Best practicestobaccocontrol.trc. 10.21.11.final

Best Practices in Tobacco Control

Proven strategies to reduce tobacco use,

prevent initiation and eliminate exposure

to tobacco smoke

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Tobacco is still the leading cause of preventable death in the US and in Colorado

• In Colorado, nearly 4,390 deaths each year due to tobacco use.*

• Smoking causes more deaths than HIV, illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders COMBINED.†

* MMWR (2009), 58 (02); 29-33.† MMWR (2008), 57 (45): 1226 – 1228; CDC (2009), Health, United States, 2008; Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual Causes of Death in the United States. JAMA: Journal of the American Medical Association 2004;291(10):1238–1245 .

Tobacco use is costly for everyone

Cost to United States economy each year in healthcare costs and lost productivity: $193 billion

Cost to Colorado each year in healthcare costs and lost productivity: $2.4 billion*

Annual U.S. Medicaid costs due to smoking: $30.9 billion

Annual Colorado Medicaid costs due to smoking: $319 million

US Adult Smoking Prevalence-2010

Cover this blue placeholder with your program logo Source:2010 BRFSS

http://www.cdc.gov/vitalsigns/AdultSmoking/index.html

Adult Cigarette Use-Gender - 2010

Source: Behavioral Risk Factor Surveillance System (BRFSS)

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CO Overall All States (median) CO Male US Male CO Female US Female

1617.4 18

21.5

14

17.3

Adult current smoking by demographic group

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Note: * Estimates for education are based on adults aged 20 years and older. Estimates for racial/ethnic groups are based on combined 2009 and 2010 data. Source: CDC Behavioral Risk Factor Surveillance System

Colorado Young Adults aged 18 – 24

2001 2005 20080

5

10

15

20

25

30

35

40

1 8 - 24

student

non student

Source: 2001, 2005, 2008 Colorado Tobacco Attitudes and Behavior Survey

Tobacco Use in Medicaid Population ~500,000 individuals receive Medicaid each year in CO

Medicaid Colorado Adults0%

5%

10%

15%

20%

25%

30%

35%

40%

38%

18%

Tobacco Use TABS 2008

Smoking Among Pregnant Women

Medicaid Non-Medicaid0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0 33.0

13.3

19.2

5.3

25.8

8.5

Before pregnancy During pregnancy After delivery

Colorado PRAMS, 2004-2008

Middle School & High School Students Ever Smoking-Colorado

Middle School High School0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

25.7%

54.2%

16.7%

43.2%

14.4%

36.8%

Source: Colorado Healthy Kids Colorado Survey on Tobacco and Health, 2001, 2006, and 2008

200120062008

SOLVING THE TOBACCO PUZZLE:

REDUCE OR ELIMINATE CO-PAYMENTS FOR CESSATION THERAPY

CREATE REMINDERS SYSTEMS FOR MEDICAL PROFESSIONALS

PROVIDE CESSATION

SUPPORT TO HELP PEOPLE QUIT

PROHIBIT SMOKING IN INDOOR PUBLIC

AND PRIVATE WORKPLACES

INCREASE THE PRICE OF TOBACCO

TARGET SPECIFIC AND HIGH-RISK POPULATIONS THROUGH MASS MEDIA CAMPAIGNS

REDUCE THE AVAILABILITY OF TOBACCO PRODUCTS TO YOUTH

CDC reports “statewide tobacco control programs that are evidence-based,

comprehensive, sustained and accountable are shown to reduce

smoking rates, tobacco related deaths and diseases caused by smoking.”

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CDC (Community Guide)

IOM (Tobacco Blueprint)

NIH (State of the Science)

Increase the price of tobacco

Prohibit smoking in indoor public and private workplaces

Reduce the availability of tobacco products to youth

Provide cessation services

Target specific and high-risk populations through mass media campaigns

Evidence Base for Interventions

Tobacco Excise Tax by State & Ranking

Moving Forward: Work to be done• Decrease the cessation disparity affecting low

SES smokers• Decrease smoking prevalence and initiation

among young adults who are not in college• Place constraints on the tobacco industry based

on new FDA law• Reduce initiation among low SES youth• Recognize and treat tobacco addiction as a

chronic disease• Increase the price of tobacco products

“It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change.”

- Institute of Medicine