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September 18, 1996

The Ledger of Tobacco Control

JAMA. 1996;276(11):871-872. doi:10.1001/jama.1996.03540110025020

To the Editor.  —Dr Davis'1 assessment of the "balance sheet" on tobacco control accurately assessed many "assets and liabilities" of the tobacco control movement in the United States today. However, Davis failed to mention the most important practical accomplishments in tobacco control; namely, the 3 state initiatives by which voters enacted increases in the tobacco tax with funds allocated for aggressive media- and community-based tobacco control programs:The rate of decline in total tobacco consumption significantly increased in California (P<.001) following implementation of the tobacco control initiative. Data from the Tobacco Institute's Tax Burden on Tobacco,2 analyzed as described by Glantz.3 The solid line is cigarette sales; dashed line is linear trend established during 8 years prior to passage of the initiative. California Proposition 99 (1988), Massachusetts Question 1 (1992), and Arizona Proposition 200 (1994). While it is too early to evaluate the effectiveness of the