impacts of tobacco use and what we can do about it

Impacts of Tobacco Use and What We Can Do About it

Philip Huang, MD, MPHMedical Director/Health AuthorityAustin/Travis County Health Dept.August 19,2010

Summary:Burden and Impacts of Tobacco UseWhat we are doing about it - ARRA Communities Putting Prevention to Work (CPPW) Policy ChangeCessation resourcesHow can we work together?

Data Source: Texas Department of State Health Services, Center for Health Statisticshttp://soupfin.tdh.state.tx.us/death10.htmLeading Causes of Death, Travis County, 2007

Lung Cancer Mort 99-06

6067.957.654.45861.557.946.713.111.113.211.312.110.211.79.81210.212.210.411.59.810.18.6

3838.741.739.334.433.636.537.28.37.18.37.18.57.28.277.76.57.56.47.76.57.66.5

50.152.65249.945.547.647.745.38.27.38.17.487.27.97.17.56.77.66.87.66.87.26.5

53.980.858.856.273.869.568.24827.919.833.425.228.120.127.619.731.123.129.621.729.221.526.218.2

024.6025.3022.224.722.70017.710.70018.111.40015.49.714.69.814.29.4

4651.24845.343.844.945.741.46.76.176.36.666.45.86.35.66.35.66.35.75.95.3

1999

2000

2001

2002

2003

2004

2005

2006

Rate per 100,000

Lung CA Mort 00-04

67.957.654.45861.513.211.312.110.211.79.81210.212.210.4

38.741.739.334.433.68.37.18.57.28.277.76.57.56.4

52.65249.945.547.68.17.487.27.97.17.56.77.66.8

80.858.856.273.869.533.425.228.120.127.619.731.123.129.621.7

24.6025.3022.217.710.70018.111.40015.49.7

51.24845.343.844.976.36.666.45.86.35.66.35.6

2000

2001

2002

2003

2004

Age Adjusted Rate per 100,000

Lung and Bronchus Cancer1 Age Adjusted Mortality Rate Travis County, 2000-2004

Lung CA Mortality

Age Adjusted Mortality Rate for Travis County

Year19992000200120022003200420052006

Males6067.957.654.45861.557.946.7

Females3838.741.739.334.433.636.537.2

White Non-Hispanic50.152.65249.945.547.647.745.3

Black Non-Hispanic53.980.858.856.273.869.568.248

Hispanic*024.6025.3022.224.722.7

Total4651.24845.343.844.945.741.4

Lower 95% CL

Year19992000200120022003200420052006

Males48.956.647.444.647.851.148.138.1

Females30.931.634.532.327.927.23030.7

White Non-Hispanic42.845.244.842.838.840.840.938.8

Black34.155.638.736.550.747.846.729.8

Hispanic013.9013.9012.514.913.3

Total39.944.94239.538.239.34036.1

Upper 95% CL

Year19992000200120022003200420052006

Males73.181.169.766.17073.769.456.8

Females46.34750.247.542.141.144.244.8

White Non-Hispanic58.360.76057.85355.255.352.5

Black81.8114.286.983.8104.999.197.474.2

Hispanic042.3043.4037.639.336.9

Total52.758.254.651.750.151.25247.3

Minus

Year19992000200120022003200420052006

Males11.111.310.29.810.210.49.88.6

Females7.17.17.276.56.46.56.5


Black19.825.220.119.723.121.721.518.2

Hispanic010.7011.409.79.89.4

Total6.16.365.85.65.65.75.3

Plus

Year19992000200120022003200420052006

Males13.113.212.111.71212.211.510.1

Females8.38.38.58.27.77.57.77.6


Black27.933.428.127.631.129.629.226.2

Hispanic017.7018.1015.414.614.2

Total6.776.66.46.36.36.35.9

cvd mort

288.6266243.7245.4227.1221.2206.5201.428.126.226.324.524.823.124.923.123.62223.121.421.620.121.219.6

200.2186.8180.3154159.5141.2136.6136.818.11716.915.816.515.415.214.215.414.414.513.513.91313.912.9

226.1215.5202.2192.3190.7174.2168.316016.516.115.515.214.814.720.914.320.714.214.313.413.91313.412.5

390.6320.8308.6272.5276.9210.2269.9227.469.561.461.553.758.15155.948.555.448.347.940.95346.448.441.8

221.3196.1196.6146.9141.9166.4112.4160.746.640.344.738.244.838.336.7313630.338.332.829.924.93630.8

238.9221207.7191.8188.9173.9166.5163.414.914.713.813.713.31312.712.512.512.411.911.711.511.211.211

1999

2000

2001

2002

2003

2004

2005

2006

Rate per 100,000

cvd re

ICD-10 Death Statistics for Travis County

Diseases of the Heart (I00-I09I11I13I20-I51)

Year

Race1999200020012002200320042005200620071999&2000&2001&2002&2003&2004&2005&2006

NumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence Interval

Male489288.6262.4316.7482266241.5292.3462243.7220.6268.5471245.4222.3270.3448227.1205.1250.7450221.2199.8244.3445206.5186.4228.1444201.4181.8222.6200.2

Female519200.2183.2218.3519186.8171203.7510180.3164.9196.8439154139.8169.2458159.5145.1174.9408141.2127.7155.7416136.6123.6150.5423136.8123.9150.7434136.1

White Non-Hispanic733226.1210242.6750215.5200.3231718202.2187.5217685192.3178213.2685190.7176.5211.4634174.2160.8188.5632168.3155.3182.2619160147.5173.45456190.4185.3195.5

Black Non Hispanic149390.6329.2460.1130320.8267.1382.3137308.6257.6366.7119272.5224328.4123276.9228.6332.399210.2169.3258.1131269.9223.5322.9113227.4185.6275.81001282264.3300.1

Hispanic118221.3181267.9107196.1157.9240.8107196.6158.3241.494146.9115.9183.691141.9111.6177.9111166.4133.6204.791112.487.5142.3116160.7129.9196.7835164.9152.9177.2

Total1008238.9224.2253.81001221207.3234.8972207.7194.7221910191.8179.3204.5906188.9176.5201.4858173.9162.2185.8861166.5155.3178867163.4152.4174.67383192.7188.3197.2

Other8...14...10...12...7...14...7...19...9191.571.2115.7

Minus

Year19992000200120022003200420052006

Males26.224.523.123.12221.420.119.6

Females1715.815.414.214.413.51312.9


Black Non Hispanic61.453.75148.548.340.946.441.8

Hispanic40.338.238.33130.332.824.930.8

Total14.713.71312.512.411.711.211

Plus

Year19992000200120022003200420052006

Males28.126.324.824.923.623.121.621.2

Females18.116.916.515.215.414.513.913.9



Hispanic46.644.744.836.73638.329.936

Total14.913.813.312.712.511.911.511.2

cvd mort by sex 1999-2006



Year

Sex199920002001200220032004200520061999&2000&2001&2002&2003&2004&2005&2006

NumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence Interval

Male489288.6262.4316.7482266241.5292.3462243.7220.6268.5471245.4222.3270.3448227.1205.1250.7450221.2199.8244.3445206.5186.4228.1444201.4181.8222.63691235.7227.7243.8

Female519200.2183.2218.3519186.8171203.7510180.3164.9196.8439154139.8169.2458159.5145.1174.9408141.2127.7155.7416136.6123.6150.5423136.8123.9150.73692161155.8166.2

Both Sexes1008238.9224.2253.81001221207.3234.8972207.7194.7221910191.8179.3204.5906188.9176.6201.4858173.9162.3185.8861166.5155.3178867163.4152.4174.67383192.7188.3197.2

leading causes Travis

1001

917

332

242

239

212

133

111

100

Number

Sheet1


Year

2006

Cause of DeathNumber

Malignant Neoplasms1001

Diseases of the Heart917

Accidents (Injuries)332

Cerebrovascular Diseases (Stroke)242

Organic Dementia239

Chronic Lower Respiratory Diseases212

Alzheimer's Disease133

Intentional Self-Harm (Suicide)111

Diabetes Mellitus100

Kidney Diseases95

Nephritis, Nephrotic Syndrome and Nephrosis (N00-N07, N17-N19, N25-N27)69

Parkinson's Disease (G20-G21)57

Septicemia (A40-A41)55

Pneumonitis Due to Solids and liquids (J69)51

Certain Conditions Originating in the Perinatal Period (P00-P96)43

Human Immunodeficiency Virus (HIV) Disease (B20-B24)40

Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99)32

Essential (Primary) Hypertension and Hypertensive Renal Disease (I10, I12)30

Atherosclerosis (I70)30

Assault (Homicide) (X85-Y09, Y87.1)27

In Situ Neoplasms, Benign Neoplasms and Neoplasms of Uncertain or Unknown Behavior (D00-D48)19

Aortic Aneurysm and Dissection (I71)18

Viral Hepatitis (B15-B19)14

Anemias (D50-D64)8

Nutritional Deficiencies (E40-E64)5

Cholelithiasis and Other Disorders of Gallbladder (K80-K82)5

Peptic Ulcer (K25-K28)3

Meningitis (G00, G03)2

Pneumoconioses and Chemical Effects (J60-J66, J68)2

Diseases of Appendix (K35-K38)2

Infections of Kidney (N10-N12, N13.6, N15.1)2

Legal Intervention (Y35, Y89.0)2

Complications of Medical and Surgical Care (Y40-Y84, Y88)2

Tuberculosis (A16-A19)1

Hernia (K40-K46)1

Pregnancy, Childbirth and the Puerperium (O00-O99)1

Salmonella Infections (A01-A02)0

Shigellosis and Amebiasis (A03, A06)0

Whooping Cough (A37)0

Scarlet Fever and Erysipelas (A38, A46)0

Meningococcal Infection (A39)0

Syphilis (A50-A53)0

Acute Poliomyelitis (A80)0

Arthropod-Borne Viral Encephalitis (A83-A84, A85.2)0

Measles (B05)0

Malaria (B50-B54)0

Acute Bronchitis and Bronchiolitis (J20-J21)0

Hyperplasia of Prostate (N40)0

Inflammatory Diseases of Female Pelvic Organs (N70-N76)0

Operations of War and their Sequelae (Y36, Y89.1)0

Total for Selection4,339

All Causes4,339

dm mort

29.324.630.42526.425.227.922.39.27.58.46.89.27.58.46.88.26.78.16.58.56.97.46

23.817.323.122.52322.819.920.66.85.65.74.66.45.36.206.45.36.35.15.84.75.94.8

1811.418.716.21715.516.516.75.24.34.13.354.24.76.84.944.63.84.73.94.73.9

045.753.950.759.644.6000024.817.82719.728.55.229.121.42517.80000

7059.140.945.95250.354.829.727.421.224.818.92014.720.83.922.617.220.115.421.816.814.910.9

