best practicestobaccocontrol.trc. 10.21.11.final
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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 .
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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
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US Adult Smoking Prevalence-2010
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http://www.cdc.gov/vitalsigns/AdultSmoking/index.html
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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
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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
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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
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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
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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
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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
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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
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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
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Tobacco Excise Tax by State & Ranking
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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
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“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