Jay Colum, nicotine dependency specialist for the Hamilton County Health Department, was the the speaker at the August 5 meeting of the Chattanooga Area’s Southside Council. Colum’s topic was "Tobacco Control in Tennessee and Resources for Quitters." Colum provided business people with the following information: * How Tennessee smoking policies affect you * How to help cut down on second-hand smoke * How to make your environment healthier Colum has worked in addictions therapy for over 20 years, focusing on providing addiction therapy to families. For the last five years he has provided tobacco control and education through the Health Department. He is responsible for maintaining a Tobacco Community Coalition, which includes the Smoke-Free Chattanooga campaign. Collum is seeking volunteers with an interest in helping change the culture of tobacco in Tennessee.

1. Putting Together the Local
Tobacco Control and
Prevention Puzzle
Comprehensive Local Tobacco
Control Programs

2. Why Tobacco Control?
■ Tobacco use is America’s
single most preventable cause
of death and disease
■ It is also the largest modifiable
risk factor for chronic disease
■ Tobacco-related illness eats up
75% of healthcare dollars spent
in the U.S.
Source: Anderson, G. et al. (2004)

3. Why Tobacco Control? (continued)
■ In 2004, tobacco addiction
cost the nation almost $200
billion in medical expenses
and lost productivity
■ In 2005, the Society of
Actuaries estimated that the
effects of exposure to
secondhand smoke cost the
U.S. $10 billion per year
Source: CDC (2007)
1-4

4. Local Responsibility
■ Local governments have a statutory responsibility to
address tobacco use as a dominant threat to the
health of their communities, especially among
vulnerable populations:
● Those experiencing tobacco-related disparities
● Youth
● Persons with lower levels of education
● People with substance abuse issues

5. Local Response
■ Response to the tobacco
problem varies widely
depending on availability of
funds
■ Local politics and pressure from
the tobacco industry have also
influenced the degree of
government involvement

6. 2009 Family Smoking and Prevention
Tobacco Control Act
■ Gives the U.S. Food and Drug
Administration (FDA) the authority to
regulate tobacco
■ Will greatly change the tobacco
marketing and sales environment in this
country
■ Taking full advantage of the provisions
of the FDA legislation will strengthen
local tobacco control programs

7. 2009 Family Smoking and Prevention
Tobacco Control Act—Provisions
■ New restrictions on tobacco marketing to children
■ Enhanced enforcement of the federal prohibition on
sales to persons younger than 18
■ No vending machine sales or self-service displays of
cigarettes or smokeless tobacco except in adult-
only facilities
■ No branded product tie-ins, such as T-shirts, with
purchases

8. 2009 Family Smoking and Prevention
Tobacco Control Act—Provisions (cont.)
■ No free samples of cigarettes or smokeless
tobacco products, except in certain
restricted situations
■ No outdoor advertising within 1,000 feet or
schools, parks, or playgrounds
■ No sponsorship of athletic or cultural
events by tobacco product manufacturers,
distributors, or retailers
■ All advertising at point of sale must be
black text on white background only
Source: CTFK, Campaign for Tobacco Free Kids (2009)

9. Community Interventions: Rationale
■ Effective community programs involve and influence
people in their homes, work places, schools, and
public places.
■ Community interventions influence societal
organizations, systems, networks, and social norms to
help many people make behavior changes
Sources: CDC (2007); CDC (2000b)

10. Community Involvement
■ To achieve individual behavior change,
whole communities must change the way
tobacco products are marketed, sold,
and used
■ Changing policies takes the involvement
of community partners and buy-in from
local decision-makers
■ Local coalitions have been a powerful
and effective tool
SMOKE FREE CHATTANOOGA COALITION

11. Examples of Community Interventions
■ Establishing partnerships with local organizations
■ Educating decision-makers about changing systems
and environments to de-normalize tobacco use
■ Encouraging policies that support tobacco use
prevention and cessation

12. School-Based Community
Interventions
■ Developing and implementing tobacco-free school
grounds policies
■ Promoting risk-reduction curricula, teacher training,
and in-school cessation support services