26.520.425.723.524.923.622.9215.34.64.63.954.34.820.24.94.34.744.644.33.7

1999

2000

2001

2002

2003

2004

2005

2006

Rate per 100,000

dm mort by re 1999-2006


Diabetes Mellitus (E10-E14)

Year

Race199920002001200220032004200520061999&2000&2001&2002&2003&2004&2005&2006


Male5829.321.838.55024.617.8336330.422.939.6542518.233.46126.419.734.65925.218.733.36327.92136.45422.316.329.7

Female6123.818.230.64817.312.7236723.117.829.56522.517.328.7652317.729.46822.817.729.16219.915.225.76420.615.826.5

White Non-Hispanic611813.723.24111.48.115.56918.714.523.76016.212.320.962171321.96015.511.720.16416.512.621.26516.712.821.448216.314.817.8

Black Non-Hispanic18...2145.727.970.52453.934.280.92150.730.579.22659.638.288.72144.626.869.614...19...16445.238.453

Hispanic407048.897.43659.140.283.93140.926.260.93545.930.266.7375234.874.64350.334.970.44454.83876.63029.718.844.629649.343.356

Total11926.521.931.89820.416.52513025.721.430.711923.519.428.312624.920.629.812723.619.628.312522.918.927.51182117.325.396223.52225

Minus

Year19992000200120022003200420052006

Males7.56.87.56.86.76.56.96

Females5.64.65.305.35.14.74.8


Black017.819.75.221.417.800

Hispanic21.218.914.73.917.215.416.810.9

Total4.63.94.320.24.3443.7

Plus

Year19992000200120022003200420052006

Males9.28.49.28.48.28.18.57.4

Females6.85.76.46.26.46.35.85.9


Black024.82728.529.12500

Hispanic27.424.82020.822.620.121.814.9

Total5.34.654.84.94.74.64.3

Other0...0...6...3...1...3...3...4...20179.528.1

dm mort by sex 1999-2006



Year

Sex199920002001200220032004200520061999&2000&2001&2002&2003&2004&2005&2006


Male5829.321.838.55024.617.8336330.422.939.6542518.233.46126.419.734.65925.218.733.36327.92136.45422.316.329.746226.223.728.9

Female6123.818.230.64817.312.7236723.117.829.56522.517.328.7652317.729.46822.817.729.16219.915.225.76420.615.826.550021.619.723.6

Both Sexes11926.521.931.89820.416.52513025.721.430.711923.519.428.312624.920.629.812723.619.628.312522.918.927.51182117.325.396223.52225

Diabetes Prev Est 02-08

7.173.7

7.58.16.4

7.27.76

7.87.97.3

8.188.1

8.610.36.4

8.89.76.9

US

Texas

Travis County

Year

% Respondents


7.27.75.3

7.87.97

8.187

8.610.36

8.89.76.4

US

Texas

Travis County

Year

% Respondents

Austin MSA Diabetes Prev 2008

6.82.11.7

6.13.32.2

7.72.92.2

5.71.81.5

8.86.94

5.95.12.8

83.32.5

15.15.64.2

Weighted Percent %

Overwt Obese Prev Est 02-08

58.862.855.7

59.461.556.5

60.262.955.8

6364.152.8

61.562.359.6

62.865.749.6

6366.254.1

US

Texas

Travis County

Year

Weighted Percent %

Travis Co Ovwt SMART 04-08

55.8

52.8

59.6

49.6

54.1

Weighted Percent %

Travis Obesity 2008

51.46.36.3

55.59.69.5

467.27.3

51.37.17.1

Black Non-Hispanic

59.813.813.8

57.310.110.1

53.28.48.4

56.410.510.5

Weighted Percent %

Overwt Obese Prev Est

Overweight or Obesity

Year19951996199719981999200020012002200320042005200620072008

US58.859.460.26361.562.863

Texas62.861.562.964.162.365.766.2

Travis County55.756.555.852.859.649.654.1

Austin MSA60.156.458.455.160.558.460.1

Overweight Prevalence Estimate Travis 2008

%Lower CLUpper CLMinusPlus

Travis51.445.157.76.36.3

Males55.54665.19.59.6

Females4638.753.27.37.2

White Non-Hispanic51.344.258.47.17.1

Black Non-Hispanic

Hispanic59.84673.613.813.8

30-4457.347.267.410.110.1

45-6453.244.861.68.48.4

65+56.445.966.910.510.5

PA prev est 02-08

25.329.321.1

24.627.617.4

2426.120.6

25.527.423.9

24.228.422.6

24.228.317.9

25.528.521.4

US

Texas

Travis County

Weighted Percent %

PA Travis Pt 1

21.45.35.2

2288

20.75.85.7

14.14.54.5

34.413.213.2

21.39.39.3

21.17.47.4

26.98.78.8

Weighted Percent %

LT PA Travis 08

21.45.35.2

2288

20.75.85.7

14.14.54.5

34.413.213.2

21.39.39.3

21.17.47.4

26.98.78.8

Weighted Percent %

LT PA Travis 08 pt 2

21.45.35.2

30.916.516.6

2611.311.4

9.45.34.7

33.816.816.8

36.213.713.6

104.74.8

Weighted Percent %

nutrition travis 08

72.144.1

75.96.26.2

67.64.94.9

66.455

Black Non-Hispanic

77.89.29.2

70.812.612.6

77.86.16

65.16.66.6

68.67.98

Weighted Percent %

lt pa prev est

Lack of Physical Activity

Year19951996199719981999200020012002200320042005200620072008

Texas29.327.626.127.428.428.328.5

US25.324.62425.524.224.225.5

Travis County19.318.315.521.117.420.623.922.617.921.4

Lack of PA Travis 2008Poor Nutrition Travis 2007

%Lower CLUpper CLMinusPlus%Lower CLUpper CLMinusPlus

Travis21.416.226.75.25.3Travis72.16876.14.14

Males22143088Males75.969.782.16.26.2

Females20.71526.55.75.8Females67.662.772.54.94.9

White Non-Hispanic14.19.618.64.54.5White Non-Hispanic66.461.471.455

Hispanic34.421.247.613.213.2Black Non-Hispanic

30-4421.31230.69.39.3Hispanic77.868.6879.29.2

45-6421.113.728.57.47.418-2970.858.283.412.612.6

65+26.918.135.68.88.730-4477.871.883.966.1

45-6465.158.571.76.66.6

HS Grad30.914.347.416.616.565+68.660.676.587.9

Some College2614.637.311.411.3

College9.44.714.74.75.3

< $25K33.81750.616.816.8

$25K to $49,99936.222.649.913.613.7

$50K +105.214.74.84.7

No HS55.635.475.820.220.2

Travis Diabetes 2008

6.92.22.3

5.52.82.8

8.73.53.5

6.42.32.4

7.85.45.4

5.74.14

9.34.14.1

15.414.56.5

Weighted Percent %

Diabetes Prev Est

Diabetes Prevalence Estimate

Year19951996199719981999200020012002200320042005200620072008

US4.74.85.25.25.96.46.87.17.57.27.88.18.68.8

Texas5.23.75.95.56.26.27.178.17.77.9810.39.7

5.37766.4

Travis County7.87.34.73.24.43.76.467.38.16.46.9

Austin MSA

Data in red was calculated by A/TCHHSD in 8/20082004-2008 Travis Co Prevalence Estimates from CDC SMART BRFSS

Diabetes Prevalence Estimate Austin MSA 2008


Austin MSA6.85.18.91.72.1

Males6.13.99.42.23.3

Females7.75.510.62.22.9


Hispanic8.84.815.746.9

30-445.93.1112.85.1

45-6485.511.32.53.3

65+15.110.920.74.25.6

Diabetes Prevalence Estimate Travis 2008


Travis6.94.69.12.32.2

Males5.52.78.32.82.8

Females8.75.212.23.53.5

White Non-Hispanic6.448.72.42.3

Hispanic7.82.413.25.45.4

30-445.71.79.844.1

45-649.35.213.44.14.1

65+15.48.929.96.514.5

Adult Cig Smoking 2008

19.654.2

257.86.5

12.44.93.7

18.45.84.6

Black Non-Hispanic

2612.39.4

39.416.914.6

20.27.45.8

11.74.63.4

5.94.32.6

Weighted Percent %

Travis Co Smoking 97-08

24.6

21.4

15

24.3

18.1

17.1

Prev Est %

Year

Travis County Adult Current Smoking Rates


19.1

18.5

19.6

19.1

18.5

Prev Est %

Austin MSA Smoking Rates

18.6

21

18.7

18.5

18.9

17.2

19.6

Prev Est %

Weighted Percent %

Austin MSA Current Smoking Rates

YRBS Smoking

31.826.32324.13.234.33.932.73.43.2

24.92219.118.22.52.33.22.83.93.43.22.8

30.628.926.523.93.234.64.24.13.73.33

13.614.210.811.93.93.24.43.53.72.84.13.1

30.823.119.322.54.54.14.33.83.93.33.93.4

28.424.221.121.22.52.33.12.83.12.82.52.3

2001

2005

2007

2009

Weighted Percent %

Percent of Students Who Smoked One or More Cigarettes in the Past 30 Days

Smoking Travis 2008

19.465.9

24.99.59.4

125.55.4

19.17.27.2

Black Non-Hispanic

23.413.613.5

19.18.38.2

11.54.94.9

3.32.82.9

Weighted Percent %

Travis Smoking Rates 02-08

17.1

20.7

18.7

19.7

18.7

18.7

19.4

Weighted Percent %

Smoking Prev

Current Smoking Prevalence Estimate Austin MSA 2008Current Smoking Prevalence Estimate Travis 2008


