Best Practices for Tobacco Control
Mar 27, 2015
Best Practices for Tobacco Control
Background
32,844
2,214
2268
3,436
3,597
5,445
7,735
7,854
10,596
33,437
43,100
All Other Causes
Suicide
Nephritis, Nephrotic Syndrome and Nephrosis
Alzheimers Disease
Pneumonia and Influenza
Diabetes Mellitus
Chronic Lower Respiratory Diseases
Accidents
Cerebrovascular Diseases
Malignant Neoplasms
Diseases of the Heart
0 10,000 20,000 30,000 40,000 50,000
LEADING CAUSES OF DEATH, TEXAS, 2001
Actual Causes of Death, Texas 2001
218
1,052
1,405
1,807
2,214
2,851
3,736
11,132
18,649
24,899
0 5000 10000 15000 20000 25000 30000
Fire
AIDS
Homicide
DWI**
Suicide
Drugs*
Auto Accidents
Alcohol*
Overweight/Obesity
Tobacco
Economic Cost
In 1998/1999, Texas Smoking-Attributable Costs = $10.09 billion Direct Medical expenditures - $4.55
billion Lost Productivity costs - $5.54 billion
In 1998, about 15% ($1,265,000,000 or $543.87 per recipient) of all Texas Medicaid expenditures were spent on smoking-related illnesses and diseases. (includes state and federal contributions to Medicaid)
Tobacco Industry Expenditures In 2005 the tobacco industry spent
$13.36 billion on advertising and promotion in the U.S. (more than $36.6 million per day)
Approximately $884.7 million was spent in Texas in 2005 (over $2.4 million every single day)
Texas Tobacco Settlement 1998 - Texas became the 3rd state
to settle with the tobacco industry Settlement represented
compensation for the state’s cost of tobacco-related disease
Texas to receive $17.3 billion over 25+ years
FY 00 -01 $1.8 billion available from the
settlement in FY 00-01 Texas Department of Health
appropriated the interest from a $200 million endowment ($9 million) per year to implement programs to reduce the use of tobacco products
Special attention to populations targeted by the tobacco industry
Texas Tobacco Task Force ReportProgram Elements and Best Practices
Community & School Programs
Media Campaigns Cessation Enforcement Efforts Targeted to
Diverse/Special Populations
Surveillance & Evaluation Research
Funding for Comprehensive Tobacco Prevention and Cessation Programs (media, provider reminder systems, telephone quitline…)
Tobacco Excise Tax Increases
Restrictions on Secondhand Smoke
Coverage for Smoking Cessation
Healthcare Provider Reminder Systems
Recommended Tobacco Interventions
Latest Results From 2000 to 2006, current use of any
tobacco products in the comprehensive program area showed a 42% reduction among middle school students (from 24.8% to 14.3%) and a 36% reduction among high school students (from 40.7% to 26.2%)
The prevalence of adult smoking in the comprehensive program area decreased 26.4% (from 21.6% in 2000 to 15.9% in 2004)
Smoking Rates for Harris & Jefferson Counties 2000-2005
Reducing tobacco use requires a comprehensive & sustained approach. Gains in Harris County regressed as
resources/efforts were reduced.
10.011.012.013.014.015.016.017.018.019.020.0
2000 2001 2002 2003 2004 2005
Year
Pre
vale
nce
Jefferson Harris
Heart Attack Deaths Decline 3 Times Faster in County with Anti-Tobacco Campaign
Heart Attack Death Rates, age-adjusted
0
20
40
60
80
100
120
140
2000 2001 2002 2003
Per
100k p
op
ula
tio
n
Harris County Jefferson County TEXAS
ROI Results from the Comprehensive Pilot Initiative (Cont.)In 2003, single year program costs
of $11.3 million ($2.71 per capita) implementing comprehensive tobacco programming in Houston and Beaumont/Port Arthur resulted in:
over 29,800 fewer adult smokers in 2003
savings of over $252 million in medical care and productivity costs over 5 years.
Projected Financial Returns from Statewide Investment in Tobacco Control
$3 per capita spending of $68.3 million for statewide program in 1 year would yield:
~164,000 fewer smokers statewide After 5 years, the single year investment of $68.3 million would achieve a cost savings of over $1.4 billion in medical care and productivity costs
Center for Health Research, Kaiser Permanente Northwest, June 2006
Tobacco Excise Tax Increases
Tobacco Price Increase Findings (Community Guide)
Results in decreases in both the number of people who use tobacco and the quantity they consume.
A 10% increase in the price of tobacco products will result in a 3.7% decrease in the number of adolescents who use tobacco and 4.1% decrease in the amount of tobacco used by the general population.
Increases in the price of tobacco products also reduce tobacco use in older adults
Restrictions on Secondhand Smoke
Second-Hand Smoke (SHS) Public Health Issue
Contains over 4,000 chemicals including 43 known carcinogens
Group A Carcinogen (like asbestos and benzene) Health Effects: Adults
Lung cancer Coronary heart disease
Health Effects: Children Lower respiratory tract infections in children < 18
months old each year Middle ear infections Asthma SIDS
Smoking Ban Findings (Community Guide) Smoking bans in workplaces observed
average of 72% reduction in exposure to components of ETS.
Effective in a wide variety of public and private workplaces and healthcare settings.
Studies evaluating smoking bans also observed reductions in the amount smoked.
PM 2.5 Austin Texas
0
0.2
0.4
0.6
0.8
1
1.2
Bar
A
PM
2.5 Before Sept 1 2005
After Sept 1 2005
Smokefreee Laws =Reduced Profits for Big Tobacco
“Financial impact of smoking bans will be tremendous – three to five fewer cigarettes per day per smoker will reduce annual manufacturer profits a billion dollars plus per year.”
Philip Morris internal document. A Smokers’ Alliance: draft. Bates Nos. 2025771934-
2025771937