13. Health Communications: Rationale
■ Media messages can also
have a powerful influence
Your
on public support for Message
Here
tobacco control policy and
help bolster school and
community efforts
Sources: CDC (2000a); CDC (2000b); Farrelly, M. C., Pechacek, T. F., Thomas, K. Y., and
Nelson, D. (2008); Frieden, T. R., Bassett, M. T., Thorpe, L. E., and Farley, T. A. (2008);
Goldman, L. K., and Glantz, S. A. (1998); McAlister, A., Morrison, T. C., Hu, S., Meshack, A. F.,
Ramirez, A., Gallion, K., et al. (2004)
2-13

14. Cessation Interventions: Rationale
■ More than 2/3 of adult smokers report a desire to quit
■ More than 40% of smokers try to quit each year
■ Current estimates: most smokers who try to quit will
do so several times before succeeding
■ Both tobacco dependence and desire to quit appear
to be prevalent across racial and ethnic groups
Source: Fiore, M. (2008)
2-17

15. Examples of Cessation Strategies
■ Supporting evidence-based tobacco cessation
interventions in the community
■ Promoting systems-level changes to more effectively
track tobacco use by patients and to more
consistently refer tobacco users to cessation services
■ Increasing the use of culturally sensitive, linguistically
appropriate cessation interventions for specific
underserved populations

16. More Spending = Less Smoking
Smoking

17. ―Top 5 Reasons We Should
Care About Tobacco Use
and Prevention‖
I. The message is:
We as community must change the culture of acceptance (or tolerance)
of tobacco use and secondhand smoke in order to make real progress.

18. II. “If nothing changes, nothing changes.”
•What should the culture of tobacco in Chattanooga be in 3 years, or 5
years? What role do we have to impact that culture….?
•Will we still have smoking on school grounds and properties? (Today
there is a 50‖ feet rule from an entrance, but faculty and staff can smoke
on grounds and students report observing this.) After regular hours, the
guidance is more lax.
• Knox County established all school property as tobacco-free in January
of 2008. A School Board member stated: ―Popular teachers who smoke
and serve as role models to students could unintentionally encourage
students to smoke‖.

19. III. ―Tobacco is not a product of choice, it is a
product of addiction.‖
■ Youth, especially 12-17, and 18-24 are the primary targets of tobacco
advertising (9.6 billion per year). Most youth when they first try tobacco
don’t plan to continue for life, but only to ―experiment‖ but find themselves
hooked in a very short smoking experience – sometimes only a few
episodes.
■ In TN, 46.9% of 18-24 years olds smoke (38% for U. S. A.): 25.5% of TN High
School students, 20% for entire country.
■ Our community example, our parental examples and our voluntary public
policies matter.

20. IV. One of our newcomers to the area and a great
corporate example in this area, Volkswagen, has
already – proactively - established a strong
comprehensive workplace tobacco policy.
■ ―Consumption of tobacco products will be prohibited on company property,
including offices, sidewalks, parking lots, streets and all VW vehicles.‖ And
Volkswagen will provide smoking cessation assistance to employees.
■ One fact to remember: For every $1.00 Tennessee takes in revenue, the state
spends at least $8.00 in related healthcare and other costs.
■ The Chattanooga Times’ recent editorial detailed the major reasons Tennessee is
―losing the smoking wars‖. The solutions are not a secret. Many states have
drastically cut smoking rates in both adults and adolescents. The wheel doesn’t
have to be re-invented. But action has to be taken and funding put where it was
intended.

21. V. Get Involved
■ The Campaign for a Healthy and Responsible Tennessee (C.H.A.R.T.), First
Things First, Smoke Free Chattanooga and all our partners need and
welcome your help and input.
■ Objective surveys show Tennesseans overwhelmingly support the law and
better control of tobacco.
■ The facts are on our side. Let’s increase our motivation and willingness to
work to impact - in a major way – the most preventable cause of death and
disease in our nation – more than is caused by alcohol and drugs,
homicides, suicides, motor vehicle accidents and AIDS combined every
year. That’s over 430,000 deaths annually in this country.