Austin MSA19.615.424.64.25Travis19.413.525.45.96

Males2518.532.86.57.8Males24.915.534.49.49.5

Females12.48.717.33.74.9Females126.617.55.45.5

White Non-Hispanic18.413.824.24.65.8White Non-Hispanic19.111.926.37.27.2

Black Non-HispanicBlack Non-Hispanic

Hispanic2616.638.39.412.3Hispanic23.49.93713.513.6

18-2939.424.856.314.616.930-4419.110.927.48.28.3

30-4420.214.427.65.87.445-6411.56.616.44.94.9

45-6411.78.316.33.44.665+3.30.46.12.92.8

65+5.93.310.22.64.3

Travis County Current Smoker

Year199719981999200020012002200320042005200620072008

Prev Est %19.118.519.619.118.5

24.621.41524.318.117.120.718.719.718.718.719.4

2004-2008 Travis Co Prevalence Estimates from CDC SMART BRFSS

Data in red was calculated by A/TCHHSD in 8/2008

Data in blue was calculated by A/TCHHSD in 4/2010

Austin MSA Current Smoker

Year2002200320042005200620072008

Prev Est %18.62118.718.518.917.219.6

Cigarette Smoking Among Youtt - % Students Smoked in Past 30 Days

2001200520072009

Males31.826.32324.1

Females24.92219.118.2


Black Non-Hispanic13.614.210.811.9

Hispanic30.823.119.322.5

Texas28.424.221.121.2


LOWER2001200520072009

Males28.822.420.320.9

Females22.619.215.715.4


Black Non-Hispanic10.410.788.8

Hispanic26.719.31619.1

Texas26.121.418.318.9


UPPER2001200520072009

Males3530.62627.5

Females27.425.22321.4


Black17.518.614.516

Hispanic35.327.423.226.4

Texas30.927.324.223.7


MINUS2001200520072009

Males33.92.73.2

Females2.32.83.42.8

White Non-Hispanic34.23.73


Hispanic4.13.83.33.4

Texas2.32.82.82.3


PLUS2001200520072009

Males3.24.333.4

Females2.53.23.93.2




Texas2.53.13.12.5

Youth Nutrition

19.919.417.421.31.41.21.91.81.51.31.71.6

22.42120.223.71.41.32.11.92.122.62.4

17.317.614.618.82.32.22.52.21.71.51.71.6

17.917.21518.82.42.13.22.82.11.92.42.2

20.618.618.222.51.81.72.42.22.72.432.7

2426.119.523.62.82.53.83.54.23.66.95.8

2001

2005

2007

2009

Weighted Percent %

Percent Ate Fruits and Vegetables 5 or More Times per Day During the Past 7 Days

YRBS fruitveg

TexasMalesFemalesWhite Non-HispanicHispanicBlack Non-Hispanic

200119.922.417.317.920.624

200519.42117.617.218.626.1

200717.420.214.61518.219.5

200921.323.718.818.822.523.6

Ate 5+ fruits and vegetables during the past 7 days

2001200520072009

Texas19.919.417.421.3

Males22.42120.223.7

Females17.317.614.618.8

White Non-Hispanic17.917.21518.8

Hispanic20.618.618.222.5


LOWER2001200520072009

Texas18.717.616.119.7

Males21.119.118.221.3

Females15.115.413.117.2


Hispanic18.916.415.819.8


UPPER2001200520072009

Texas21.321.318.923

Males23.823.122.326.3

Females19.620.116.320.5


Hispanic22.42120.925.5


Minus2001200520072009

Texas1.21.81.31.6

Males1.31.922.4

Females2.22.21.51.6




Plus2001200520072009

Texas1.41.91.51.7

Males1.42.12.12.6

Females2.32.51.71.7


Hispanic1.82.42.73


YRBS Overwt

19.416.419.915.93.12.82.92.52.92.62.32.1

8.611.211.611.12.61.91.51.42.52.12.82.4

10.910.213.8101.81.62.422.62.32.31.8

17.31814.616.73.42.86.44.94.33.43.42.9

17.616.919.216.54.53.82.50.33.12.82.92.5

14.213.915.913.62.121.71.62.21.91.91.7

2001

2005

2007

2009

Weighted Percent %

YRBS Overweight

Overweight Among Youth - % Students Obese - see YRBS query site

2001200520072009

Males19.416.419.915.9

Females8.611.211.611.1



Hispanic17.616.919.216.5

Texas14.213.915.913.6


LOWER2001200520072009

Males16.613.917.313.8

Females6.79.89.58.7



Hispanic13.816.616.414

Texas12.212.31411.9


UPPER2001200520072009

Males22.519.322.818.2

Females11.212.714.113.9



Hispanic22.119.422.319.4

Texas16.315.618.115.5


MINUS2001200520072009

Males2.82.52.62.1

Females1.91.42.12.4




Texas21.61.91.7


PLUS2001200520072009

Males3.12.92.92.3

Females2.61.52.52.8




Texas2.11.72.21.9

Travis Co BRFSS Trend data

Source: BRFSS Datasets (Travis and MSA), created in 8/200819971998199920002001200220032004200520062007

Percent prevalence of Adults:LowerUpperLowerUpperLowerUpperLowerUpperLowerUpperLowerUpperLowerUpperLowerUpperLowerUpperLowerUpperLowerUpper

Obese18.410.426.319.113.524.72012.527.513.88.319.315.71120.416.410.7221914.523.521.116.32612.98.517.323.216.130.318.414.921.9

Current smoker24.61534.121.414.428.4159.820.324.317.730.918.112.423.917.112.22220.716.325.418.71423.519.713.226.218.712.824.518.714.722.8

Have Dr. dx Diabetes7.81.314.37.33.611.14.71.57.93.215.44.41.87.13.71.466.43.89638.97.34.310.28.14.112.16.44.68.1

MinusPlusMinusPlusMinusPlusMinusPlusMinusPlusMinusPlusMinusPlusMinusPlusMinusPlusMinusPlusMinusPlus

Obese87.95.65.67.57.55.55.54.74.75.75.64.54.54.84.94.44.47.17.13.53.5

Current smoker9.69.5775.25.36.66.65.75.84.94.94.44.74.74.86.56.55.95.844.1

Have Dr. dx Diabetes6.56.53.73.83.23.22.22.22.62.72.32.32.62.632.932.9441.81.7

1 ICD 9 Codes: I00-I09, I11, I13, I20-I51Data Source: Texas Department of State Health Services, Center for Health Statistics http://soupfin.tdh.state.tx.us/death10.htmDiseases of the Heart1 Age Adjusted Mortality Rate Travis County 1999-2006

Cancer Death Rates*, for Men, US, 1930-1999*Age-adjusted to the 2000 US standard population.Source: US Mortality Public Use Data Tapes 1960-1999, US Mortality Volumes 1930-1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.LungColon and rectumProstatePancreasStomachLiverRate Per 100,000Leukemia

Cancer Death Rates*, for Women, US, 1930-1999*Age-adjusted to the 2000 US standard population.Source: US Mortality Public Use Data Tapes 1960-1999, US Mortality Volumes 1930-1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.LungColon and rectumUterusStomachBreastOvaryPancreasRate Per 100,000

1 ICD 9 Codes: C34* The number of deaths due to Lung and Bronchus Cancer for Hispanics is too small for rate calculation in 2001 and 2003.Data Source: Texas Department of State Health Services, Texas Cancer Registry, http://www.cancer-rates.info/tx/Lung and Bronchus Cancer1 Age Adjusted Mortality Rate Travis County 1999-2006

Data Source: Texas Department of State Health Services, Center for Health Statisticshttp://soupfin.tdh.state.tx.us/death10.htmLeading Causes of Death, Travis County, 2007

Lung Cancer Mort 99-06

6067.957.654.45861.557.946.713.111.113.211.312.110.211.79.81210.212.210.411.59.810.18.6

3838.741.739.334.433.636.537.28.37.18.37.18.57.28.277.76.57.56.47.76.57.66.5

50.152.65249.945.547.647.745.38.27.38.17.487.27.97.17.56.77.66.87.66.87.26.5

53.980.858.856.273.869.568.24827.919.833.425.228.120.127.619.731.123.129.621.729.221.526.218.2

024.6025.3022.224.722.70017.710.70018.111.40015.49.714.69.814.29.4

4651.24845.343.844.945.741.46.76.176.36.666.45.86.35.66.35.66.35.75.95.3

1999

2000

2001

2002

2003

2004

2005

2006

Rate per 100,000

Lung CA Mort 00-04

67.957.654.45861.513.211.312.110.211.79.81210.212.210.4

38.741.739.334.433.68.37.18.57.28.277.76.57.56.4

52.65249.945.547.68.17.487.27.97.17.56.77.66.8

80.858.856.273.869.533.425.228.120.127.619.731.123.129.621.7

24.6025.3022.217.710.70018.111.40015.49.7

51.24845.343.844.976.36.666.45.86.35.66.35.6

2000

2001

2002

2003

2004

Age Adjusted Rate per 100,000

Lung and Bronchus Cancer1 Age Adjusted Mortality Rate Travis County, 2000-2004

Lung CA Mortality

Age Adjusted Mortality Rate for Travis County

Year19992000200120022003200420052006

Males6067.957.654.45861.557.946.7

Females3838.741.739.334.433.636.537.2


Black Non-Hispanic53.980.858.856.273.869.568.248

Hispanic*024.6025.3022.224.722.7

Total4651.24845.343.844.945.741.4

Lower 95% CL

Year19992000200120022003200420052006

Males48.956.647.444.647.851.148.138.1

Females30.931.634.532.327.927.23030.7


Black34.155.638.736.550.747.846.729.8

Hispanic013.9013.9012.514.913.3

Total39.944.94239.538.239.34036.1

Upper 95% CL

Year19992000200120022003200420052006

Males73.181.169.766.17073.769.456.8

Females46.34750.247.542.141.144.244.8

White Non-Hispanic58.360.76057.85355.255.352.5

Black81.8114.286.983.8104.999.197.474.2

Hispanic042.3043.4037.639.336.9

Total52.758.254.651.750.151.25247.3

Minus

Year19992000200120022003200420052006

Males11.111.310.29.810.210.49.88.6

Females7.17.17.276.56.46.56.5


Black19.825.220.119.723.121.721.518.2

Hispanic010.7011.409.79.89.4

Total6.16.365.85.65.65.75.3

Plus

Year19992000200120022003200420052006

Males13.113.212.111.71212.211.510.1

Females8.38.38.58.27.77.57.77.6


Black27.933.428.127.631.129.629.226.2

Hispanic017.7018.1015.414.614.2

Total6.776.66.46.36.36.35.9

cvd mort

288.6266243.7245.4227.1221.2206.5201.428.126.226.324.524.823.124.923.123.62223.121.421.620.121.219.6

