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TUPE: Tobacco-Use Prevention & Education Program

TUPE: Tobacco-Use Prevention & Education Program. Anna Hanisko , MPH Tobacco-Use Prevention & Education Coordinator Siskiyou County Office of Education October 30, 2018. Implications of Youth Tobacco Use. Nearly 90% of adult smokers began before the age of 18

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TUPE: Tobacco-Use Prevention & Education Program

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  1. TUPE:Tobacco-Use Prevention & Education Program Anna Hanisko, MPH Tobacco-Use Prevention & Education Coordinator Siskiyou County Office of Education October 30, 2018

  2. Implications of Youth Tobacco Use • Nearly 90% of adult smokers began before the age of 18 • The #1 cause of preventable death in the United States • Over 40,000 deaths per year in California from tobacco-related diseases • Annual health care costs in California attributed to tobacco use: $13.29 billion • $3.58 billion a year of Medi-Cal dollars spent to treat tobacco-related diseases • The tobacco industry spends approximately $26 billion a day on advertisements • $7.87 billion a year, combined. Cigarettes and smokeless tobacco • Mostly targeted at youth Sources: U.S. Department of Health & Human Services; Center for Disease Control and Prevention; Campaign for Tobacco Free Kids; California Healthy Kids Survey Data; WestEd

  3. Implications of Youth Tobacco Use,Continued • The tobacco industry uses predatory marketing strategies that target youth and young adults, people with low income, and more • “The ability to attract new smokers and develop them into a young adult franchise is key to brand development.” – Phillip Morris, 1992 • Highly correlated with poverty and lower educational attainment • No high school diploma: 38% use tobacco. College diploma: 16% use tobacco • At or below FPL: 40% use tobacco. 2 x the FPL level: 23% use tobacco • Correlation between other risky behaviors • Alcohol use, marijuana use, physical violence and school engagement Sources: U.S. Department of Health & Human Services; Center for Disease Control and Prevention; Campaign for Tobacco Free Kids; California Healthy Kids Survey Data; WestEd

  4. Tobacco Prevention History • 1964 – First U.S. Surgeon Generals Report on Smoking and Health • 1988 – Proposition 99 passed in CA, increasing tobacco taxes by $0.25 a pack • 1993 – FDA classifies secondhand smoke as a carcinogen • 1994 – CA bans smoking in restaurants and other indoor spaces • 1994 – U.S. Congressional Hearing: tobacco companies testified that nicotine is not addictive and try to sue CA for publishing the recording of the hearing • 1998 – Master Settlement Agreement, largest civil settlement in U.S. history • 1999 – TUPE programs begin in Siskiyou County schools • 2009 – U.S. Congress passes a law granting FDA the authority to regulate tobacco products • 2014 – Introduction of e-cigarettes to the U.S. tobacco market • 2016 – CA passes Tobacco 21 law, raising legal age from 18 to 21 • 2016 - CA adds e-cigarettes to existing tobacco product laws and restrictions • 2016 – CA schools must all be tobacco-free • 2016 – Proposition 56 passes, increasing tobacco taxes by $2.00 a pack Sources: Centers for Disease Control and Prevention; Tobacco-Free California; State of California Department of Justice

  5. California Tobacco Product Taxes • Proposition 99 • Passed in 1988 • $0.25 tax per pack • Provides funding for: CA Department of Public Health, CA Department of Education (TUPE), tobacco research, health care services to indigents & resource programs for the environment. • Proposition 10 • Passed in 1998 • $0.50 tax per pack • Provides funding for: First 5 agencies. Established state and county commissions to provide early childhood development during critical first 5 years and tobacco prevention programs. • Proposition 56 • Passed in 2016 • $2.00 tax per pack • Provides funding for: Medi-Cal, CA Department of Public Health, CA Department of Education (TUPE), tobacco research, replace revenues lost and State Dental Program. Sources: California Department of Tax and Fee Administration; American Lung Association; California Department of Public Health

  6. Master Settlement Agreement • Tobacco Industry money paid to U.S. states, annually and ongoing, beginning in 1999 • 46 State Attorney General Office’s, 4 U.S. territories and the District of Columbia won the case against 5 largest tobacco companies in 1998 • The Master Settlement Agreement (MSA) also imposed restrictions on the marketing and sale of tobacco products • In 2017 U.S. states collected over $7 billion in MSA payments • Less then 3% of that was spent on tobacco prevention efforts • No state in the U.S. currently funds tobacco prevention programs at the level recommended by CDC • From 1999 – 2018 California, state and local jurisdictions, have received a total of $15,700,365,372.82 from the MSA settlement • From 1999 - 2018 Siskiyou County has received $9,041,146.46 Sources: State of California Department of Justice; Public Health Law Center; Tobacco Free Kids

  7. What is TUPE? • TUPE = Tobacco-Use Prevention and Education Program • Administered by the California Department of Education (CDE) • Competitive and non-competitive funds available to County Offices of Education and School Districts in California • TUPE Technical Assistance and Leadership Funds • Non-competitive; Annual allocation • TUPE Tier 1 Grant • Competitive; 3-year grant cycle • TUPE Tier 2 Grant • Competitive; 3-year grant cycle • Funded by Prop 99 and Prop 56

