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Postgrad Med J. 2016 Nov;92(1093):670-676. doi: 10.1136/postgradmedj-2014-133193. Epub 2016 Sep 22.

The effectiveness of tobacco control policies on vulnerable populations in the USA: a review.

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Division of General Internal Medicine, University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California, USA.
Division of General Internal Medicine, University of California, San Francisco, California, USA.


Despite population-wide efforts to reduce tobacco use, low-income populations in the USA have much higher rates of tobacco use compared with the general population. The principal components of tobacco control policies in the USA include cigarette taxes, clean indoor air laws and comprehensive interventions to increase access to tobacco cessation services. In this review, we describe the effectiveness of these policies and interventions in reducing tobacco use among vulnerable populations, focusing on persons with mental health disorders and substance use disorders, persons who have experienced incarceration or homelessness, and low-income tenants of public housing. We discuss the challenges that evolving tobacco and nicotine products pose to tobacco control efforts. We conclude by highlighting the clinical implications of treating tobacco dependence in healthcare settings that serve vulnerable populations.


Cigarette price; Smoke-free policies; Tobacco Cessation; Tobacco control policy; Vulnerable populations

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