200.2186.8180.3154159.5141.2136.6136.818.11716.915.816.515.415.214.215.414.414.513.513.91313.912.9

226.1215.5202.2192.3190.7174.2168.316016.516.115.515.214.814.720.914.320.714.214.313.413.91313.412.5

390.6320.8308.6272.5276.9210.2269.9227.469.561.461.553.758.15155.948.555.448.347.940.95346.448.441.8

221.3196.1196.6146.9141.9166.4112.4160.746.640.344.738.244.838.336.7313630.338.332.829.924.93630.8

238.9221207.7191.8188.9173.9166.5163.414.914.713.813.713.31312.712.512.512.411.911.711.511.211.211

1999

2000

2001

2002

2003

2004

2005

2006

Rate per 100,000

cvd re



Year

Race1999200020012002200320042005200620071999&2000&2001&2002&2003&2004&2005&2006

NumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence IntervalNumberRateConfidence Interval

Male489288.6262.4316.7482266241.5292.3462243.7220.6268.5471245.4222.3270.3448227.1205.1250.7450221.2199.8244.3445206.5186.4228.1444201.4181.8222.6200.2

Female519200.2183.2218.3519186.8171203.7510180.3164.9196.8439154139.8169.2458159.5145.1174.9408141.2127.7155.7416136.6123.6150.5423136.8123.9150.7434136.1

White Non-Hispanic733226.1210242.6750215.5200.3231718202.2187.5217685192.3178213.2685190.7176.5211.4634174.2160.8188.5632168.3155.3182.2619160147.5173.45456190.4185.3195.5

Black Non Hispanic149390.6329.2460.1130320.8267.1382.3137308.6257.6366.7119272.5224328.4123276.9228.6332.399210.2169.3258.1131269.9223.5322.9113227.4185.6275.81001282264.3300.1

Hispanic118221.3181267.9107196.1157.9240.8107196.6158.3241.494146.9115.9183.691141.9111.6177.9111166.4133.6204.791112.487.5142.3116160.7129.9196.7835164.9152.9177.2

Total1008238.9224.2253.81001221207.3234.8972207.7194.7221910191.8179.3204.5906188.9176.5201.4858173.9162.2185.8861166.5155.3178867163.4152.4174.67383192.7188.3197.2

Other8...14...10...12...7...14...7...19...9191.571.2115.7

Minus

Year19992000200120022003200420052006

Males26.224.523.123.12221.420.119.6

Females1715.815.414.214.413.51312.9



Hispanic40.338.238.33130.332.824.930.8

Total14.713.71312.512.411.711.211

Plus

Year19992000200120022003200420052006

Males28.126.324.824.923.623.121.621.2

Females18.116.916.515.215.414.513.913.9



Hispanic46.644.744.836.73638.329.936

Total14.913.813.312.712.511.911.511.2

cvd mort by sex 1999-2006



Year

Sex199920002001200220032004200520061999&2000&2001&2002&2003&2004&2005&2006


Male489288.6262.4316.7482266241.5292.3462243.7220.6268.5471245.4222.3270.3448227.1205.1250.7450221.2199.8244.3445206.5186.4228.1444201.4181.8222.63691235.7227.7243.8

Female519200.2183.2218.3519186.8171203.7510180.3164.9196.8439154139.8169.2458159.5145.1174.9408141.2127.7155.7416136.6123.6150.5423136.8123.9150.73692161155.8166.2

Both Sexes1008238.9224.2253.81001221207.3234.8972207.7194.7221910191.8179.3204.5906188.9176.6201.4858173.9162.3185.8861166.5155.3178867163.4152.4174.67383192.7188.3197.2

leading causes Travis

1001

917

332

242

239

212

133

111

100

Number

Sheet1


Year

2006

Cause of DeathNumber

Malignant Neoplasms1001

Diseases of the Heart917

Accidents (Injuries)332

Cerebrovascular Diseases (Stroke)242

Organic Dementia239

Chronic Lower Respiratory Diseases212

Alzheimer's Disease133

Intentional Self-Harm (Suicide)111

Diabetes Mellitus100

Kidney Diseases95

Nephritis, Nephrotic Syndrome and Nephrosis (N00-N07, N17-N19, N25-N27)69

Parkinson's Disease (G20-G21)57

Septicemia (A40-A41)55

Pneumonitis Due to Solids and liquids (J69)51

Certain Conditions Originating in the Perinatal Period (P00-P96)43

Human Immunodeficiency Virus (HIV) Disease (B20-B24)40

Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99)32

Essential (Primary) Hypertension and Hypertensive Renal Disease (I10, I12)30

Atherosclerosis (I70)30

Assault (Homicide) (X85-Y09, Y87.1)27

In Situ Neoplasms, Benign Neoplasms and Neoplasms of Uncertain or Unknown Behavior (D00-D48)19

Aortic Aneurysm and Dissection (I71)18

Viral Hepatitis (B15-B19)14

Anemias (D50-D64)8

Nutritional Deficiencies (E40-E64)5

Cholelithiasis and Other Disorders of Gallbladder (K80-K82)5

Peptic Ulcer (K25-K28)3

Meningitis (G00, G03)2

Pneumoconioses and Chemical Effects (J60-J66, J68)2

Diseases of Appendix (K35-K38)2

Infections of Kidney (N10-N12, N13.6, N15.1)2

Legal Intervention (Y35, Y89.0)2

Complications of Medical and Surgical Care (Y40-Y84, Y88)2

Tuberculosis (A16-A19)1

Hernia (K40-K46)1

Pregnancy, Childbirth and the Puerperium (O00-O99)1

Salmonella Infections (A01-A02)0

Shigellosis and Amebiasis (A03, A06)0

Whooping Cough (A37)0

Scarlet Fever and Erysipelas (A38, A46)0

Meningococcal Infection (A39)0

Syphilis (A50-A53)0

Acute Poliomyelitis (A80)0

Arthropod-Borne Viral Encephalitis (A83-A84, A85.2)0

Measles (B05)0

Malaria (B50-B54)0

Acute Bronchitis and Bronchiolitis (J20-J21)0

Hyperplasia of Prostate (N40)0

Inflammatory Diseases of Female Pelvic Organs (N70-N76)0

Operations of War and their Sequelae (Y36, Y89.1)0

Total for Selection4,339

All Causes4,339

dm mort

29.324.630.42526.425.227.922.39.27.58.46.89.27.58.46.88.26.78.16.58.56.97.46

23.817.323.122.52322.819.920.66.85.65.74.66.45.36.206.45.36.35.15.84.75.94.8

1811.418.716.21715.516.516.75.24.34.13.354.24.76.84.944.63.84.73.94.73.9

045.753.950.759.644.6000024.817.82719.728.55.229.121.42517.80000

7059.140.945.95250.354.829.727.421.224.818.92014.720.83.922.617.220.115.421.816.814.910.9

26.520.425.723.524.923.622.9215.34.64.63.954.34.820.24.94.34.744.644.33.7

1999

2000

2001

2002

2003

2004

2005

2006

Rate per 100,000

dm mort by re 1999-2006



Year

Race199920002001200220032004200520061999&2000&2001&2002&2003&2004&2005&2006


Male5829.321.838.55024.617.8336330.422.939.6542518.233.46126.419.734.65925.218.733.36327.92136.45422.316.329.7

Female6123.818.230.64817.312.7236723.117.829.56522.517.328.7652317.729.46822.817.729.16219.915.225.76420.615.826.5

White Non-Hispanic611813.723.24111.48.115.56918.714.523.76016.212.320.962171321.96015.511.720.16416.512.621.26516.712.821.448216.314.817.8

Black Non-Hispanic18...2145.727.970.52453.934.280.92150.730.579.22659.638.288.72144.626.869.614...19...16445.238.453

Hispanic407048.897.43659.140.283.93140.926.260.93545.930.266.7375234.874.64350.334.970.44454.83876.63029.718.844.629649.343.356

Total11926.521.931.89820.416.52513025.721.430.711923.519.428.312624.920.629.812723.619.628.312522.918.927.51182117.325.396223.52225

Minus

Year19992000200120022003200420052006

Males7.56.87.56.86.76.56.96

Females5.64.65.305.35.14.74.8


Black017.819.75.221.417.800

Hispanic21.218.914.73.917.215.416.810.9

Total4.63.94.320.24.3443.7

Plus

Year19992000200120022003200420052006

Males9.28.49.28.48.28.18.57.4

Females6.85.76.46.26.46.35.85.9


Black024.82728.529.12500

Hispanic27.424.82020.822.620.121.814.9

Total5.34.654.84.94.74.64.3

Other0...0...6...3...1...3...3...4...20179.528.1

dm mort by sex 1999-2006



Year

Sex199920002001200220032004200520061999&2000&2001&2002&2003&2004&2005&2006


Male5829.321.838.55024.617.8336330.422.939.6542518.233.46126.419.734.65925.218.733.36327.92136.45422.316.329.746226.223.728.9

Female6123.818.230.64817.312.7236723.117.829.56522.517.328.7652317.729.46822.817.729.16219.915.225.76420.615.826.550021.619.723.6

Both Sexes11926.521.931.89820.416.52513025.721.430.711923.519.428.312624.920.629.812723.619.628.312522.918.927.51182117.325.396223.52225


