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Building a Legacy of Tobacco-Free Communities

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Building a Legacy of Tobacco-Free Communities

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  1. <?xml version="1.0"?><AllQuestions /> <?xml version="1.0"?><AllResponses /> <?xml version="1.0"?><Settings><answerBulletFormat>Numeric</answerBulletFormat><answerNowAutoInsert>No</answerNowAutoInsert><answerNowStyle>Explosion</answerNowStyle><answerNowText>Answer Now</answerNowText><chartColors>Use PowerPoint Color Scheme</chartColors><chartType>Horizontal</chartType><correctAnswerIndicator>Checkmark</correctAnswerIndicator><countdownAutoInsert>No</countdownAutoInsert><countdownSeconds>10</countdownSeconds><countdownSound>TicToc.wav</countdownSound><countdownStyle>Box</countdownStyle><gridAutoInsert>No</gridAutoInsert><gridFillStyle>Answered</gridFillStyle><gridFillColor>255,255,0</gridFillColor><gridOpacity>50%</gridOpacity><gridTextStyle>Keypad #</gridTextStyle><inputSource>Response Devices</inputSource><multipleResponseDivisor># of Responses</multipleResponseDivisor><participantsLeaderBoard>5</participantsLeaderBoard><percentageDecimalPlaces>0</percentageDecimalPlaces><responseCounterAutoInsert>No</responseCounterAutoInsert><responseCounterStyle>Oval</responseCounterStyle><responseCounterDisplayValue># of Votes Received</responseCounterDisplayValue><insertObjectUsingColor>Red</insertObjectUsingColor><showResults>Yes</showResults><teamColors>Use PowerPoint Color Scheme</teamColors><teamIdentificationType>None</teamIdentificationType><teamScoringType>Voting pads only</teamScoringType><teamScoringDecimalPlaces>1</teamScoringDecimalPlaces><teamIdentificationItem></teamIdentificationItem><teamsLeaderBoard>5</teamsLeaderBoard><teamName1></teamName1><teamName2></teamName2><teamName3></teamName3><teamName4></teamName4><teamName5></teamName5><teamName6></teamName6><teamName7></teamName7><teamName8></teamName8><teamName9></teamName9><teamName10></teamName10><showControlBar>All Slides</showControlBar><defaultCorrectPointValue>0</defaultCorrectPointValue><defaultIncorrectPointValue>0</defaultIncorrectPointValue><chartColor1>187,224,227</chartColor1><chartColor2>51,51,153</chartColor2><chartColor3>0,153,153</chartColor3><chartColor4>153,204,0</chartColor4><chartColor5>128,128,128</chartColor5><chartColor6>0,0,0</chartColor6><chartColor7>0,102,204</chartColor7><chartColor8>204,204,255</chartColor8><chartColor9>255,0,0</chartColor9><chartColor10>255,255,0</chartColor10><teamColor1>187,224,227</teamColor1><teamColor2>51,51,153</teamColor2><teamColor3>0,153,153</teamColor3><teamColor4>153,204,0</teamColor4><teamColor5>128,128,128</teamColor5><teamColor6>0,0,0</teamColor6><teamColor7>0,102,204</teamColor7><teamColor8>204,204,255</teamColor8><teamColor9>255,0,0</teamColor9><teamColor10>255,255,0</teamColor10><displayAnswerImagesDuringVote>Yes</displayAnswerImagesDuringVote><displayAnswerImagesWithResponses>Yes</displayAnswerImagesWithResponses><displayAnswerTextDuringVote>Yes</displayAnswerTextDuringVote><displayAnswerTextWithResponses>Yes</displayAnswerTextWithResponses><questionSlideID></questionSlideID><controlBarState>Expanded</controlBarState><isGridColorKnownColor>True</isGridColorKnownColor><gridColorName>Yellow</gridColorName></Settings> <?xml version="1.0"?><AllAnswers /> Building a Legacy of Tobacco-Free Communities Jeff McKenna, MS Associate Director for Communication Science Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion ACHIEVE Action Institute April 25, 2012

  2. The Good News: We Have Recast Social Norms

  3. The Bad News: Smoking Kills 443,000 Americans Each Year Average annual number of deaths, 2000-2004. Source:Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses – United States, 2000-2004. MMWR 2008;57(45):1226-1228.

