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More than 13 years after its completion, NCI's Community Intervention Trial for Smoking Cessation (COMMIT) continues to be a source of valuable insights for tobacco control research. COMMIT was a major NCI intervention trial that ran from 1988-1993 and sought to accelerate quit rates among smokers aged 25 to 64, especially those who smoked 25 or more cigarettes per day. COMMIT featured 11 matched pairs of intervention and comparison communities in the United States (10) and Canada (1). There were 58 intervention channels in 4 broad categories: media and community-wide events, health care providers, workplaces and other community organizations, and cessation resources.

In the March/April issue of the American Journal of Health Promotion, Dr. Andrew Hyland and colleagues at the Roswell Park Cancer Institute, report on a 13-year follow-up study of a sample of smokers in both the intervention and control COMMIT communities. Their purpose was twofold: to measure the long-term impact of the COMMIT intervention and to evaluate the impact of large, state-based tobacco-control program and policy activity on smoker behavior.

The authors found that quit rates were higher in the COMMIT intervention communities during the period when the trial was funded, but were no different than comparison communities 8 years after the program ended. This suggests that tobacco control interventions need sustained funding to continue to have an impact. The authors also observed a trend toward a greater impact of tobacco-control programs among people with lower levels of education; this finding is consistent with earlier research from the COMMIT program.

The authors also found that quit rates were highest in those communities in states with both strong tobacco-control policies and aggressive tobacco-control programs, such as California and Massachusetts. Communities located in states with little tobacco-control activity, such as Iowa, New Mexico, and North Carolina, had lower quit rates. California was a leader among the COMMIT states in adopting aggressive tobacco-control measures, starting in 1989. The state's budget for those activities was $88 million in 2003, or $2.56 per capita. "Between 1988 and 2001, per capita cigarette consumption in California declined by 60 percent compared with a 34-percent decline in the entire nation during the same period," the researchers note.

"This is a very significant study because it provides strong evidence demonstrating the value of comprehensive tobacco control as a way to increase quit rates in a population," noted Bob Vollinger, program director for the Tobacco Research Initiative for State and Community Interventions in NCI's Tobacco Control Research Branch. "We know that quitting smoking will reduce cancer and save lives. This study shows that well-funded tobacco control programs, combined with strong policies, reduce smoking. States that want to get serious about reducing cancer deaths and controlling medical costs should know that tobacco control is one of the best investments they can make."