7.173.7

7.58.16.4

7.27.76

7.87.97.3

8.188.1

8.610.36.4

8.89.76.9

US

Texas

Travis County

Year

% Respondents


7.27.75.3

7.87.97

8.187

8.610.36

8.89.76.4

US

Texas

Travis County

Year

% Respondents

Austin MSA Diabetes Prev 2008

6.82.11.7

6.13.32.2

7.72.92.2

5.71.81.5

8.86.94

5.95.12.8

83.32.5

15.15.64.2

Weighted Percent %

Overwt Obese Prev Est 02-08

58.862.855.7

59.461.556.5

60.262.955.8

6364.152.8

61.562.359.6

62.865.749.6

6366.254.1

US

Texas

Travis County

Year

Weighted Percent %

Travis Co Ovwt SMART 04-08

55.8

52.8

59.6

49.6

54.1

Weighted Percent %

Travis Obesity 2008

51.46.36.3

55.59.69.5

467.27.3

51.37.17.1

Black Non-Hispanic

59.813.813.8

57.310.110.1

53.28.48.4

56.410.510.5

Weighted Percent %

Overwt Obese Prev Est

Overweight or Obesity

Year19951996199719981999200020012002200320042005200620072008

US58.859.460.26361.562.863

Texas62.861.562.964.162.365.766.2

Travis County55.756.555.852.859.649.654.1

Austin MSA60.156.458.455.160.558.460.1

Overweight Prevalence Estimate Travis 2008


Travis51.445.157.76.36.3

Males55.54665.19.59.6

Females4638.753.27.37.2


Black Non-Hispanic

Hispanic59.84673.613.813.8

30-4457.347.267.410.110.1

45-6453.244.861.68.48.4

65+56.445.966.910.510.5

PA prev est 02-08

25.329.321.1

24.627.617.4

2426.120.6

25.527.423.9

24.228.422.6

24.228.317.9

25.528.521.4

US

Texas

Travis County

Weighted Percent %

PA Travis Pt 1

21.45.35.2

2288

20.75.85.7

14.14.54.5

34.413.213.2

21.39.39.3

21.17.47.4

26.98.78.8

Weighted Percent %

LT PA Travis 08

21.45.35.2

2288

20.75.85.7

14.14.54.5

34.413.213.2

21.39.39.3

21.17.47.4

26.98.78.8

Weighted Percent %

LT PA Travis 08 pt 2

21.45.35.2

30.916.516.6

2611.311.4

9.45.34.7

33.816.816.8

36.213.713.6

104.74.8

Weighted Percent %

nutrition travis 08

72.144.1

75.96.26.2

67.64.94.9

66.455

Black Non-Hispanic

77.89.29.2

70.812.612.6

77.86.16

65.16.66.6

68.67.98

Weighted Percent %

lt pa prev est

Lack of Physical Activity

Year19951996199719981999200020012002200320042005200620072008

Texas29.327.626.127.428.428.328.5

US25.324.62425.524.224.225.5

Travis County19.318.315.521.117.420.623.922.617.921.4

Lack of PA Travis 2008Poor Nutrition Travis 2007


Travis21.416.226.75.25.3Travis72.16876.14.14

Males22143088Males75.969.782.16.26.2

Females20.71526.55.75.8Females67.662.772.54.94.9

White Non-Hispanic14.19.618.64.54.5White Non-Hispanic66.461.471.455

Hispanic34.421.247.613.213.2Black Non-Hispanic

30-4421.31230.69.39.3Hispanic77.868.6879.29.2

45-6421.113.728.57.47.418-2970.858.283.412.612.6

65+26.918.135.68.88.730-4477.871.883.966.1

45-6465.158.571.76.66.6

HS Grad30.914.347.416.616.565+68.660.676.587.9

Some College2614.637.311.411.3

College9.44.714.74.75.3

< $25K33.81750.616.816.8

$25K to $49,99936.222.649.913.613.7

$50K +105.214.74.84.7

No HS55.635.475.820.220.2

Travis Diabetes 2008

6.92.22.3

5.52.82.8

8.73.53.5

6.42.32.4

7.85.45.4

5.74.14

9.34.14.1

15.414.56.5

Weighted Percent %

Diabetes Prev Est

Diabetes Prevalence Estimate

Year19951996199719981999200020012002200320042005200620072008

US4.74.85.25.25.96.46.87.17.57.27.88.18.68.8

Texas5.23.75.95.56.26.27.178.17.77.9810.39.7

5.37766.4

Travis County7.87.34.73.24.43.76.467.38.16.46.9

Austin MSA

Data in red was calculated by A/TCHHSD in 8/20082004-2008 Travis Co Prevalence Estimates from CDC SMART BRFSS

Diabetes Prevalence Estimate Austin MSA 2008


Austin MSA6.85.18.91.72.1

Males6.13.99.42.23.3

Females7.75.510.62.22.9


Hispanic8.84.815.746.9

30-445.93.1112.85.1

45-6485.511.32.53.3

65+15.110.920.74.25.6

Diabetes Prevalence Estimate Travis 2008


Travis6.94.69.12.32.2

Males5.52.78.32.82.8

Females8.75.212.23.53.5


Hispanic7.82.413.25.45.4

30-445.71.79.844.1

45-649.35.213.44.14.1

65+15.48.929.96.514.5

Adult Cig Smoking 2008

19.654.2

257.86.5

12.44.93.7

18.45.84.6

Black Non-Hispanic

2612.39.4

39.416.914.6

20.27.45.8

11.74.63.4

5.94.32.6

Weighted Percent %


24.6

21.4

15

24.3

18.1

17.1

Prev Est %

Year

Travis County Adult Current Smoking Rates


19.1

18.5

19.6

19.1

18.5

Prev Est %

Austin MSA Smoking Rates

18.6

21

18.7

18.5

18.9

17.2

19.6

Prev Est %

Weighted Percent %

Austin MSA Current Smoking Rates

YRBS Smoking

31.826.32324.13.234.33.932.73.43.2

24.92219.118.22.52.33.22.83.93.43.22.8

30.628.926.523.93.234.64.24.13.73.33

13.614.210.811.93.93.24.43.53.72.84.13.1

30.823.119.322.54.54.14.33.83.93.33.93.4

28.424.221.121.22.52.33.12.83.12.82.52.3

2001

2005

2007

2009

Weighted Percent %

Percent of Students Who Smoked One or More Cigarettes in the Past 30 Days

Smoking Travis 2008

19.465.9

24.99.59.4

125.55.4

19.17.27.2

Black Non-Hispanic

23.413.613.5

19.18.38.2

11.54.94.9

3.32.82.9

Weighted Percent %

Travis Smoking Rates 02-08

17.1

20.7

18.7

19.7

18.7

18.7

19.4

Weighted Percent %

Smoking Prev

Current Smoking Prevalence Estimate Austin MSA 2008Current Smoking Prevalence Estimate Travis 2008


Austin MSA19.615.424.64.25Travis19.413.525.45.96

Males2518.532.86.57.8Males24.915.534.49.49.5

Females12.48.717.33.74.9Females126.617.55.45.5

White Non-Hispanic18.413.824.24.65.8White Non-Hispanic19.111.926.37.27.2

Black Non-HispanicBlack Non-Hispanic

Hispanic2616.638.39.412.3Hispanic23.49.93713.513.6

18-2939.424.856.314.616.930-4419.110.927.48.28.3

30-4420.214.427.65.87.445-6411.56.616.44.94.9

45-6411.78.316.33.44.665+3.30.46.12.92.8

65+5.93.310.22.64.3

Travis County Current Smoker

Year199719981999200020012002200320042005200620072008

Prev Est %19.118.519.619.118.5

24.621.41524.318.117.120.718.719.718.718.719.4

2004-2008 Travis Co Prevalence Estimates from CDC SMART BRFSS

Data in red was calculated by A/TCHHSD in 8/2008

Data in blue was calculated by A/TCHHSD in 4/2010

Austin MSA Current Smoker

Year2002200320042005200620072008

Prev Est %18.62118.718.518.917.219.6


2001200520072009

Males31.826.32324.1

Females24.92219.118.2



Hispanic30.823.119.322.5

Texas28.424.221.121.2


LOWER2001200520072009

Males28.822.420.320.9

Females22.619.215.715.4



Hispanic26.719.31619.1

Texas26.121.418.318.9


UPPER2001200520072009

Males3530.62627.5

Females27.425.22321.4


Black17.518.614.516

Hispanic35.327.423.226.4

Texas30.927.324.223.7


MINUS2001200520072009

Males33.92.73.2

Females2.32.83.42.8

White Non-Hispanic34.23.73



Texas2.32.82.82.3


PLUS2001200520072009

Males3.24.333.4

Females2.53.23.93.2




Texas2.53.13.12.5

Youth Nutrition

19.919.417.421.31.41.21.91.81.51.31.71.6

22.42120.223.71.41.32.11.92.122.62.4

17.317.614.618.82.32.22.52.21.71.51.71.6

17.917.21518.82.42.13.22.82.11.92.42.2

20.618.618.222.51.81.72.42.22.72.432.7

2426.119.523.62.82.53.83.54.23.66.95.8

2001

2005

2007

2009

Weighted Percent %

Percent Ate Fruits and Vegetables 5 or More Times per Day During the Past 7 Days

YRBS fruitveg

TexasMalesFemalesWhite Non-HispanicHispanicBlack Non-Hispanic

200119.922.417.317.920.624

200519.42117.617.218.626.1

200717.420.214.61518.219.5

200921.323.718.818.822.523.6

Ate 5+ fruits and vegetables during the past 7 days

2001200520072009

Texas19.919.417.421.3

Males22.42120.223.7

Females17.317.614.618.8


Hispanic20.618.618.222.5


LOWER2001200520072009

Texas18.717.616.119.7

Males21.119.118.221.3

Females15.115.413.117.2


Hispanic18.916.415.819.8


UPPER2001200520072009

Texas21.321.318.923

Males23.823.122.326.3

Females19.620.116.320.5


Hispanic22.42120.925.5


Minus2001200520072009

Texas1.21.81.31.6

Males1.31.922.4

Females2.22.21.51.6




Plus2001200520072009

Texas1.41.91.51.7

Males1.42.12.12.6

Females2.32.51.71.7


Hispanic1.82.42.73


YRBS Overwt

19.416.419.915.93.12.82.92.52.92.62.32.1

8.611.211.611.12.61.91.51.42.52.12.82.4

10.910.213.8101.81.62.422.62.32.31.8

17.31814.616.73.42.86.44.94.33.43.42.9

17.616.919.216.54.53.82.50.33.12.82.92.5

14.213.915.913.62.121.71.62.21.91.91.7

2001

2005

2007

2009

Weighted Percent %

YRBS Overweight


2001200520072009

Males19.416.419.915.9

Females8.611.211.611.1



Hispanic17.616.919.216.5

Texas14.213.915.913.6


LOWER2001200520072009

Males16.613.917.313.8

Females6.79.89.58.7



Hispanic13.816.616.414

Texas12.212.31411.9


UPPER2001200520072009

Males22.519.322.818.2

Females11.212.714.113.9



Hispanic22.119.422.319.4

Texas16.315.618.115.5


MINUS2001200520072009

Males2.82.52.62.1

Females1.91.42.12.4




Texas21.61.91.7


PLUS2001200520072009

Males3.12.92.92.3

Females2.61.52.52.8




Texas2.11.72.21.9

Travis Co BRFSS Trend data

Source: BRFSS Datasets (Travis and MSA), created in 8/200819971998199920002001200220032004200520062007

