According to the Centers for Disease Control and Prevention (CDC) tobacco use is the most preventable cause of death and disease in the United States. Each year, approximately 443,000 Americans die from tobacco-related illnesses. Medical expenses and lost productivity cost the United States $193 billion a year. This presentation will address prevention of tobacco use, one of the Healthy People 2020 objectives: A framework for ending the tobacco use epidemic. Nevada has successfully implemented evidence-based best practice guidelines and built a Tobacco Prevention and Education Program to substantially reduce the use of tobacco in the state.
The Nevada Evaluation and Statistical Manuel is compiled of several reports which us a wide range of assessment and evaluation tools which were developed for the Nevada Tobacco Prevention and Education Program and all tobacco control internal and external partners.
The Adult Tobacco Survey (ATS) of 2008 serves as a model surveillance tool to be conducted annually. This survey provides statistically valid reliable data about the impact of the tobacco prevention and control programs in 2008. Many of the survey items have also been used by the Centers for disease Control (CDC) to assess tobacco use and behaviors relating to this. Starting in 2001, a statewide 15-minute Random Digital Dial (RDD) survey was conducted on 1,604 adults which established a baseline regarding tobacco use among Nevada adults (age 18 and over). The data was collected from a representative sample and they were questioned on opinions, attitudes and behaviors relating to tobacco use. In 2001 the total of 2,382 adult interviews were completed across the state. In 2008, a total of 2,410 interview were completed. The survey instrument and method used in 2008 were similar to the ones used in 2001 and 2005 to maintain comparability with past data collection. Data collection for the 2008 ATS was done using the CATI technology and was conducted from January 4th, 2008 to March 25th,2008. Survey items included questions on: Cigarette use history, other tobacco use, quit smoking history, secondhand smoke exposure, policy issues and tobacco, comorbidity and tobacco, media, and demographics.
In Nevada the State Health Division (NSHD) in an effort to reduce the use of tobacco throughout its state provides leadership to the community stakeholders and tobacco prevention experts using data from the Nevada Behavioral Risk Factor Surveillance System (BRFSS), and Youth Risk Behavior Surveys.The Behavioral Risk Factor Surveillance System (BRFSS) is primarily funded by the Centers for Disease Control and Prevention (CDC). BRFSS in Nevada surveys adults eighteen years and older, and is used to assess risk for chronic disease, identify demographic differences in health-related behaviors, address emerging health issues, evaluate public health policies and programs, assess special populations, and measure progress toward achieving state and health objectives. Many states also use BRFSS data to support health-related legislative efforts. The State of Nevada contracted the Center for Research Design and Analysis (CRDA) at the University of Nevada, Reno to conducted telephone interviews, on a monthly basis, then CRDA submits data to the Behavioral Surveillance Branch (BSB) at CDC, who weights the data annually according to state specific population estimates and then distribute a yearly state-specific and nationwide data of risk factors that can be used the state to estimate prevalence. According to the 2009 BRFSS, 22.2% of Nevada adults are current smokers compared to the national value of 18.4% and the prevalence of smoking among Nevada adults is greater among individuals with less education and those in the lower income brackets (Department of Health and Human Services Nevada State Health Division Bureau of Health Statistics, Planning, Epidemiology, and Response Office of Health Statistics and Surveillance, 2012).
Source: Nevada Behavioral Risk Factor Surveillance System (BRFSS) Report February 2011.
Nevada along with other states have access to CDC’s national Youth Risk Behavior Surveillance Systems (YRBSS) data that is used to monitor six categories of priority health-risk behaviors among youth, behaviors such as unintentional injuries and violence, tobacco use, alcohol and other drug use, sexual behaviors that leads to unintended pregnancy and sexually transmitted disease, and overweight. Under the supervision of CDC, each state hires a contractor to conduct the surveys, collect the data, weights the data, and prepares the data for analysis. The data is then sent to Westat (a leading statistical organization) where the data is evaluated for sufficiency, appropriate documentation, and that the local site had followed sampling protocols. When the data is finished at Westat, it is then sent to CDC to be incorporated to the edited data file. According to Nevada Public Health Foundation (n.d.), “2007 Nevada Youth Risk Behavior Survey (YRBS) found that 13.6% of high school students smoked cigarettes one or more days in the past 30 days. The social norms approach uses local data (Nevada YRBS) to reinforce positive messages that most youth don't smoke in order to change the misperception” (para. 4).