  4. U.S. Adult Per-Capita Cigarette Consumption, 1900-2010 Source: USDA Tobacco & Situation Outlook report until 2002; 2003-2010 Office on Smoking & Health Data

  5. U.S. Adult Per-Capita Cigarette Consumption Projectedthrough 2035 Tobacco use is a minor public health nuisance Source: USDA Tobacco & Situation Outlook report until 2002; 2003-2010 Office on Smoking & Health Data Projection: Calculations from Gary Giovino, University of Buffalo

  6. Trends in Current Cigarette Smoking by High School Students and Adults—U.S., 1965-2010 High school students* Adults** *High school students who smoked on 1 >/ of the 30 days preceding the survey--United States, CDC. Youth Risk Behavior Survey,1991-2009. ** Total population adults who were current cigarette smokers, National Health Interview Surveys, 1965-2010.

  7. Surgeon General’s Report:Preventing Tobacco Use Among Youth and Young Adults

  8. Current High School Cigarette Smoking and Projected Rates if Decline Had Continued—U.S., 1991-2009 3 million fewer youth and young adults would be smokers 8% Source: 1999-2009 YRBS: Centers for Disease Control and Prevention, Division of Adolescent and School Health, Office on Smoking and Health (unpublished data).

  9. Adult Per Capita Cigarette Consumption and Major Smoking-and-Health Events—U.S., 1900-2010 1st Surgeon General’s Report End of WW II Master Settlement Agreement Fairness Doctrine Messages on TV and Radio FDA Granted Authority to Regulate Tobacco 1st Smoking- Cancer Concern Federal Cigarette Tax More Than Doubles Great Depression Source: USDA Tobacco & Situation Outlook report until 2002; 2003-2010 Office on Smoking & Health Data

  10. Lung Cancer Incidence, US Men, 1998 U.S. Cancer Statistics: 1998–2007 Incidence and Mortality. www.cdc.gov/uscs

  11. Lung Cancer Incidence, US Men, 2007 U.S. Cancer Statistics: 1998–2007 Incidence and Mortality. www.cdc.gov/uscs 11

  12. Adult Smoking Prevalence by State Behavioral Risk Factor Surveillance System, 2010

  13. Percent of Adults Who Smoke by Sex National Health Interview Survey, 2010

  14. Percent of Adults Who Smoke by Racial/Ethnic Group National Health Interview Survey, 2010

  15. Percent of Adults Who Smoke by Poverty Level National Health Interview Survey, 2010

  16. Percent of Adults Who Smoke By Education Level National Health Interview Survey, 2010

  17. We Know What Works: Evidence-Based Interventions

  18. CDC’s Recommendations for Prioritizing Policies Phase I • Comprehensive Smoke-Free Policies • Price Increases • Hard-Hitting Media Campaigns • Sustained/Increased Program Funding Phase II • Policy-Based Cessation • Expanded Smoke-Free Environments • Reduce Retailer Density, Location, Type • Product Display Bans • Graphic Retail Health Warnings

  19. Smallest Impact Largest Impact Factors that Affect Health Examples Eat healthy, be physically active Counseling & Education Rx for high blood pressure, high cholesterol, diabetes Clinical Interventions Immunizations, brief intervention, cessation treatment, colonoscopy Long-lasting Protective Interventions Fluoridation, 0g trans fat, iodization, smoke-free laws, tobacco tax Changing the Context to make individuals’ default decisions healthy Poverty, education, housing, inequality Socioeconomic Factors

  20. Changing the Cost-Benefit Calculus Tobacco easily accessible Smoking in public legal Unfettered advertising, no counter-advertising Hard to access quitting resources Cigarettes designed to addict Individual

  21. Changing the Cost-Benefit Calculus Tobacco more expensive, less accessible Smoke-free policies Counter-marketing, promotion restrictions Easy access to help Cigarettes made less addictive Individual

  22. Phase I Priorities • Comprehensive Smoke-Free Policies • Price Increases • Hard-Hitting Media Campaigns • Sustained/Increased Program Funding

  23. State Smoke-Free Indoor Air Laws for Private Worksites, Restaurants, and Bars Laws in effect as of Dec 31, 2004 WA VT MT ME ND OR MN NH ID WI MA NY SD WY MI RI PA IA CT NV NE NJ OH IL IN UT DE CA WV CO VA MD KY KS MO D.C. NC TN AZ OK SC NM AR Ban in worksites, restaurants, and bars (n=3) GA MS AL LA Ban in two of three locations (n=1) TX AK FL No Ban in all these locations (n=47) HI N=51 Source: Centers for Disease Control and Prevention. State Tobacco Activities Tracking and Evaluation (STATE) System. Available at: http://www.cdc.gov/tobacco/statesystem.

