measuring progress in tobacco control

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Measuring Progress in Tobacco Control Patrick Remington Erich Mussak Ann Christiansen David Ahrens

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Measuring Progress in Tobacco Control. Patrick Remington Erich Mussak Ann Christiansen David Ahrens. Overview. Predicting expected rates of tobacco use using historical trends Setting goals based on predicted rates Evaluating progress using comparison states. - PowerPoint PPT Presentation

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Page 1: Measuring Progress in Tobacco Control

Measuring Progress in Tobacco Control

Patrick RemingtonErich Mussak

Ann ChristiansenDavid Ahrens

Page 2: Measuring Progress in Tobacco Control

Overview

1. Predicting expected rates of tobacco use using historical trends

2. Setting goals based on predicted rates

3. Evaluating progress using comparison states

Page 3: Measuring Progress in Tobacco Control

Background: Wisconsin Tobacco Control Board

• Established in 2001 with funds from the Master Settlement Agreement

• $24 million per year in first year/$15 million per year since then

• Comprehensive program following the CDC guidelines

Page 4: Measuring Progress in Tobacco Control

Monitoring and Evaluation Program

• Goal: Evaluate the effectiveness of Wisconsin’s $15 million/year tobacco control program

• 3 components:– Monitor trends in tobacco use in Wisconsin– Evaluate statewide programs– Provide training and technical assistance for local

program evaluation

Page 5: Measuring Progress in Tobacco Control

1. Predicting Future Trends in Tobacco Use

• First step: calculate the expected rates of tobacco use in 2005

• Use Wisconsin historical trends to predict future trends

• Will use per capita sales estimates as an example – Can be applied to other measures of tobacco use

Page 6: Measuring Progress in Tobacco Control

Trends in Per Capita Cigarette Sales, Wisconsin, 1950-2000

0

20

40

60

80

100

120

140

1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005

Year

Packs/y

ear

Page 7: Measuring Progress in Tobacco Control

Trends in Per Capita Cigarette Sales, Wisconsin, 1950-2000

0

20

40

60

80

100

120

140

1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005

Year

Packs/y

ear

Page 8: Measuring Progress in Tobacco Control

Trends in Per Capita Cigarette Sales, Wisconsin, 1950-2000

0

20

40

60

80

100

120

140

1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005

Year

Packs/y

ear

Page 9: Measuring Progress in Tobacco Control

Predicting Trends in the Future

64

30

48

0

20

40

60

80

100

120

1990 1995 2000 2005

Year

Packs/y

ear

What is expected by 2005?

Page 10: Measuring Progress in Tobacco Control

Predicted Trend Using Linear Regression

79

0

20

40

60

80

100

120

1990 1995 2000 2005

Year

Packs/y

ear

Page 11: Measuring Progress in Tobacco Control

Predicted Trend Using 2nd Order Polynomial

59

0

20

40

60

80

100

120

1990 1995 2000 2005

Year

Packs/y

ear

Page 12: Measuring Progress in Tobacco Control

Predicted Trend Using 3rd Order Polynomial

27

0

20

40

60

80

100

120

1990 1995 2000 2005

Year

Packs/y

ear

Page 13: Measuring Progress in Tobacco Control

Predicted Trend Using “Visual Extrapolation”

59

0

20

40

60

80

100

120

1990 1995 2000 2005

Year

Packs/y

ear

Page 14: Measuring Progress in Tobacco Control

Trends in Per Capita Cigarette Sales, Wisconsin, 1950-2000

70

75

80

85

90

95

100

1990 1995 2000 2005

Year

Packs/y

ear

Measure Percent Change from Year-to-Year

Page 15: Measuring Progress in Tobacco Control

2%1%

-5%

1%

2%

-2%

0%

-4%

-5%-5%-6%-5%-4%-3%-2%-1%0%1%2%3%

1990 1995 2000 2005

Year

Ch

an

ge f

rom

pri

or

year

70

75

80

85

90

95

100

1990 1995 2000 2005

Year

Packs/y

ear

Page 16: Measuring Progress in Tobacco Control

Year-to-Year Changes in Per Capita Sales

2%1%

-5%

1%

2%

-2%

0%

-4%

-5%-5%-6%-5%-4%-3%-2%-1%0%1%2%3%

1990 1995 2000 2005

Year

Ch

an

ge f

rom

pri

or

year

Page 17: Measuring Progress in Tobacco Control

Year-to-Year Changes in Per Capita Sales

2%1%

-5%

1%

2%

-2%

0%

-4%

-5%-5%-5%-5%-5%-5%-5%-6%-5%-4%-3%-2%-1%0%1%2%3%

1990 1995 2000 2005

Year

Ch

an

ge f

rom

pri

or

year

Page 18: Measuring Progress in Tobacco Control

Expected Rate with a 5% Annual Decline

62

50556065707580859095

100

1990 1995 2000 2005

Year

Packs/y

ear

Page 19: Measuring Progress in Tobacco Control

Year-to-Year Changes in Per Capita Sales

2%1%

-5%

1%

2%

-2%

0%

-4%

-5%-5%

-3%-3%-3%-3%-3%

-6%-5%-4%-3%-2%-1%0%1%2%3%

1990 1995 2000 2005

Year

Ch

an

ge f

rom

pri

or

year

Page 20: Measuring Progress in Tobacco Control

Expected Rate with a 3% Annual Decline

69

50556065707580859095

100

1990 1995 2000 2005

Year

Packs/y

ear

Page 21: Measuring Progress in Tobacco Control

Expected Rate with a 3% Annual Decline

69

50556065707580859095

100

1990 1995 2000 2005

Year

Packs/y

ear

Page 22: Measuring Progress in Tobacco Control

Summary

Assumption Expected RateLinear regression 79Polynomial regression 59 (or 27)“Visual regression” 595% per year decrease 623% per year decrease 69*

*Best estimate?