Percent prevalence of Adults:LowerUpperLowerUpperLowerUpperLowerUpperLowerUpperLowerUpperLowerUpperLowerUpperLowerUpperLowerUpperLowerUpper

Obese18.410.426.319.113.524.72012.527.513.88.319.315.71120.416.410.7221914.523.521.116.32612.98.517.323.216.130.318.414.921.9

Current smoker24.61534.121.414.428.4159.820.324.317.730.918.112.423.917.112.22220.716.325.418.71423.519.713.226.218.712.824.518.714.722.8

Have Dr. dx Diabetes7.81.314.37.33.611.14.71.57.93.215.44.41.87.13.71.466.43.89638.97.34.310.28.14.112.16.44.68.1

MinusPlusMinusPlusMinusPlusMinusPlusMinusPlusMinusPlusMinusPlusMinusPlusMinusPlusMinusPlusMinusPlus

Obese87.95.65.67.57.55.55.54.74.75.75.64.54.54.84.94.44.47.17.13.53.5

Current smoker9.69.5775.25.36.66.65.75.84.94.94.44.74.74.86.56.55.95.844.1

Have Dr. dx Diabetes6.56.53.73.83.23.22.22.22.62.72.32.32.62.632.932.9441.81.7

Smoking-Attributable DeathsTravis County, 2007Approximately 584 deaths caused by smoking among adults 35+ years in Travis County (over 11 each week)

Health Effects of Tobacco UseCigarette smoking remains the leading preventable cause of death in the United States, causing an estimated 438,000 deaths - or about 1 out of every 5 - each year. (In 2007 in Travis County approximately 584 smoking-related deaths-over 11 per week)Tobacco kills more than AIDS, heroin, cocaine, alcohol, car accidents, fire and murder combined.Lung cancer is the leading cause of cancer death among both men and women in the United States, with 85- 90 percent of lung cancer deaths attributed to smoking.Smoking also increases the risk of many other types of cancer, including cancers of the throat, mouth, pancreas, kidney, bladder, and cervix.People who smoke are up to six times more likely to suffer a heart attack than nonsmokers, and the risk increases with the number of cigarettes smoked. Smoking also causes most cases of chronic obstructive lung disease, which includes bronchitis and emphysema. In the United States, approximately 38,000 deaths each year are caused by exposure to secondhand smoke.

Tobacco Use in the US, 1900-2000*Age-adjusted to 2000 US standard population. Source: Death rates: US Mortality Public Use Tapes, 1960-2000, US Mortality Volumes, 1930-1959, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002. Cigarette consumption: US Department of Agriculture, 1900-2000.Per capita cigarette consumptionMale lung cancer death rateFemale lung cancer death rate

Second-Hand Smoke (SHS)Public Health IssueContains over 4,000 chemicals including 69 known carcinogens Group A Carcinogen (like asbestos and benzene)Health Effects: AdultsLung cancerCoronary heart disease Health Effects: ChildrenLower respiratory tract infections in children < 18 months old each yearMiddle ear infectionsAsthmaSIDS

Even Brief Exposure to SHS Poses Serious Health RisksEven brief exposure to SHS can:result in upper airway changes in healthy personslead to more frequent asthma attacks in asthmatic childrenJust 30 minutes of exposure to SHS can:increase risk of blot clotsslow the rate of blood flow through the coronary arteriesinjure blood vessels and interfere with their repair

Who Smokes By Education and IncomeCurrent Population Survey - Tobacco Use Supplement

Sheet1

Smoking Status by Demographic Characteristics 1965 and 1999.

Current Smokers% Decline

19651999

Race/Ethnicity

White41.923.544%

African-American45.224.745%

Other39.819.950%

Education (Years)

18, Elementary36.719.148%

911, Some HS[ 46.7 ]38.118%

12, HS Graduate28.639%

13, Some College44.024.445%

4, College Graduate39.813.267%

5+, Post-Graduate32.88.574%

Family Income (quintile)

Lowest33.830.99%

242.928.733%

346.125.046%

446.421.454%

Highest43.616.662%

Sheet2

Sheet3

HomelessAbout one-third to one-half of the 750,000 homeless individuals in the U.S. have chronic diseases, and more than half lack health insurance. Homeless individuals have a life expectancy of between ages 42 and 52, according to National Health Care for the Homeless Council. Among the homeless, the cigarette smoking rate is an alarming 70% or more; these rates are 3 times higher than national average. Two of the three leading causes of death among homeless persons, heart disease and cancer are tobacco related

Homeless (Cont.)Many of those working with homeless people do not regard smoking as a priority. As a result of their low income, they use tobacco in an even more hazardous way: hand-rolled cigarettes without filters; recycled tobacco from butts; group smoking, a cigarette passing from mouth to mouth. They also leave shorter butts by smoking the cigarette down as close to the filter or to the end as possible.Many homeless people who smoke want to quit.There is real opportunity for helping this population.Actions include: recognizing that smoking is a major cause of ill health among homeless people; offering a tobacco-free environment; making smoking cessation services more accessible to homeless smokers; and providing resources to those who want to quit.

Prevalence of Cigarette Smoking Among Youth1, Texas Public Schools 2001, 2005, 2007, 20091Youth is defined as a student in public schools ranging in age from 15-18 years old.Data Source: Texas Department of State Health Services, Center for Health Statisticshttp://www.dshs.state.tx.us/chs/yrbs/query/yrbss_form.shtm

Economic Data

Economic CostIn 1998/1999, Texas Smoking-Attributable Costs = $10.09 billionDirect Medical expenditures - $4.55 billionLost Productivity costs - $5.54 billionIn 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)

Potentially Preventable HospitalizationsTobacco-Related DiseasesTravis County, 2005-2008

Hospitalizations forAdult Residents of Travis CountyNumber of HospitalizationsAverage HospitalChargeTotal Hospital ChargesAverage $ Impact for all Adult ResidentsAngina (without procedures)228$16,104$3,671,690$5Congestive Heart Failure5,942$24,905$147,986,462$207Asthma1,951$17,931$34,983,318$49Chronic Obstructive Pulmonary Disease2,075$24,393$50,615,186$71TOTAL10,196$22,790$237,256,656$751

Economic Costs Due To SmokingTravis County, 2007584 deaths caused by smoking among adults 35+ years

Loss of future earnings and productivity of $165.4 million

2004 Direct Health Care Costs for Travis County- $243 million

Smokefree Laws:Employer Economic IssuesAbsenteeismIllness and discomfort among non-smokers to SHSHealth insurance and life insurance costs and claimsSmoke pollution (increased cleaning and maintenance costs)The US EPA estimates that smokefree restaurants can expect to save about $190 per 1,000 square feet each year in lower cleaning and maintenance costs.

*

Smokefree Laws:Employer Economic IssuesLiabilityWorkers CompensationEmployee filed claimsIncreased employer premiumsDisability DiscriminationFailing to provide a reasonable accommodation (e.g worker with asthma)Failure to Provide a Safe WorkplaceSecondhand smoke cases have been filed against the hospitality industry, and won or settled favorably*

Smokefree Laws:Employer Economic IssuesAccidents, property damage and fires (plus related insurance costs)Matches and cigarettes account for 12% and 9% of outdoor fires (According to CleanUp.org.au, "a cigarette butt can smolder for up to three hours causing a grass fire or even a bushfire)The National Fire Protection Association found that in 1998 smoking materials caused 8,700 fires in non-residential structures resulting in direct property damage of $60.5 million.According to a study by the Department of Epidemiology and Preventive Medicine at the University of California, "Smoking causes an estimated 30% of U.S. and 10% of global fire death burdens."Landlords and restaurants with smokefree premises have negotiated lower fire and property insurance premiums.*

Green and Tobacco-FreeAccording to the Smithsonian Institute, "it takes ten years for one cigarette butt to degrade."According to Eco Recycle, "50% of all litter in urban areas is tobacco-related products including butts, cellophane wrapping, foil inserts and packaging." According to Cigarette Litter Org, "4.5 trillion cigarette butts are littered worldwide every year."According to the Texas Department of Transportation: "130 million butts will be tossed out in Texas alone this year.San Francisco - spends over $6 million annually to clean cigarette litter

Texas Employer Costs of SmokingEstimated annual EXCESS absence and productivity cost per smoker $2,625 (not including health costs)Smoke breaks $2,261 26 minutes per day more than non-smokers (Source: Study by Halpern and Rentz) multiplied by the Texas average hourly wage $19.76 (Source: Bureau of Labor Statistics, May 2009)Absences $364 2.3 days of additional absences (Source: Study by Halpern and Rentz) multiplied by Texas average hourly wage of $19.76. (Source: Bureau of Labor Statistics, May 2009)

Comprehensive smoke-free workplacelaws reduce cigarette consumptionTobacco-free environments reduces smoking prevalence by 3.8% and helps ex-smokers by eliminating cues to smoke and (Study by Fichtenberg and Glantz).

Excerpts from Philip Morris internal documentstotal prohibition of smoking in the workplace strongly affects industry volume. Smokers facing these restrictions consume 11%-15% less than average and quit at a rate that is 85% higher than average...Milder workplace restrictions, such as smoking only in designated areas, have much less impact on quitting rates and very little effect on consumption.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.