  8. TUPE Schools • Siskiyou County Office of Education (SCOE) and Siskiyou County schools are currently funded by the 3 TUPE programs • SCOE coordinates the consortium of Tier 1 and Tier 2 competitive grants • Only County Offices of Education eligible for the non-competitive funds

  9. Goals of the TUPE Program • EDUCATION: tobacco education resources and curriculum • POLICY: tobacco-free K-12 campus policies and enforcement • YOUTH: youth development programs • CESSATION: provide or promote existing cessation services and opportunities • EVALUATION: evaluate effectiveness of program and policy changes • COLLABORATION: collaborate with community organizations and grant advisory committee

  10. TUPE Non-Competitive Funds • California Technical Assistance and Leadership Funds (CTALF) • Each County Office of Education in California receives an annual allocation • Funds are to be spent on: • Tobacco prevention assistance to school districts and direct-funded charter schools to reduce tobacco use by school aged youth • Providing training to districts to support their tobacco prevention efforts • Assist with developing successful grant application proposals • Maintain and enforce tobacco free policies • Administer and evaluate the California Healthy Kids Survey • Identify and address disparate populations • Implement compliant and effective tobacco-use prevention programs • Budget monitoring and revisions • Annual reporting to CA Department of Education

  11. TUPE Competitive Grants • TIER 1- • Maintain each campus in district as a certified tobacco-free campus • Document enforcement procedures for tobacco-free campus status • Deliver the California Healthy Kids Survey to students • TIER 2 – • Maintain each campus in district as a certified tobacco-free campus • Document enforcement procedures for tobacco-free campus status • Deliver the California Healthy Kids Survey to students • Implement evidence-based drug prevention curriculum at each site • Provide tobacco cessation referral services • Provide youth development opportunities • Collaboration with other community resources • Address priority populations: rural & low socioeconomic status

  12. California Health Kids Survey (CHKS) Data:Current Cigarette Use *NOTE: Graph begins in 1999 *30-day use rates considered to be “current users” GOOD NEWS! We have seen significant decreases in smoking rates since 1999 when TUPE began NT students hold the highest rate at 28% and 11th graders are the 2nd highest at only 4%

  13. CHKS Data:Current Cigarette Use, CA versus Siskiyou County

  14. CHKS Data:Perceived Ease of Obtaining Cigarettes Perceptions tells us that social norms amongst youth tend to be changing Good news youth feel it is harder to obtain cigarettes under age

  15. CHKS Data: Current Smokeless Tobacco Users *NOTE: Graph begins in 1999 There have been many fluctuations in the chewing rates since 1999 Overall, there has been a decrease Though each grades rate is less than 10%, we would like each grade to be below 5%

  16. CHKS Data:Current Chewing Rates, CA versus Siskiyou County

  17. CHKS Data: Current e-cigarette users Lifetime Use = ever tried any type of e-cigarette Each grade surveyed is below 20% Goal is to get all grade levels below 5%

  18. Tobacco and Marijuana Overlap • Prop 64, passed in 2016, legalized recreational marijuana • Have seen an ensuing decrease in the perception of harm from youth • Prior to Prop 64, 60% of CA youth co-used marijuana and tobacco • Marijuana smoke has a toxicity profile similar to tobacco smoke • Cannabis products, especially flavored products, advertised heavily towards youth. Same tactics as the tobacco industry. • Risks for youth brains not fully developed • Marijuana use is an emerging issue for youth health • The California Tobacco Education and Research Oversight Committee states that: • “To protect public health, marijuana should be treated like tobacco – legal but unwanted- subject to a robust demand reeducation program modeled on successful and evidence-based tobacco control programs.” January 2018, Master Plan

  19. CHKS Data: Ever Used Marijuana Rates Lifetime Use = ever tried any type of e-cigarette No 30-day use rates for marijuana Would like to stall these rates and eventually see a decrease

  20. CHKS Data: Perceived Harm of Using Marijuana **2017 Question changed from 1-2 times/week to daily use Want Perceived Harm to be HIGH

  21. CHKS Data: Perceived Ease of Obtaining Marijuana 7th and 9th graders are also reporting that it is easier to obtain Marijuana Whereas 11th graders and NT students report that they think it is harder to obtain Marijuana

  22. CHKS Data: Lifetime Use Rate Comparison Alcohol continues to be the most commonly used substance amongst youth, followed by marijuana and then cigarettes

  23. CHKS Data: Perceived Harm Comparison We want Perceived Harm to be HIGH Typically, high perceived harm rates correlate with lower use rates for that substance We see that trend we our youth, with a few small variations

  24. Protective Factors • Caring adult relationships • Community engagement – sense of belonging • Education • Extracurricular and volunteer activities • Youth development opportunities • Delayed onset of use – brain development • Parent education and training • Meaningful opportunities to participate • Having an active role in decision making, ie youth coalitions • And many more!

  25. Thank you!Questions? Comments?Anna Hanisko(530) 842-8417ahanisko@siskiyoucoe.net

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