental
27-13h.	Territories	Developmental	Developmental
27-13i.*	Bars	0	51

* For data control purposes, subobjectives are not renumbered.

Target setting method: Total coverage.

Data source: State Tobacco Activities Tracking and Evaluation System (STATE System), CDC, NCCDPHP, OSH.

Social and Environmental Changes

NO CHANGE IN OBJECTIVE

27-14.

Reduce the illegal sales rate to minors through enforcement of laws prohibiting the sale of tobacco products to minors.

Target and baseline:

Objective	Jurisdictions With a 5 Percent or Less Illegal Sales Rate to Minors	1998 Baseline Number	2010 Target Number
27-14a.	States and the District of Columbia	0	51
27-14b.	Territories	0	All

Target setting method: Based on published literature and expert opinion.

Data source: State Synar Enforcement Reporting, SAMHSA, CSAP.

NO CHANGE IN OBJECTIVE

27-15.

Increase the number of States and the District of Columbia that suspend or revoke State retail licenses for violations of laws prohibiting the sale of tobacco to minors.

Target: All States and the District of Columbia.

Baseline: 34 States with some form of retail licensure could suspend or revoke the license for violation of minors’ access laws in 1998.

Target setting method: Total coverage.

Data source: State Tobacco Activities Tracking and Evaluation System (STATE System), CDC, NCCDPHP, OSH.

ORIGINAL OBJECTIVE

27-16.

(Developmental) Eliminate tobacco advertising and promotions that influence adolescents and young adults.

Potential data source: American Legacy Foundation and National Association of Attorneys General.

OBJECTIVE WITH REVISIONS

27-16.

~~(Developmental) Eliminate~~Reduce the proportion of adolescents and young adults who are exposed to tobacco advertising and promotion~~s that influence~~ ~~adolescents and young adults~~.

Target and baseline:

Objective	Reduction in the Proportion of Adolescents in Grades 6 Through 12 Exposed to Tobacco Advertising and Promotion	2000 Baseline Percent	2010 Target Percent
27-16a.	Internet advertising and promotion	28	25
27-16b.	Magazine and newspaper advertising and promotion	74	67

Target setting method: Better than the best.

~~Potential d~~Data source: ~~American Legacy Foundation and National Association~~ ~~of Attorneys General.~~National Youth Tobacco Survey (NYTS), American Legacy Foundation and CDC.

REVISED OBJECTIVE

27-16.

Reduce the proportion of adolescents and young adults who are exposed to tobacco advertising and promotion.

Target and baseline:

Objective	Reduction in the Proportion of Adolescents in Grades 6 Through 12 Exposed to Tobacco Advertising and Promotion	2000 Baseline Percent	2010 Target Percent
27-16a.	Internet advertising and promotion	28	25
27-16b.	Magazine and newspaper advertising and promotion	74	67

Target setting method: Better than the best.

Data source: National Youth Tobacco Survey (NYTS), American Legacy Foundation and CDC.

NO CHANGE IN OBJECTIVE

27-17.

Increase adolescents’ disapproval of smoking.

Target and baseline:

Objective	Increase in Adolescents' Disapproval of Smoking	1998 Baseline Percent	2010 Target Percent
27-17a.	8th grade	80	95
27-17b.	10th grade	75	95
27-17c.	12th grade	69	95

Target setting method: Retain year 2000 target.

Data source: Monitoring the Future Study (MTF), NIH, NIDA.

ORIGINAL OBJECTIVE

27-18.

(Developmental) Increase the number of Tribes, Territories, and States and the District of Columbia with comprehensive, evidence-based tobacco control programs.

Potential data sources: State Tobacco Activities Tracking and Evaluation System (STATE System), CDC, NCCDPHP, OSH; IHS.

OBJECTIVE WITH REVISIONS

27-18.

~~(Developmental)~~ Increase the number of ~~Tribes, Territories, and~~ States and the District of Columbia, Territories, and Tribes with sustainable and comprehensive evidence-based tobacco control programs.

Target and baseline:

Objective	Increase in Sustainable and Comprehensive Evidence-Based Tobacco Control Programs	2002 Baseline Number	2010 Target Number
27-18a.	States and the District of Columbia	5	51
27-18b.	Territories	Developmental	Developmental
27-18c.	Tribes	Developmental	Developmental

Target setting method: Total coverage.

~~Potential d~~Data sources: State Tobacco Activities Tracking and Evaluation System (STATE System), CDC, NCCDPHP, OSH; IHS.

REVISED OBJECTIVE

27-18.

Increase the number of States and the District of Columbia, Territories, and Tribes with sustainable and comprehensive evidence-based tobacco control programs.

Target and baseline:

Objective	Increase in Sustainable and Comprehensive Evidence-Based Tobacco Control Programs	2002 Baseline Number	2010 Target Number
27-18a.	States and the District of Columbia	5	51
27-18b.	Territories	Developmental	Developmental
27-18c.	Tribes	Developmental	Developmental

Target setting method: Total coverage.

Data source: State Tobacco Activities Tracking and Evaluation System (STATE System), CDC, NCCDPHP, OSH; IHS.

NO CHANGE IN OBJECTIVE
27-19.	Eliminate laws that preempt stronger tobacco control laws. Target: Zero States. Baseline: 30 States had preemptive tobacco control laws in the areas of clean indoor air, minors’ access laws, or marketing in 1998. Target setting method: Retain year 2000 target. Data source: State Tobacco Activities Tracking and Evaluation System (STATE System), CDC, NCCDPHP, OSH.