Page 23: Measuring Progress in Tobacco Control

3. What Should the Goal be for 2005?

69

40

50

60

70

80

90

100

1990 1995 2000 2005

Year

Packs/y

ear

Expected by 2005

Program begins

Page 24: Measuring Progress in Tobacco Control

3. What Should the Goal be for 2005?

69

55

40

50

60

70

80

90

100

1990 1995 2000 2005

Year

Packs/y

ear

Expected by 2005

20% reduction from expected

Page 25: Measuring Progress in Tobacco Control

3. What Should the Goal be for 2005?

69

55

64

40

50

60

70

80

90

100

1990 1995 2000 2005

Year

Packs/y

ear

Expected by 2005

Actual Board Goal (20% less than 2000)

Page 26: Measuring Progress in Tobacco Control

Summary

• It is difficult to estimate the “expected” rates of tobacco use, using historical trends

• Regardless, should calculate these expected rates PRIOR to setting goals!

• Goals should be set based on a reduction for the expected rate, not from the current rate.

Page 27: Measuring Progress in Tobacco Control

4. Evaluating Program Effects

• The Board wants to know if the program is effective (the sooner, the better)

• Strongest design is to use ‘comparison’ groups

• Control for ‘inputs’ (e.g., annual tobacco control spending)

Page 28: Measuring Progress in Tobacco Control

Recent Example

• Data from 2001 become available on per capita sales (77 packs per capita?)

• These data showed a 3% decline from the value in 2000

• Is there any “early” evidence that the program is working?

Page 29: Measuring Progress in Tobacco Control

Annual Rates of Per Capita Cigarette Sales, if the State is to Meet its 2005 Goal

8077

74

7067

64

80

75

70

65

60

55

50

55

60

65

70

75

80

2000 2001 2002 2003 2004 2005

Year

Packs/y

ear

Board Goal

‘Aggressive’ Goal

Page 30: Measuring Progress in Tobacco Control

Long-Term Trends in Per Capita Cigarette Sales, Wisconsin and US

5060708090

100110120130140

1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005

Year

Packs/y

ear

US

WI

Page 31: Measuring Progress in Tobacco Control

Long-Term Trends in Per Capita Cigarette Sales, Wisconsin and US

0

20

40

60

80

100

120

140

160

1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005

Year

Packs/y

ear

US

WI

Page 32: Measuring Progress in Tobacco Control

Long-Term Trends in Difference Between U.S. and Wisconsin in Per Capita Cigarette Sales

-30-20-10

0102030405060

1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005

Year

Packs/y

ear

Page 33: Measuring Progress in Tobacco Control

Difference Between U.S. and Wisconsin Per Capita Cigarette Sales

0

2

4

6

8

10

12

1990 1995 2000 2005

Year

Packs/y

ear

Page 34: Measuring Progress in Tobacco Control

Difference Between U.S. and Wisconsin Per Capita Cigarette Sales

0

2

4

6

8

10

12

1990 1995 2000 2005

Year

Packs/y

ear

Effective

NotEffective

Page 35: Measuring Progress in Tobacco Control

Adjustments

• Stratify states prospectively, on the amount spend per capita for tobacco control

• Compare Wisconsin to the low- medium- and high-spending states

• Hypothesis: Wisconsin’s program will be effective if it achieves rates similar to states spending $3 per capita (and greater than states spending less)

Page 36: Measuring Progress in Tobacco Control

Trends in Per Capita Cigarette Sales, Wisconsin and Arkansas, 1950-2000

30

50

70

90

110

130

150

1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005

Year

Packs/y

ear

AK

WI

Page 37: Measuring Progress in Tobacco Control

Trends in Per Capita Cigarette Sales, Wisconsin and California, 1950-2000

30

50

70

90

110

130

150

1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005

Year

Packs/y

ear

CA

WI

Page 38: Measuring Progress in Tobacco Control

Trends in Per Capita Cigarette Sales, Wisconsin, 1950-2000

-30

-20

-10

0

10

20

30

40

50

60

Year

Packs/y

ear

CA

WI

AR

US

Page 39: Measuring Progress in Tobacco Control

Summary

• States need to use historical data to predict future trends in tobacco use– Per capita sales– Current smoking (BRFSS)– Smoking in pregnancy (vital records)– Middle and high school (YTS/YRBS)

Page 40: Measuring Progress in Tobacco Control

Summary, cont.

• Program effects can be assessed by comparing progress with other states, stratified by per capita program investments

• Future research should consider long-term trends in tobacco use in states

Page 41: Measuring Progress in Tobacco Control

Acknowledgments

• Monitoring and Evaluation Program– Ellen Taylor-Powell, Paul Moberg– David Ahrens, Ann Christiansen, Erich Mussak, Ann

Olen, Barbara Hill, Matthew Renfro-Sargent, Amanda Riemer, Eden Schafer

• Wisconsin Tobacco Control Board– David Gunderson, Earnestine Willis

• Wisconsin Division of Public Health– Meg Taylor, Tom Conway, Nancy Chudy, Cathryn Brue,

Jenny Commons

Page 42: Measuring Progress in Tobacco Control

Trailer slide

• 41 slides * 1 set = 41 total slides

• Monitoring and Evaluation (WTCB)

• 265-9931 (Erich Mussak)

• 1 of 3 sets of slides