Last week, I was among many others in Washington State who celebrated the exciting news that the adult smoking prevalence had dropped to a new low this year of 15.3 percent, down from 16.5 percent last year. Washington’s adult smoking prevalence is not only the sixth lowest in the nation, but is significantly lower than the national average of 18.4 percent.

While year after year press releases and articles make the decreasing tobacco prevalence among adults in Washington seem like it has been effortless and give the impression that our battle against tobacco has been won, those of us in Washington who know someone who smokes or who have helped someone to quit over the past several years know that our work is far from over.

Washington’s continued and increasing success in helping tobacco users to quit and stay quit can be attributed largely to an evidence-based comprehensive tobacco prevention and control strategy that actively addresses all areas of tobacco control from policy and secondhand smoke to prevention and cessation (Dilley et al, 2007). A comprehensive approach to tobacco is advocated by the CDC because of the dramatic results it can produce.

The Tobacco Cessation Resource Center (TCRC) is a Department of Health program run by Free & Clear that helps health care providers and community leaders learn how to assist Washingtonians who want to quit tobacco. As the Senior Program Manager for the TCRC, I have seen how effective Washington’s programs can be in working together to create the right environment for people to quit tobacco and stay tobacco free. But a “comprehensive” tobacco control and prevention strategy is not always easy to understand. Often it seems sufficient to have a smoke-free policy in place, or to have a Quit Line in place. Maybe we only need to work with children on prevention—then they won’t start smoking and we can prevent future problems right? If health care providers are trained to treat patients to quit tobacco, isn’t that enough? Why would a state need all of these programs?

Here is an example of how all of these programs work together to effectively reduce tobacco use in a synergistic way: A nurse trained by a Washington State Department of Health program refers a father to the free Washington State Tobacco Quit Line for help quitting. He is ready to quit and receives free coaching and medication to help him successfully stop smoking. He no longer smokes at home and his daughter grows up in a smoke-free household. His daughter also goes to a smoke-free school and participates in a program to where peers teach students about how to avoid tobacco. The YMCA where she plays after school has also received information and tools that help her dad from relapsing and help him relieve his stress with exercise instead. When the family goes out to eat, the restaurant is also smoke free. As this brief example demonstrates, the programs that Washington has built work together to reinforce a healthy, tobacco-free environment.

A comprehensive approach is necessary now more than ever. A number of disparate populations continue to struggle when trying to quit smoking and need our help. Individuals below the poverty line are three to four times more likely to smoke than those at or above the poverty line. Those living below the poverty line also struggle more when trying to quit (CDC, 2008). In addition, those suffering from mental illness may require additional or different approaches to help them quit successfully. Our fight to end the death and disease caused by tobacco use in Washington is far from over.

Washington State has been on the forefront of innovation in tobacco prevention and control – piloting programs that combine treatment for chronic diseases with treatment for tobacco use, working with individuals who have mental illness and smoke, and working with low income populations. To continue our progress in reducing adult smoking prevalence and to maintain our work today, we must continue to innovate in these areas. We must continue to use a multifaceted approach to help populations in need.

Unfortunately, tobacco prevention and control programs across the United States have taken budget cuts in these hard economic times. While it may be tempting to look at the success in Washington and feel like our work is done, I encourage us to search for ways to sustain and build on our success. We’ve worked too hard to give up now. Congratulations Washington – here’s to another decade of progress!