ORIGINAL OBJECTIVE

27-20.

(Developmental) Reduce the toxicity of tobacco products by establishing a regulatory structure to monitor toxicity.

Potential data source: FDA.

OBJECTIVE WITH REVISIONS

27-20.

~~(Developmental)~~ Reduce ~~the toxicity of~~the sales-weighted average level of toxic chemicals in tobacco products ~~by establishing a regulatory structure to monitor toxicity~~sold in the United States.

Target and baseline:

Objective	Reduction in Sales-Weighted Average Levels of Toxic Chemicals in the Smoke of Cigarettes Sold in the United States	2003 Baseline (unless noted) Nanograms per Cigarette	2010 Target Nanograms per Cigarette
27-20a.	Tobacco-specific nitrosamines	121.5	109.4
27-20b.	Polyaromatic hydrocarbon compounds (PAHs)	993.7	894.3
		Micrograms per Cigarette	Micrograms per Cigarette
27-20c.	Volatile organic compounds (VOCs)	707.0 (2002)	636.3

Target setting method: 10 percent improvement.

~~Potential d~~Data sources: ~~FDA.~~ CDC, NCCDPHP, OSH; NCEH, Division of Laboratory Sciences.

REVISED OBJECTIVE

27-20.

Reduce the sales-weighted average level of toxic chemicals in tobacco products sold in the United States.

Target and baseline:

Objective	Reduction in Sales-Weighted Average Levels of Toxic Chemicals in the Smoke of Cigarettes Sold in the United States	2003 Baseline (unless noted) Nanograms per Cigarette	2010 Target Nanograms per Cigarette
27-20a.	Tobacco-specific nitrosamines	121.5	109.4
27-20b.	Polyaromatic hydrocarbon compounds (PAHs)	993.7	894.3
		Micrograms per Cigarette	Micrograms per Cigarette
27-20c.	Volatile organic compounds (VOCs)	707.0 (2002)	636.3

Target setting method: 10 percent improvement.

Data sources: CDC, NCCDPHP, OSH; NCEH, Division of Laboratory Sciences.

ORIGINAL OBJECTIVE

27-21.

Increase the average Federal and State tax on tobacco products.

Target and baseline:

Objective	Increase in Combined Federal and Average State Tax	1998 Baseline	2010 Target
27-21a.	Cigarettes	$0.63*	$2.00
27-21b.	Spit tobacco	Developmental^†	Developmental^†

* 24 cent Federal tax; 38.9 cent average State tax in 1998.
^†2.7 cent Federal tax in 1999; 7 States and the District of Columbia did not tax smokeless tobacco products in 1999.

Target setting method: Expert opinion; comparison to international tax rates.

Data source: The Tax Burden on Tobacco, The Tobacco Institute.

OBJECTIVE WITH REVISIONS

27-21.

Increase the average Federal and State tax on ~~tobacco products~~cigarettes and expand the number of States with higher smokeless tobacco taxes over the decade.

Target and baseline:

Objective	Increase in Combined Federal and Average State Tax and in the Number of States With Higher Smokeless Tobacco Taxes	1998 Baseline (unless noted) Dollars per Standard U.S. Package of Cigarettes	2010 Target Dollars per Standard U.S. Package of Cigarettes
27-21a.	Cigarettes	$0.63* $0.59¹	$2.00
		Number of States and the District of Columbia	Number of States and the District of Columbia
27-21b.	~~Spit~~ Smokeless tobacco²	3³ (2000–2001)³ ~~Developmental~~	51*

* 2.7 cent Federal tax in 1999; 7 States and the District of Columbia did not tax smokeless tobacco products in 1999.

Target setting method: EFor 27-21a, expert opinion; ~~comparison to international tax rates.~~for 27-21b, total coverage.

Data source: ~~The Tax Burden on Tobacco, The Tobacco Institute;~~ State Tobacco Activities Tracking and Evaluation System (STATE System), CDC, NCCDPHP, OSH.

¹ Baseline revised from $0.63 after November 2000 publication.
² Smokeless tobacco now used instead of spit tobacco.
³ Number of States that have increased taxes on smokeless tobacco.

REVISED OBJECTIVE

27-21.

Increase the average Federal and State tax on cigarettes and expand the number of States with higher smokeless tobacco taxes over the decade.

Target and baseline:

Objective	Increase in Combined Federal and Average State Tax and in the Number of States With Higher Smokeless Tobacco Taxes	1998 Baseline (unless noted) Dollars per Standard U.S. Package of Cigarettes	2010 Target Dollars per Standard U.S. Package of Cigarettes
27-21a.	Cigarettes	$0.59¹	$2.00
		Number of States and the District of Columbia	Number of States and the District of Columbia
27-21b.	Smokeless tobacco²	3(2000–2001)	51*

* 2.7 cent Federal tax in 1999; 7 States and the District of Columbia did not tax smokeless tobacco products in 1999.

Target setting method: For 27-21a, expert opinion; for 27-21b, total coverage.

Data source: State Tobacco Activities Tracking and Evaluation System (STATE System), CDC, NCCDPHP, OSH.

¹ Baseline revised from $0.63 after November 2000 publication.
² Smokeless tobacco now used instead of spit tobacco.

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