Data provided by the State of Nevada/Nevada State Health Division support the efforts toward tobacco use cessation programs targeting the youth population. Per the Health Division website, 29% of adults in Nevada smoke compared with 23.5% in 2001 studies. Only Kentucky, which is a tobacco producing state, has a higher prevalence rate. (www.health.nv.gov/CD) Among youth, 25% of high school students reported to smoke and this is the highest in the nation. It was additionally reported per the CDC that each day in the United States, approximately 3600 young people between the ages of 12 and 17 start smoking. An estimated 1100 of these became daily smokers. In 2009, 19% of high school students reported current cigarette use and 14% reported cigar use. (www.cdc.gov) Even more startling than these statistics is the fact that, in the state of Nevada, 2600 people die annually from smoking related illness. This leads the nation in deaths from lung cancer. It is important to provide education regarding the health risks related to smoking to young people in an effort to help them choose to refrain from engaging in this behavior. It is to this end that the state of Nevada has developed and implemented programs targeting the youth population.
The national epidemiological data on tobacco-use provides a comparative study on health events in regards to human behavior in relation to the U.S. population. Specific to this study evidence based data gives support to tobacco-use risk factors as well as preventative measures associated with cancer. In order to develop an effective intervention, it is necessary for data focus on a subgroup that represents communities with a high prevalence rate of the public healthissue of tobacco-use.Understanding the origin of this nationally recognized health issue starts by identifying the intended group it designed for. According to Baker, Brandon, and Chassin (2004), “Additional support for the link between smoking and the affect is found in population-based studies examining the covariation of smoking which clinically syndromes characterized by high negative affectivity, particularly clinical depression” (Baker, Brandon, & Chassin, p.478, 2004). The identified population seeking relief from what has been identified as an unhealthy behavior, typically find themselves consumed by the habit forming sub-content known as nicotine.
“Adolescent smoking is correlated with self-report exposure to tobacco advertising, and epidemiological trends over time show correlations between rises in adolescent smoking and times of tobacco use over time of tobacco ads” (Baker, Brandon, & Chassin, p.478, 2004). Makers of tobacco products use crafty advertisement to appeal to said group of people with intentions of creating lifelong customers. The human race is predisposed to additions through genetic make-up which can contribute to the likelihood account for the causality of the addition (Baker, Brandon, & Chassin, p.478, 2004). On a local level, it is very necessary to factor demographics as an influential factor. This is true because there are trends of high rates of depression in certain demographic areas which can account for similar findings in rates of tobacco-use. Family is another factor which influences tobacco use as it varies in acceptance between ethnic groups (Baker, Brandon, & Chassin, p.478, 2004). The most powerful tool to fight against tobacco-use is educating the nation of the negative side effects in regards to its negative effect on carrying out a long and healthy life. Local agencies can aid in these efforts by enforcing governmental regulations on proper sales of the product as well as health warnings. The prevalence and patter of tobacco-use requires health officials at a local and state level to put forth a concerted effort to follow the population effected by this health issue, and educate said group on the risks. As a preventative measure, educating early adolescents on know trends for their population will optimistically head-off tobacco-use.
Data collected via the Youth Risk Behavior Surveillance System supports the implementation of tobacco cessation programs targeting the youth population. The YRBSS included a national school based survey that was administered to students and collected data on six different risk behaviors, including tobacco use. (www.cdc.gov/HealthyYouth) The state of Nevada used the data provided via the surveys and launched the Nevada Tobacco Prevention and Education Program in 2007. The program included a five year strategic plan with several specific goals aimed at preventing and decreasing tobacco use among young people as well as eliminating the exposure of nonsmokers to environmental tobacco use. The program outlines specific strategies that engage community leaders, schools and the public in a collaborative effort to address the prevalence of tobacco use in Nevada.
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• 2005 Nevada Adult Tobacco Survey (ATS)• Healthy People 2010 (HP 2010) • Nevada Behavioral Risk Factor Surveillance System (BRFSS) • National Youth Tobacco Survey (YTS)
• Centers for Disease Control and Prevention • Random Digital Dial (RDD) • Computer Assisted Telephone Interviewing (CATI)
• Behavioral Risk Factor Surveillance System (BRFSS)
• Youth Risk Behavior Surveillance System (YRBSS)
• State of Nevada Nevada State Health Division• Centers for Disease Control
*Understanding the origin*Attributions to tobacco-use*Risk Factors of tobacco-use
*Educating targeted population*Identifying local and community level support *Preventative measures
*Youth Risk Behavior Surveillance System*Nevada Tobacco Prevention and Education Program
CDC: Adolescent and School Health". (n.d.). Retrieved from http://www.cdc.gov/HealthyYouthDepartment of Health and Human Services NevadaState Health Division Bureau of Health Statistics,Planning, Epidemiology, and Response Office ofHealth Statistics and Surveillance. (2012).
"Nevada State Health Division". (2006). Retrieved from http://www.health.nv.gov/CDNevada Public Health Foundation. (n.d.). Tobacco prevention and education. Retrieved from http://www.nevadapublichealthfoundati on.org./tpep.asp
"Nevada State Health Division". (2006). Retrieved from http://www.health.nv.gov/CD