eliminating tobacco disparities health disparities council july 16, 2012

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Eliminating Tobacco Disparities Health Disparities Council July 16, 2012. State of Lung Disease in Diverse Communities. Compared to White smokers, Black smokers were: 70% less likely to be asked by a doctor about their tobacco use 72% less likely to be advised to quit. - PowerPoint PPT Presentation


  • Eliminating Tobacco Disparities

    Health Disparities Council July 16, 2012

  • State of Lung Disease in Diverse CommunitiesCompared to White smokers, Black smokers were: 70% less likely to be asked by a doctor about their tobacco use 72% less likely to be advised to quit

  • Cost of Tobacco Use9,000 adults die every year in MA from tobacco use.

    For every person who dies from a smoking-related disease, 20 people suffer from a smoking-related illness.

    We spend over $4.3 billion a year treating tobacco-related illnesses in Massachusetts. That represents 10% of our states health care costs.

  • Community Awareness: Rhode Island

    Point of Purchase/Retail Advertising:

    Increases current smokers consumption May reduce current smokers resolve to quit Encourages former smokers to resume their habit Encourages youth smoking initiation

  • Minority Pop = 70.1% -95.4%Minority Pop = 7.5% - 20%Minority Pop = 20% - 50%South Side/West SidePopulation = 38,718 Area = 2.83 sq. mi.

    East SidePopulation = 34,580Area = 4.27 sq mi

    36 Vendors 27 Outdoor Ads

    66 Vendors153 Outdoor AdsProvidence, RI2007-2008

  • Community Awareness: New York CityYouth-led walking tours in all 5 boroughs of NYC

    Highlighted tobacco ads that target the community

    Engaged decision makers

  • Eye level is buy level.- British American Tobacco

  • Community Awareness: Massachusetts

  • Policy Solutions: Local PermittingPackaging Point of Purchase/Retail Advertising Expanding Products Covered Restricting the Sale of Tobacco Products

  • Tobacco Free Pharmacies38 communities in Massachusetts have passed policies including: Boston, Worcester, Springfield, Lowell

    Cover 32.2% of state population (over 2 million people)

    State legislation filed by Chairwoman Susan Fargo and Representative Sean Garballey

  • Tobacco Prevention & Cessation Funding

    Tax policy

    Access to tobacco cessation treatments

    Smokefree laws Policy Solutions: State

  • http://www.tobaccofreekids.org/what_we_do/state_local/tobacco_settlement/massachusetts

    Massachusetts Tobacco Revenue vs. Spending

  • http://www.massbudget.org/

  • The number of packs sold in Massachusetts decreased 59% from FY92 to FY10.

    State excise tax revenue from cigarettes increased 6% annually.

    Increase Price, Decrease Consumption

  • Other Tobacco Products Tax LoopholeState Cigarette tax = $2.51 per pack Lower tax rate on kid-friendly, non-cigarette tobacco productsLegislation filed by Representative Hecht to close this loophole.

  • Source: MA Department of Public Health, Behavioral Risk Factor Surveillance System, 1998- 2008Helping Smokers Quit

  • Smoking Cessation TreatmentsComprehensive insurance coverage of 7 FDA-approved medications & counseling options Expanding MassHealth cessation benefit to Group Insurance Commission and Commonwealth Care plans would save $1.4 million in Year 1 and $7.4 million by Year 5.

  • Going SmokefreeProtecting our 2004 Smokefree Workplace LawInstitutions Academic, Health CarePublic & Private HousingOutdoor spaces Cars

  • Policy Solutions: FederalCessation Coverage Affordable Care Act Federal Employees & Department of Defense

    FDAs Center for Tobacco Products Graphic Warning LabelsBan on flavored cigarettes (Menthol TBD)

  • Engaging Policy PartnersAcross the Health Sector EducationElder Affairs Housing Veterans

  • Questions?

    Katie KingDirector, Public Policy kking@lungne.org (781) 314 9011

    Katie KingDirector, Health Promotion & Public Policy American Lung Association of the NortheastWe cover New England & New York.

    *Source: http://www.lung.org/finding-cures/our-research/solddc-index.html

    State of Lung Disease in Diverse Communities 2010 (March 2010) Report covers: Air Quality, Asthma, COPD, Cystic Fibrosis, Influenza, Lung Cancer, Occupational Lung Disease, SIDS, Tobacco, Tuberculosis 1st in Series of national reports focused on lung health disparities. Other reports have highlighted lung cancer in African Americans, burden of asthma in Hispanic population and influenza among older adults. Compared to Caucasian smoker, African American smokers were 70% less likely to be asked by doctor about tobacco use, 72% less likely to be advised to quit; Hispanic smokers were 69% less likely to be asked, 64% less likely to be advised

    Hispanics and American Indians/Alaska Natives report being the least protected from secondhand smoke. 68.4% of these populations worked in a place where smoking was not allowed, compared to 75.3% overall. *Source: http://www.lung.org/lung-disease/disparities-reports/index.html

    Other disparities: LGBT, veterans, those with behavioral health diagnoses.

