American Stop-Smoking Intervention Study
American Stop-Smoking Intervention Study was a six year effort (1991-1997) to reduce smoking rate in 17 U.S. states. ASSIST was funded with approximately $114 million over six years in the early to mid 1990's by the American Cancer Society and the National Cancer Institute for a period of approximately 6 years.
The tobacco industry considred ASSIST a major threat to sales and its political control.
ASSIST was the largest federally-funded project ever to help states develop effective strategies to reduce smoking. In 1991, the National Cancer Institute (NCI), in partnership with the American Cancer Society, provided funds to 17 state health departments the study.
ASSIST's goal was to alter the social, cultural, economic and environmental factors that promote smoking by utilizing four policy strategies: promoting smoke-free environments; countering tobacco advertising and promotion; limiting youths' access to tobacco products; and raising excise taxes to increase the price of tobacco products. These interventions were developed and implemented by networks of state and local tobacco control coalitions. The project consisted of two phases: first a two-year planning phase from 1991 to 1993, and then a six-year implementation phase from 1993 to 1999. NCI provided an average of $1.14 million per state per year during the intervention years, for a total of $128 million over the eight years of the program. Other additional funding and support were available to the states through voluntary organizations and other non-federal sources.
The tobacco industry reacted strongly to ASSIST, putting together a well-coordinated attack to try and thwart it.
Page 145 (Bates No. 2051363569) of a Philip Morris internal document describes PM's strategy to divert health department funds away from tobacco control and towards "support[ing] other health programs (pre-natal care, half-way houses, etc.)" (areas which don't threaten cigarette sales), in order to counter the ASSIST program:
"Long Term Goals
• Counter ASSIST Program in 17 states: - Work with grass roots organizations to divert state health department funds, equivalent to the amount of ASSIST funding, to support other health programs (pre-natal care, half-way houses, etc.)."
The American Journal of Public Health in 2004 published an analysis of tobacco industry opposition to ASSIST.
Shalala worked to defend and support the ASSIST program and assure its completion through years of highly strategized and well-organized attacks against the program by the tobaco industry.
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