Items for the Notes section:Past 20 year prevalence trend – peaked over 24% in 1994 currently at 16% an all time low in Colorado.1.5 billion fewer cigarettes smoked per year in the past decadeProgress has been made, but more to be done.Nationally and in Colo data show that there is a stall in the decrease for both youth and adults
*(2nd Row)$579 per Colorado Household Smoking harms others and costs everyone money. Tobacco addiction results in chronic disease that is expensive to treat and contributes to the ever-increasing medical costs that healthcare reform can’t fully solve. And exposure to second-hand smoke kills others. In fact, it has been shown to contribute to infant SIDS deaths.There are a number of things we are doing at CDPHE to address tobacco use. The one that citizens are most familiar with is Amendment 35.$193 billion – MMWR (2008) 57(45);1226-1228.$2306 million – CDC (2007) Best Practices…Medicare and Medicaid fed stat: Campaign for Tobacco Free KidsState Medicaid _ 2007 CDC Best Practices2nd-hand smoke stat: 2006 Surgeon General’s report on 2nd hand smoke – pg. 5-6.
Adult prevalence has declinedCan see disparities among certain groups ethnicity, age and education (why?)Smoking rate is inversely proportional to educational atainment
Looking more closely at 18-24, highlighting the education disparity.
As you can see from this figure, the rate of ever smoking among both middle and high school students has decreased since 2001. The prevalence of high school ever smokers is twice that of middle school students. While we don’t have income data on youth smoking (don’t ask for it), we know based on other research that kids who smoke are more likely to be low-income, based in part on what we infer from other data about low-income smokers.We know that kids who have friends or family who smoke, who don’t have a trusted adult tell them not to use tobacco, and that are exposed to higher levels of advertising, which is more prominent in low-income neighborhoods, are more likely to try tobacco.
And – a key reason we are all here today – according to the Healthy Kids Colorado survey, 60% of the smokers under 18 who tried to buy tobacco illegally, tell us that the were successful in their attempt. 60 percent!Furthermore, the rate of successful attempts INCREASED 24% between 2006 and 2008.In addition, 53% of youth in grades 6 – 12 said it would be “very easy” or “pretty easy” to get cigarettes if they wanted. *We conducted key informant interviews with several parents. It doesn’t have the statistical validity of the youth survey, but gave us some insights on what parents might think. Most of the parents agreed that it is not hard for underage youth to get cigarettes, and most felt that the current laws are not adequately enforced.When we met with the Youth Partnership for Health, a youth advisory board to the Health Dept, and asked for their opinions, they mirrored the parents. Youth and parents overwhelmingly stated that current laws prohibiting sales to kids under 18 are meaningless if they are not effectively enforced. The retailers – to a lesser extent – agreed that enforcing current laws would make them more effective.
This graph represents current smokeless tobacco among males from high school to adulthood. Often the perception of smokeless tobacco is that the prevalence is higher among older male adults; however, as seen in this graphic, the prevalence currently peaks in high school. Moving forward, the high prevalence among high school students could lead to problems as these males age over time. Again, it is important to remember that we simply don’t know if this data will be reflective of youth use of the newer tobacco products like dissolvables.
Tobacco wb webinar 6.22.12
CDPHE Winnable Battles: Tobacco August, 2012 CDPHE Tobacco Program Team
Top Row: Dee Thomas – Enforcement Program Coordinator Emma Goforth – Adult Cessation Coordinator Celeste Schoenthaler – Unit Manager Gracie Cash – Tobacco Program GeneralistBottom Row:Jennie Munthali –Stephanie Walton – Youth Policy CoordinatorJill Bednarek – Secondhand Smoke CoordinatorNot pictured:Sharon Tracey – Youth and Young Adult Initiatives CoordinatorJennifer Schwartz – Tobacco Initiatives Work Lead
Tobacco Program MissionIn partnership with communities, youth and stakeholders, our team provides leadership for tobacco prevention by promoting and implementing evidence-based, data-driven strategies across Colorado.
