2. Top Row:
Dee Thomas –
Enforcement Program Coordinator
Emma Goforth –
Adult Cessation Coordinator
Celeste Schoenthaler –
Unit Manager
Gracie Cash –
Tobacco Program Generalist
Bottom Row:
Jennie Munthali –
Stephanie Walton – Youth Policy Coordinator
Jill Bednarek – Secondhand Smoke Coordinator
Not pictured:
Sharon Tracey – Youth and Young Adult Initiatives Coordinator
Jennifer Schwartz – Tobacco Initiatives Work Lead
3. Tobacco Program Mission
In partnership with communities, youth and
stakeholders, our team provides leadership for
tobacco prevention by promoting and
implementing evidence-based, data-driven
strategies across Colorado.
4.
5. Tobacco use is costly for everyone
Cost to United States economy each year in
healthcare costs and lost productivity:
$193 billion
Cost to Colorado each year in healthcare costs and
lost productivity:
$2.4 billion*
Annual U.S. Medicaid costs due to smoking:
$30.9 billion
Annual Colorado Medicaid costs due to smoking:
$319 million
6. Adult current smoking by demographic group
Cover this blue placeholder Note: * Estimates for education are based on adults aged 20 years and older. Estimates for racial/ethnic groups
with your program logo are based on combined 2009 and 2010 data. Source: CDC Behavioral Risk Factor Surveillance System
8. Tobacco Use in Medicaid Population
~500,000 individuals receive Medicaid each year in CO
40%
35%
30%
25%
20% 38%
15%
10% 18%
5%
0%
Medicaid Colorado Adults
Tobacco Use TABS 2008
9. Middle School & High School Students Ever Smoking-Colorado
100.0%
80.0%
60.0%
2001
2006
40.0%
2008
54.2%
20.0% 43.2%
36.8%
25.7%
16.7% 14.4%
0.0%
Middle School High School
Source: Colorado Healthy Kids Colorado Survey on Tobacco and Health, 2001, 2006, and 2008
10. ~90% of adult smokers first try tobacco before the age of 18†
Each Year in the Unites States…
Approximately 400,000 kids become regular smokers*
6 Million kids will die prematurely from their addiction*
Each Year in Colorado…
4,900 youth become regular smokers*
92,000 kids will die prematurely from smoking*
That is more than twice the entire population of Grand Junction!
† Surgeon General’s Report: Preventing Tobacco Use Among Young People, 1994.
* CDC: Best Practices for Tobacco Control Programs, 2007.
11. 6 out of 10 Colorado high school students attempting to
purchase cigarettes are successful
12.
13. Youth vs. Adult Smokeless Tobacco Use
25.0%
Male Smokeless Tobacco Use
20.0%
15.0%
10.0% 2008
12.9%
5.0% 9.5%
7.3%
4.1% 1.8%
0.0%
High School 18-24 years 25-44 years 45-64 years 65+ years
old old old old
Colorado Healthy Kids Colorado Survey on Tobacco and Health, 2008 & Tobacco
Attitudes and Behavior Survey, 2008
14. Strategic Plan Goals
2020 Goals
1. The cessation success gap affecting low SES youth and adult smokers
decreases by 50 percent
2. A majority of people and health care systems in Colorado recognize
and treat tobacco dependence as a chronic condition
3. A majority of Coloradans live, learn, work and play in communities
that have effective policies and regulations that reduce youth and
adult use and access to tobacco
4. Tobacco prevalence and initiation among young adults, especially
straight-to-work, decreases by 50 percent
5. Initiation among youth, especially high burden and low SES
populations, decreases by 50 percent
6. Exposure to secondhand smoke with an emphasis on low SES
populations decreases by 50 percent
7. Colorado is among the 10 states with the highest price for tobacco
products
15. Tobacco Program Initiatives
• Amendment 35
• State Policy
– Youth Access/Point-of-sale
– Monitor and Sustain CCIAA
– Health Systems
• Federal Partnerships
– CDC
– FDA/Synar
– Healthy Housing
– Medicaid
• Data/Surveillance
• Partnerships/Communication
16. Priority Populations
• Low SES
• Disparately Affected Populations
• Young Adult non-Students
• Youth
17. PSD Work Plan
• Prevent initiation among youth and young
adults
• Promote quitting among adults and youth
• Eliminate exposure to secondhand smoke
• Identify and reduce tobacco-related
disparities among population groups
• Create strategic alignment among A35 review
committees
18. Progress…
Department leadership talking about licensing and tax
BOH resolution around dissolvables
4 communities with licensing/youth access policies
