In working with clinicians we're measuring and encouraging improvement measures such as tobacco use and cigarette cessation. medication reconciliation, providers may earn an incentive for reporting. as a reminder, clinical prevention strategies will focus on access of care and outcomes. we are launching models of care through the center and payment program such as bundling. the fostered team-based care coordination and patient centered care including care outside of the traditional office visit. through the qio program we're launching learning in action networks. these are drivers of quality and improvement and collaborative learning. the quality improvement organizations run and will convene in innovative learning and action network locally and every state they serve and may be accomplished or in person meetings, web access, phone conferences and other modalities that qios work with beneficiaries and providers. we just included the mechanism and we look forward to report to think collaborative improvement model in is really a knew phase in the qio program.
Cms calls upon qio toss serve on the boots on the ground and important role as conveners, organizers, change agents. by providing a call of action throughout to reach education and social marketing, serving as a trusted partner with February beneficiaries and stakeholders. execution of the following three drivers of quality, first,supporting and convening learning in action networks. second, providing technical says tans including quality improvement expertise, feedback and data shs and supporting clinicians. third, partnering with beneficiaries and providers to approve care and achieve better health at a lower cost. we are looking at additional ideas such as testing changes to medication copay's or allowing nurses and pharmacists to achieve blood pressure goals. we've already in the hospital setting lowered regulatory burdens so people can practice the full extent and proposed rule are working to finalize that rule. this all boils down to communications support partnerships. everyone working together to achieve the million hearts goal of preventing one million heart attacks and strokes. it is critical that we work together as partners. some ways at million hearts can help is support existing and already released enter vepgs intervention,proposed new interventions that cms should work on, align existing cms interventions across the federal family, and include million hearts and abcs and outreach and communications.
As a practicing clin ngs i can't tell you how proud i am to be working with the cdc and on behalf of cms, we really value our partnership and our ability to transform care in the u. s. The commissioner of the new york city department of health and mental hygiene. Since 2002 reduced cardiovascular disease. i'll be including the environmental initiatives,smoking prevention, trans fat restriction, and sodium reduction and clinical initiatives focusing on a prevention or sorry oriented record and quality improvement and technical assistance. first, our smoking program. the key policy change in our smoking program has been the smoke free air policy. in 2002 new york city passed the smoke free air act which prohibits smoking in indoor workplaces including restaurants and bars. no 2011 it was extended to outdoor parks and beaches. in this year, 2012, the university of new york will make all of the 23 campuses in the city completely tobacco free. another important policy change has been increase in cigarette prices through tax increases. in 2002 the city passed a tax increase of $1. 50 per pack. bringing the total tax on a pack of cigarettes in 2003 to over$3. additional state and federal tax increases that occurred between2002 and 2010 brought the total tax on a pack of cigarettes to$6. 86. a pack of cigarettes in new york city now costs about $11, the highest price in the nation. we've also extensively used mass media. we developed many of our own messages in which we keep fresh by providing new information or developing new ways of preventing old information, and in some cases providing testimonials testimonials. we have focus groups of smokers and place them on television and on subways. once a year we link a new campaign with the distribution of free nicotine patches and gum. this this is an example of a recent campaign. it emphasizes the suffering that smokers will endure, rather than death, which smokers don't fear very much.
This particular campaign has an emphasis on emphysema and stroke. potential of family members may have to provide care for smoker which is something we found particularly disturbing to smokers. let me see if i can show you this, one of these ads. as you can see we find it with subtlety. so what's been the effect of our smoking prevention program?this slide show transits smoking prevalence in new york city from1993 to 2010. before 2002 for about a decade the smoking prevalence in new-york city was steady at 21%. since then the prevalence has fallen more than a third to 14%. now represents 450,000 fewer smokers in new york city. next are our emphasis on trans fat. we restricted the use of trans fat based upon the rational that trans fat is an artificial chemical that increases heart disease risk. four gram consumption of trans fat or typical amount in a portion of french fries increases heart disease risk by23%.
in 2006 the new york city board of health prohibits the use of trans fats by restaurant. in 2007 they began enforcing it by issuing violation fines during restaurant inspections. by 2008, more than 90% of restaurants were in compliance. this idea has now spread to other cities. this slide shows other cities and states which are considered trans fat restrictions since that time if states and cities are shown in blue and the states and cities that have consider resurgence is shown in red. following the approval of new york city health code amendment more than 50 restaurant chains have announced or reiterated their intention to discontinue the use of artificial trans fats in their foods. new york city also led to initiative to reduce sodium called the national salt reduction initiative. it's far too high and reduction of 1200 milligrams per day on average in an American consumption could save tens of thousands of lives per year nationally. the goal of this initiative is to reduce sodium intake by 20%over five years. through meetings with food companies we have classified packaged food in the 65 categories. restaurant food in 424 categories. we set reduction targets for each of the categories in 2012012 and 2014. with the average deduction of 25%.
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