Tobacco use is costly for everyoneCost to United States economy each year inhealthcare costs and lost productivity: $193 billionCost to Colorado each year in healthcare costs andlost productivity: $2.4 billion*Annual U.S. Medicaid costs due to smoking: $30.9 billionAnnual Colorado Medicaid costs due to smoking: $319 million
Adult current smoking by demographic groupCover this blue placeholder Note: * Estimates for education are based on adults aged 20 years and older. Estimates for racial/ethnic groupswith your program logo are based on combined 2009 and 2010 data. Source: CDC Behavioral Risk Factor Surveillance System
Tobacco Use in Medicaid Population~500,000 individuals receive Medicaid each year in CO 40% 35% 30% 25% 20% 38% 15% 10% 18% 5% 0% Medicaid Colorado Adults Tobacco Use TABS 2008
Middle School & High School Students Ever Smoking-Colorado100.0% 80.0% 60.0% 2001 2006 40.0% 2008 54.2% 20.0% 43.2% 36.8% 25.7% 16.7% 14.4% 0.0% Middle School High School Source: Colorado Healthy Kids Colorado Survey on Tobacco and Health, 2001, 2006, and 2008
~90% of adult smokers first try tobacco before the age of 18†Each Year in the Unites States…Approximately 400,000 kids become regular smokers*6 Million kids will die prematurely from their addiction*Each Year in Colorado…4,900 youth become regular smokers*92,000 kids will die prematurely from smoking*That is more than twice the entire population of Grand Junction! † Surgeon General’s Report: Preventing Tobacco Use Among Young People, 1994. * CDC: Best Practices for Tobacco Control Programs, 2007.
6 out of 10 Colorado high school students attempting to purchase cigarettes are successful
Youth vs. Adult Smokeless Tobacco Use25.0% Male Smokeless Tobacco Use20.0%15.0%10.0% 2008 12.9% 5.0% 9.5% 7.3% 4.1% 1.8% 0.0% High School 18-24 years 25-44 years 45-64 years 65+ years old old old old Colorado Healthy Kids Colorado Survey on Tobacco and Health, 2008 & Tobacco Attitudes and Behavior Survey, 2008
Strategic Plan Goals2020 Goals1. The cessation success gap affecting low SES youth and adult smokers decreases by 50 percent2. A majority of people and health care systems in Colorado recognize and treat tobacco dependence as a chronic condition3. A majority of Coloradans live, learn, work and play in communities that have effective policies and regulations that reduce youth and adult use and access to tobacco4. Tobacco prevalence and initiation among young adults, especially straight-to-work, decreases by 50 percent5. Initiation among youth, especially high burden and low SES populations, decreases by 50 percent6. Exposure to secondhand smoke with an emphasis on low SES populations decreases by 50 percent7. Colorado is among the 10 states with the highest price for tobacco products
Tobacco Program Initiatives• Amendment 35• State Policy – Youth Access/Point-of-sale – Monitor and Sustain CCIAA – Health Systems• Federal Partnerships – CDC – FDA/Synar – Healthy Housing – Medicaid• Data/Surveillance• Partnerships/Communication
PSD Work Plan• Prevent initiation among youth and young adults• Promote quitting among adults and youth• Eliminate exposure to secondhand smoke• Identify and reduce tobacco-related disparities among population groups• Create strategic alignment among A35 review committees
Progress… Department leadership talking about licensing and tax BOH resolution around dissolvables 4 communities with licensing/youth access policies Over 7,000 inspections for compliance with FDA laws (since 2010) Over 600 youth participating in NOT (FY) Enhancement of interagency tobacco team Over 17,000 calls to the Colorado QuitLine (FY) Facebook and Twitter pages for QuitLine 2 new local policies to enhance CCIAA 3 new local policies to reduce SHS exposure in multi unit housing Healthy Housing Coalition formed New strategic plan for tobacco Full funding return to A35 RFA released, new funding framework…. and much much more on the horizon