Over 7,000 inspections for compliance with FDA laws (since 2010)
Over 600 youth participating in NOT (FY)
Enhancement of interagency tobacco team
Over 17,000 calls to the Colorado QuitLine (FY)
Facebook and Twitter pages for QuitLine
2 new local policies to enhance CCIAA
3 new local policies to reduce SHS exposure in multi unit housing
Healthy Housing Coalition formed
New strategic plan for tobacco
Full funding return to A35
RFA released, new funding framework
…. and much much more on the horizon
Notes de l'éditeur
Items for the Notes section:Past 20 year prevalence trend – peaked over 24% in 1994 currently at 16% an all time low in Colorado.1.5 billion fewer cigarettes smoked per year in the past decadeProgress has been made, but more to be done.Nationally and in Colo data show that there is a stall in the decrease for both youth and adults
*(2nd Row)$579 per Colorado Household Smoking harms others and costs everyone money. Tobacco addiction results in chronic disease that is expensive to treat and contributes to the ever-increasing medical costs that healthcare reform can’t fully solve. And exposure to second-hand smoke kills others. In fact, it has been shown to contribute to infant SIDS deaths.There are a number of things we are doing at CDPHE to address tobacco use. The one that citizens are most familiar with is Amendment 35.$193 billion – MMWR (2008) 57(45);1226-1228.$2306 million – CDC (2007) Best Practices…Medicare and Medicaid fed stat: Campaign for Tobacco Free KidsState Medicaid _ 2007 CDC Best Practices2nd-hand smoke stat: 2006 Surgeon General’s report on 2nd hand smoke – pg. 5-6.
Adult prevalence has declinedCan see disparities among certain groups ethnicity, age and education (why?)Smoking rate is inversely proportional to educational atainment
Looking more closely at 18-24, highlighting the education disparity.
As you can see from this figure, the rate of ever smoking among both middle and high school students has decreased since 2001. The prevalence of high school ever smokers is twice that of middle school students. While we don’t have income data on youth smoking (don’t ask for it), we know based on other research that kids who smoke are more likely to be low-income, based in part on what we infer from other data about low-income smokers.We know that kids who have friends or family who smoke, who don’t have a trusted adult tell them not to use tobacco, and that are exposed to higher levels of advertising, which is more prominent in low-income neighborhoods, are more likely to try tobacco.
And – a key reason we are all here today – according to the Healthy Kids Colorado survey, 60% of the smokers under 18 who tried to buy tobacco illegally, tell us that the were successful in their attempt. 60 percent!Furthermore, the rate of successful attempts INCREASED 24% between 2006 and 2008.In addition, 53% of youth in grades 6 – 12 said it would be “very easy” or “pretty easy” to get cigarettes if they wanted. *We conducted key informant interviews with several parents. It doesn’t have the statistical validity of the youth survey, but gave us some insights on what parents might think. Most of the parents agreed that it is not hard for underage youth to get cigarettes, and most felt that the current laws are not adequately enforced.When we met with the Youth Partnership for Health, a youth advisory board to the Health Dept, and asked for their opinions, they mirrored the parents. Youth and parents overwhelmingly stated that current laws prohibiting sales to kids under 18 are meaningless if they are not effectively enforced. The retailers – to a lesser extent – agreed that enforcing current laws would make them more effective.
This graph represents current smokeless tobacco among males from high school to adulthood. Often the perception of smokeless tobacco is that the prevalence is higher among older male adults; however, as seen in this graphic, the prevalence currently peaks in high school. Moving forward, the high prevalence among high school students could lead to problems as these males age over time. Again, it is important to remember that we simply don’t know if this data will be reflective of youth use of the newer tobacco products like dissolvables.