Tobacco Industry ExpendituresIn 2006 the Tobacco Industry spent $12.49 billion on advertising and promotion in the U.S.Approximately $1.01 billion was spent in Texas in 2006 (over $2.76 million every single day)Approximately $41.75 million was spent in Travis County in 2006 ($114,400 every single day)

Corner Store by Anderson HS

Criteria for Evaluating Economic StudiesBased on objective data (i.e. sales tax)Includes data for a sufficient time period before and after the ordinanceAccounts for underlying economic trendsUses appropriate statistical methodsIn peer-reviewed literatureSource of funding*

Texas Economic StudiesMethodsQuarterly data obtained from the Texas Comptrollers OfficeTaxable restaurant, bar and mixed beverage salesTotal retail salesLinear regression model to assess the economic impact of clean indoor air ordinances*

Figure 1. Gross Restaurant, Bar and Mixed Beverage Revenues By Fiscal Quarter*El Paso, Texas, 1990-2002Smoking Ban in effect January 2, 2002 * First fiscal quarter of each year is January 1 March 31*

Figure 2. Restaurant, Bar and Mixed Beverage Revenues, Percent of Total Retail Revenues by Fiscal Quarter*El Paso, Texas, 1990-2002Smoking Ban in effect January 2, 2002* First fiscal quarter of each year is January 1 March 31*

Ordinance*

Chart1

20259831

19098960

20928261

23453284

21602698

21159417

22144866

25823695

22660609

23556912

21685760

24524268

23118278

25527446

24268475

26223478

25177997

26195127

25662782

28522164

26887498

28983121

27039141

31165875

28164563

Austin Total Bar Sales by Quarter

Austin Formatted Data

CITYSICYEARQTRTimeOrdinance5812 GROSS_SALES5812 OUTLET_COUNT5813 gross sales5813 outlet count5814 gross sales5814 outlet5816 gross sales5816 outlet5817 gross sales5817 outletEating PlacesRetail SALES TotalRetail OUTLET_COUNT TotalPct Eating place of retailDrinking PlacesPct Drinking Places of retailEating+DrinkingPct Eating+Drinking of retailQTR2QTR3QTR4

Austin58121995110122324965110263005931406543622482557457524346278838196194178378180299581779260.1076976309128442150.00712381852070225930.1148214494000

Austin58121995220130115304112760768821306647853492699173225448787203203205894239191809003880170.107343365127247350.00663406552186189740.1139774305100

Austin58121995330131791572117366423161357378925492725214425248814046212207857762196521567981430.1057684224140212410.00713470852218790030.1129031309010

Austin581219954401361467541284606929415076175415726678558260510256412122138509532315448451121010.0923583304136868350.00591109472275377880.098269425001

Austin58121996150135000789128665960841356998301562926112926450096576216214358494196705292094390.1089744418135943850.00691104182279528790.1158854837000

Austin58121996260140206616128766895331368084800523197521027049969136221222150962211223204296150.1051735593147743330.00699465432369252950.1121682137100

Austin58121996370138617133128865746061407985184583214682327149292041217220055997208868425693170.105356277145597900.00697079512346157870.1123270721010

Austin581219964801465367511410815786114598265456530945807278514080822202288906402505182535150860.0913668512179844060.00717888052468750460.0985457317001

Austin58121997190140326800125369932031307999788563197160327449534851210221833254204798049186160.1083180504149929910.00732086612368262450.1156389165000

Austin581219972100151455314125063729111269994941603454374227651247979205237247035224021376486460.1059037485163678520.00730637952536148870.113210128100

Austin581219973110147410891125362632931338669778623453518728050187102204232133180221653478187330.1047279664149330710.00673712462470662510.111465091010

Austin58121997412015847161913958204407136100846447334073182291534021912062459469922903274186150620.0847136633182890510.0062994572642360430.0910131204001

Austin581219981130157404543126279296041298264505593463603528552055358204244095936218994271283720.1114622472161941090.00739476382602900450.118857011000

Austin581219982140169014970124777181161318331454593370576525958025634205260746369243198253181790.10721556160495700.00659937722767959390.1138149372100

Austin581219983150168127485127979471191328066379573301860025156332419212257478504235571918782730.1092993195160134980.00679771092734920020.1160970304010

Austin581219984160172331709142311504938135102527526832845856256594127032272645902682951486079143090.0896464564217576900.00737177462863479580.0970182309001

Austin581219991170168053731127188838901298864466603301496224961858652223262927345235345253282130.111719842177483560.00754141242806757010.1192612543000

Austin581219992180183358311127286922401299168964643544965325162838885229281646849259382876883230.1085834395178612040.00688603822995080530.1154694777100

Austin5812199931901857484301280811617411910061584623860633925863805279233288160048271800950183070.1060187788181777580.00668789353063378060.1127066722010

Austin581219994200195327051141712652041130113575487539385238261669183862543016306753253444753138790.0927111717240095890.00737974393256402640.1000909155001

Austin5812200012101898592681287946572812310794103694283066826568693991239301383927285877984783670.1054239722202598310.00708688043216437580.1125108526000

Austin5812200022202025934561321818065912010918301744439911626671949903248318942475297234073085160.1073034702190989600.00642556213380414350.1137290323100

Austin5812200032301999404071370854106612112387195764572268628373365988245319029081302946102786590.105308858209282610.00690824573399573420.1122171036010

Austin581220004240211799203146610863382125125899028848822700272772518672603378737703652453453136650.0925059756234532840.0064212413613270540.0989272166001

Austin5812200112501979264121327882912911012773569785095559626873550921246322432929285547502184240.1129174399216026980.00756536053440356270.1204828004000

Austin5812200122602270279411347856348011112595937794904043126674408900255350477272309830749084590.1131189442211594170.0068293473716366890.1199482912100

Austin5812200132702243115581346905344711113091419784754854327070076842252341936943303020659284410.1128427824221448660.00730803843640818090.1201508207010

Austin581220014280233232662144911984203119138394929249441944278753857492643580603553385349750134690.1057676109258236950.0076280733838840500.1133956839001

Austin5812200212902107059141351963275511213027854805059532528172860805260334162044286586728986130.1166006693226606090.00790706853568226530.1245077378000

Austin5812200223002185937061387996729411113589618805192028830175165847271345679841296372438588850.116636973235569120.00794841523692367530.1245853882100

Austin5812200233102178294501392877966911212906091814962693129471908335265339364716289529288088790.1172125688216857600.00749000563610504760.1247025745010

Austin581220024320231955129154510415803124141084659650862163302773817072823601989993339925405145040.1078464203245242680.00734275923847232670.1151891795001

Austin5812200313301904568681407977325311713345025815275086329873925792273317133523271792477989510.1166822296231182780.00850585643402518010.125188086000

Austin58122003234020498200414341079823112014729215835313617330779057750293337175927296424736391300.1137475675255274460.00861177993627033730.1223593474100

Austin5812200333501937966741448964005812114628417845492185131379323156298328041681301597850492640.1087679108242684750.00804663393523101560.1168145448010

Austin5812200343602012019141521113675301211485594810054880546318827026583233387851183788955326151910.0894138592262234780.00692103123650085960.0963348904001

Austin58122004137019510063813961124239311913935604925751447832584995385308337610501300069663991850.1125107072251779970.00839071723627884980.1209014245000

Austin58122004238020865018514311139397612614801151875897363532688503447315356127267311386864492760.1143681085261951270.00841240593823223940.1227805144100

Austin58122004339021053333314691066217212615000610905745685433084805957307352796144317886662093770.1109817385256627820.00807293453784589260.119054673010

Austin5812200444002155601021538127216941381580047010859306642336949302893323697970333643156892150980.1015045588285221640.00782896943983191970.1093335283001

Austin58122005141021348413114281089779913515989699945907297133789582240309362139342303643443591600.1192646671268874980.00885495753890268400.1281196246000

Austin58122005242022708936113791103790412417945217956141662632991934300307380440287334648084489690.1136836888289831210.0086607764094234080.1223444649100

Austin58122005343022165147013561065544611816383695946124398032188353529300371248979350855949486710.1058123653270391410.00770662183982881200.1135189871010

Austin5812200544412297804041400123777851121878809010558059397317992771613123871169623831753699122510.1010286653311658750.00813357994182828370.1091622452001

Austin5812200614512153397901231115919871081657257690609437443029577847128837206200528164563000