    Smoking out a Deadly Threat: Tobacco Use in the LGBT Community You can see that there are significantly higher smoking rates for both men and women who identify as LGBT. In those states that differentiate between bisexual vs. lesbian/gay, the highest smoking rate is among bisexuals. Kudos to these states (including MA) who track LGBT status on health data surveillance. Most states do not so, as a nation, we have much more work to do to even get an accurate picture of this disparity.

    Next report: Rural Tobacco Use out in Fall 2012.

    Sources: http://www.tobaccofreekids.org/facts_issues/toll_us/massachusetts ALA - State of Lung Disease in Diverse Communities 2010 Massachusetts Department of Public Health, Tobacco Prevention & Cessation Program

    *Source: RI Tobacco Control Network

    POP: Increases consumption triggers cravings & cues smokers to light up or buy more cigarettes

    Tobacco industry spends $35 million dollars on marketing in Rhode Island each year Tobacco industry quotes and research have shown that the industry targets certain individuals and groups RI Tobacco Control Network wanted to see if certain communities and youth in Rhode Island were exposed to greater amounts of tobacco advertising and promotions

    *Source: Rhode Island Tobacco Control Network; Tobacco Survey Done 2007-2008, Median Household Income, 2000 Census

    Did mapping of two areas of Providence South Side/West Side and the East Side Chose these to neighborhood to highlight differences in the nature of tobacco marketing between low/high income areas Highest income level SS is 25K; ES is 103K

    Walk through what youre seeing: Population in each area is similar, but the SS is significantly smaller in area (not shown to scale) Shading represents % of population that self-identified as a racial/ethnic minority with SS being 70-95% minority and the ES ranging from 7-50% minority population.

    Findings: Red dots are tobacco vendors. In SS, almost 2x the tobacco vendors compared to ES (despite less area) Density of tobacco advertising was even more striking: 153 ads on SS and 27 outdoor ads on ES. Almost 6 times more outdoor ads on the SS or 1.5 signs more PER store.

    Source: ALANY/Coalition for a Smoke-Free City

    Local youth from all five boroughs teamed up with the American Lung Association in New York and the New York City Coalition for a Smoke-Free City on October 17-20 to lead decision makers on walking tours to highlight the presence of youth-targeted tobacco advertising.

    Tour participants walked the streets in each of the five boroughs where they experienced what our kids see each and every day - tobacco advertising meant to appeal to youth and encourage them to smoke.

    Goal was to encourage further discussion with decision makers on how tobacco marketing can be limited to reduce the damaging effect it has on our youth. *Source: ALANY/Coalition for a Smoke-Free City

    Shirts say: The more tobacco advertising I see the more likely I am to smoke. Kick Butts Day, Boston, March 2012 The 84 Permits: cap/reduce number of permits in a municipality (like alcohol), no permit renewal if outstanding fines, increase licensing fees and fines

    Packaging: minimum size/price for cigars (Boston) state bill filed by Rep Sannicandro this session

    Point of Purchase advertising: require cessation signage, promote state tobacco quitline

    Expand local regulations to include nicotine delivery products and e-cigarettes (new novel products we cant even dream of today)

    Restricting the Sale of Tobacco Products -- Restricting sale in health care institutions, on university campuses

    **Source: http://www.tobaccofreekids.org/what_we_do/state_local/tobacco_settlement/massachusetts

    In Fiscal Year 2012, Massachusetts received $832 million from Master Settlement Agreement funds and tobacco tax revenues. Unfortunately, tobacco prevention & cessation programs were only appropriated $4.2 million. This is 0.5% of all the tobacco revenue the state receives.

    *Source: Mass Budget & Policy Center; http://www.massbudget.org/

    Since the first rounds of 9C cuts in 2008 to today, two-thirds of the MA Tobacco Cessation & Prevention Programs budget has been eliminated.

    That is funding that supports: The 84, targeted patch giveaways to address disparate groups, TA to municipalities trying to update regulations, funding for local boards of health to do education and compliance checks, promotion of the MassHealth cessation benefit, and more.

    *Source: Mass Department of Revenue

    Tax policy is also an important tool in reducing tobacco use. For every 10% increase in price, 7% of youth and 4% of adults will quit smoking.

    The top graph shows the number of packs of cigarettes declining by 59% in MA (from 547M in FY92 to 222M in


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