200020259831

19098960

20928261

23453284

200121602698

21159417

22144866

25823695

200222660609

23556912

21685760

24524268

200323118278

25527446

24268475

26223478

200425177997

26195127

25662782

28522164

200526887498

28983121

27039141

31165875

200628164563

Austin Formatted Data

Austin Total Bar Sales by Quarter

EZDATA.TXT

CITYSICYEARQTRGROSS_SALESAMT_SUBJ_TO_TAXOUTLET_COUNT

Austin5812199511223249651101645731102

Austin5812199521301153041187432031127

Austin5812199531317915721197916581173

Austin5812199541361467541217281481284

Austin5812199611350007891219867621286

Austin5812199621402066161284884771287

Austin5812199631386171331267869141288

Austin5812199641465367511275392521410

Austin5812199711403268001231544351253

Austin5812199721514553141350900351250

Austin5812199731474108911360727111253

Austin5812199741584716191397911131395

Austin5812199811574045431427789361262

Austin5812199821690149701533630991247

Austin5812199831681274851516592261279

Austin5812199841723317091507820791423

Austin5812199911680537311540644051271

Austin5812199921833583111687685461272

Austin5812199931857484301692590511280

Austin5812199941953270511681157291417

Austin5812200011898592681752810241287

Austin5812200022025934561845522241321

Austin5812200031999404071824322541370

Austin5812200042117992031827844051466

Austin5812200111979264121816983181327

Austin5812200122270279411886391501347

Austin5812200132243115581821676061346

Austin5812200142332326621755746411449

Austin5812200212107059141745270101351

Austin5812200222185937061834843301387

Austin5812200232178294501772684181392

Austin5812200242319551291747166161545

Austin5812200311904568681738693521407

Austin5812200322049820041824986591434

Austin5812200331937966741776108101448

Austin5812200342012019141773401811521

Austin5812200411951006381761430961396

Austin5812200422086501851904881301431

Austin5812200432105333331911103541469

Austin5812200442155601021920821601538

Austin5812200512134841311924298841428

Austin5812200522270893612056360871379

Austin5812200532216514702013023371356

Austin5812200542297804042002258161400

Austin5812200612153397901982369391231

Austin58131995163005934556327140

Austin58131995260768824358680130

Austin58131995366423164652551135

Austin58131995460692944504076150

Austin58131996165960845146000135

Austin58131996266895335027140136

Austin58131996365746065136632140

Austin58131996481578615331603145

Austin58131997169932035622350130

Austin58131997263729115064655126

Austin58131997362632934955910133

Austin58131997482044075494043136

Austin58131998179296045914004129

Austin58131998277181166298338131

Austin58131998379471196468657132

Austin581319984115049386768279135

Austin58131999188838907440340129

Austin58131999286922406862360129

Austin58131999381161746814121119

Austin581319994126520417356071130

Austin58132000194657287473089123

Austin58132000281806596778818120

Austin58132000385410666680031121

Austin581320004108633826759541125

Austin58132001188291297205709110

Austin58132001285634807040996111

Austin58132001390534477249736111

Austin581320014119842037488654119

Austin58132002196327557833703112

Austin58132002299672947480496111

Austin58132002387796696840675112

Austin581320024104158036747254124

Austin58132003197732537998266117

Austin581320032107982318661849120

Austin58132003396400588182215121

Austin581320034113675308099031121

Austin581320041112423939126261119

Austin581320042113939769488214126

Austin581320043106621729066563126

Austin581320044127216948392778138

Austin581320051108977999158404135

Austin581320052110379048768884124

Austin581320053106554468150769118

Austin581320054123777857899286112

Austin581320061115919878656433108

Austin5814199516543622316308248

Austin5814199526647853328886549

Austin5814199537378925350936949

Austin5814199547617541328897757

Austin5814199616998301354634656

Austin5814199628084800422384952

Austin5814199637985184395926358

Austin5814199649826545381662165

Austin5814199717999788383256456

Austin5814199729994941517572460

Austin5814199738669778391971962

Austin58141997410084644409428873

Austin5814199818264505385589459

Austin5814199828331454405266659

Austin5814199838066379379539657

Austin58141998410252752413739568

Austin5814199918864466403335760

Austin5814199929168964433907564

Austin58141999310061584430970162

Austin58141999411357548477623175

Austin58142000110794103491141669

Austin58142000210918301506815374

Austin58142000312387195521820276

Austin58142000412589902521750788

Austin58142001112773569546522778

Austin58142001212595937575818979

Austin58142001313091419570533078

Austin58142001413839492540598892

Austin58142002113027854538200280

Austin58142002213589618557729380

Austin58142002312906091519013081

Austin58142002414108465512104396

Austin58142003113345025509438981

Austin58142003214729215582174483

Austin58142003314628417565593884

Austin581420034148559485756181100

Austin58142004113935604548334292

Austin58142004214801151623693187

Austin58142004315000610638057790

Austin581420044158004705362300108

Austin58142005115989699588028894

Austin58142005217945217668480595

Austin58142005316383695572869294

Austin581420054187880905797557105

Austin58142006116572576553879490

Austin5816199512557457522858885243

Austin5816199522699173224596020254

Austin5816199532725214424837962252

Austin5816199542667855824298783260

Austin5816199612926112925976675264

Austin5816199623197521028534781270

Austin5816199633214682329027187271

Austin5816199643094580728054625278

Austin5816199713197160328375543274

Austin5816199723454374230945750276

Austin5816199733453518732065015280

Austin5816199743407318231253652291

Austin5816199813463603532001622285

Austin5816199823370576530898919259

Austin5816199833301860030378521251

Austin5816199843284585630087060256

Austin5816199913301496230396727249

Austin5816199923544965332208355251

Austin5816199933860633934040972258

Austin5816199943938523833984643261

Austin5816200014283066837169887265

Austin5816200024439911638947553266

Austin5816200034572268640618017283

Austin5816200044882270042708497272

Austin5816200115095559644644801268

Austin5816200124904043143513975266

Austin5816200134754854342347290270

Austin5816200144944194443157447278

Austin5816200215059532544691916281

Austin5816200225192028846304351301

Austin5816200234962693145447808294

Austin5816200245086216345225524302

Austin5816200315275086346437628298

Austin5816200325313617347421799307

Austin5816200335492185149417357313

Austin5816200345488054648920478318

Austin5816200415751447851318752325

Austin5816200425897363552521927326

Austin5816200435745685452696990330

Austin5816200445930664253754616336

Austin5816200515907297153441552337

Austin5816200526141662655864172329

Austin5816200536124398055462822321

Austin5816200545805939752262474317

Austin5816200616094374454008492302

Austin5817199514627883836760911196

Austin5817199524878720338534090203

Austin5817199534881404638365521212

Austin5817199545102564139412094212

Austin5817199615009657639342100216

Austin5817199624996913640833486221

Austin5817199634929204139964888217

Austin5817199645140808240986069220

Austin5817199714953485140112297210

Austin5817199725124797941663126205

Austin5817199735018710241497954204

Austin5817199745340219141738757206

Austin5817199815205535842513327204

Austin5817199825802563445600759205

Austin5817199835633241946909464212

Austin5817199845941270347521624227

Austin5817199916185865251507344223

Austin5817199926283888552323371229

Austin5817199936380527952509009233

Austin5817199946691838653957367254

Austin5817200016869399156411268239

Austin5817200027194990360063722248

Austin5817200037336598860601976245

Austin5817200047725186761552376260

Austin5817200117355092158984475246

Austin5817200127440890061425256255

Austin5817200137007684257693882252

Austin5817200147538574957765407264

Austin5817200217286080558601052260

Austin5817200227516584761076967271

Austin5817200237190833558773000265

Austin5817200247738170759059207282

Austin5817200317392579258890193273

Austin5817200327905775062809672293

Austin5817200337932315663809578298

Austin5817200348270265864388536323

Austin5817200418499538568619162308

Austin5817200428850344771483318315

Austin5817200438480595767814027307

Austin5817200449493028970692068332

Austin5817200518958224070711465309

Austin5817200529193430073766866307

Austin5817200538835352971251098300

Austin5817200549927716171800605312

Austin5817200619577847173782019288

Dallas5812199512222438931943124602187

Dallas5812199522403072902103006542192

Dallas5812199532415106022117620622218

Dallas5812199542490681622116973072423

Dallas5812199612431991512090202582265

Dallas5812199622645196212298671442304

Dallas5812199632639265952317215452322

Dallas5812199642651032012292607262496

Dallas5812199712503565972257874272258

Dallas5812199722735516482448042392271

Dallas5812199732737774012448876692300

Dallas5812199742760370052453671222495

Dallas5812199812704533182411114412280

Dallas5812199822864462342567817312289

Dallas5812199832791866552520504222317

Dallas5812199842942165332560695672511

Dallas5812199912843853802583393012276

Dallas5812199923118373232819601362280

Dallas5812199933105344222805940582304

Dallas5812199943236659732816334562504

Dallas5812200013131100422858271852328

Dallas5812200023258236912931907222332

Dallas5812200033269099582924322752334

Dallas5812200043350232282938518772479

Dallas5812200113202220362886848372269

Dallas5812200123299145212968701572319

Dallas5812200133199808722897555092306

Dallas5812200143232203472804091972485

Dallas5812200213097992902813797642327

Dallas5812200223200442732875684302370

Dallas5812200233058483272778173732334

Dallas5812200243138996182722436102541

Dallas5812200312910702612662980762360

Dallas5812200323161743032821200822393

Dallas5812200333126210762809413662414

Dallas5812200343393459142875714892650

Dallas5812200413207175952868996582511

Dallas5812200423388726732956014122509

Dallas5812200433410758323028943002544

Dallas5812200443677076653063468112716

Dallas5812200513451264892991831552440

Dallas5812200523518420663064578312360

Dallas5812200533484163893027966492268

Dallas5812200544798741243103722022366

Dallas5812200613489455892992347362069

Dallas5813199511344916710579994219

Dallas581319952122408139715533215

Dallas581319953124401629476202223

Dallas5813199541652744511124339250

Dallas5813199611273100110447071220

Dallas581319962112454028404236217

Dallas581319963107009088467927211

Dallas5813199641355458610360180227

Dallas581319971117284329733725196

Dallas581319972115860339215518197

Dallas581319973110534639066289201

Dallas5813199741277129410237188224

Dallas5813199811309609010541817203

Dallas5813199821265763410726693207

Dallas581319983127790989933022210

Dallas5813199841487018311263226227

Dallas5813199911734501714551837201

Dallas5813199921797061214530729202

Dallas5813199931560197612390650204

Dallas5813199942007411612713249215

Dallas5813200011701923012379052193

Dallas5813200021722261911921915202

Dallas5813200031838585313221658206

Dallas5813200041819048212539142216

Dallas5813200111781034612666776195

Dallas5813200121694746910857102196

Dallas5813200131601990311042999192

Dallas5813200141608203010685846212

Dallas5813200211531765410944055190

Dallas5813200221470072510318062191

Dallas581320023137259089750588190

Dallas581320024146242359665015209

Dallas5813200311552150510677910174

Dallas5813200321444040210318638177

Dallas581320033133953029747311171

Dallas581320034130434839046653198

Dallas581320041141530739815116171

Dallas5813200421524968410142944189

Dallas581320043154281579576396199

Dallas5813200441591794310160190225

Dallas581320051158330489842973187

Dallas581320052156625389764054173

Dallas581320053143185079278165167

Dallas5813200541504132110169463184

Dallas5813200611551429810329381154

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Dallas581419952170178766677417150

Dallas581419953201230397022675155

Dallas581419954204328698027673182

Dallas581419961197813637745321160

Dallas581419962203371908168871154

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Dallas581419964222046318568066194

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Dallas581419974266963819818320210

Dallas581419981231519199431655160

Dallas581419982245347689910814169

Dallas5814199832521557810168662171

Dallas5814199842701385810433732230

Dallas5814199912630234110700940178

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Dallas5814199943075010710722333233

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Dallas5814200212795615310862224202

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Dallas5814200232755817310940397202

Dallas5814200243027736011421899234

Dallas5814200312663049910540763198

Dallas5814200322488535810640439222

Dallas5814200332445004210253139216

Dallas5814200342519598210293003259

Dallas581420041237837059576501214

Dallas581420042229748499937062225

Dallas5814200432489779710118978206

Dallas581420044246699159190876248

Dallas581420051240760899187341191

Dallas581420052245606179442151183

Dallas581420053253972859718397180

Dallas581420054279957809911927209

Dallas581420061232229259011006153

Dallas5816199513570892927906553254

Dallas5816199523414944628392550249

Dallas5816199533404222028023283241

Dallas5816199543509794328335767247

Dallas5816199613277458327095209234

Dallas5816199623215948226751709226

Dallas5816199633029663425215015220

Dallas5816199643305039826553060229

Dallas5816199713227687327973127218

Dallas5816199723279397929562846220

Dallas5816199733285339929011816222

Dallas5816199743619502930137320234

Dallas5816199813463582930617103212

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impacts of tobacco use and what we can do about it

Documents

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