  24. State Smoke-Free Indoor Air Laws for Private Worksites, Restaurants, and Bars Laws in effect as of April* 2012 WA VT MT ME ND OR MN NH ID WI MA NY SD WY MI RI PA IA CT NV NE NJ OH IL IN UT DE CA WV CO VA MD KY KS MO D.C. NC TN AZ OK SC NM AR Ban in worksites, restaurants, and bars (n=26) GA MS AL LA Ban in two of three Locations (n=5) TX AK FL No Ban in all these locations (n=20) HI N=51 Source: Centers for Disease Control and Prevention. State Tobacco Activities Tracking and Evaluation (STATE) System. Available at: http://www.cdc.gov/tobacco/statesystem. *Note Indiana is effective in July 2012

  25. Almost 50% of U.S. population is covered by comprehensive state or local smoke-free laws Population figures are as of December 31 of each given year; July for 2010. All population figures are from the United States Census. Source: American Nonsmokers’ Rights Foundation, 2000-2010.

  26. Reductions in exposure among nonsmoking hospitality workers general population of nonsmokers Health improvements among nonsmoking hospitality workers Reductions in sensory and respiratory symptoms Improved lung function Reductions in hospital heart attack admissions among the general public Increased cessation, reduced smoking rates among workers Benefits of Smoke-free Policies

  27. There is Also a Good Business Case for Going Smoke-Free

  28. Children and adolescents African Americans Blue-collar, service, and hospitality workers Low-income Americans Groups Disproportionately Exposedto Secondhand Smoke

  29. Phase I Priorities • Comprehensive Smoke-Free Policies • Price Increases • Hard-Hitting Media Campaigns • Sustained/Increased Program Funding

  30. State Cigarette Excise Tax Rates Laws in effect as of Jan 1, 2011 WA Chicago $3.66 (state + local) VT MT ME ND OR MN NH ID WI MA NY SD WY MI RI PA IA CT NV NE NJ OH IL NYC $5.85 (state + local) IN UT DE CA WV CO VA MD KY KS MO D.C. NC TN AZ OK SC NM AR ≥$3.00 per pack GA MS AL $2.00-$2.99 per pack LA TX $1.50-$1.99 per pack AK FL $1.00-$1.49 per pack Anchorage $3.45 (state + local) HI 50-99 cents per pack <50 cents per pack CDC, Office on Smoking and Health. State Tobacco Activities Tracking and Evaluation (STATE) System. 30

  31. Phase I Priorities • Comprehensive Smoke-Free Policies • Price Increases • Hard-Hitting Media Campaigns • Sustained/Increased Program Funding

  32. Florida Truth Campaign: Dramatic Impact on Youth Smoking Over 2 years, cigarette use plunged 40% among middle-school studentsand18% among high-school students

  33. National truth® Campaign • Research finding: more truth® ad exposure, less risk of beginning to smoke among teens • Annual media buy down from $100 million in 2000 to $30 million today Farrellyet al. The Influence of the National truth Campaign on Smoking Initiation. AJPM 2009.

  34. CDC’s National Tobacco Education Campaign“Tips from Former Smokers” National Center for Chronic Disease Prevention and Health Promotion Office on Smoking and Health

  35. Week 1 Metrics Week 1 Metrics • Campaign website : 230,000 page views • Terrie ad: viewed over 240,000 times • Quitline calls doubled U.S. Total Quitline Calls: March 1-26 Campaign Launch

  36. Phase I Priorities • Comprehensive Smoke-Free Policies • Price Increases • Hard-Hitting Media Campaigns • Sustained/Increased Program Funding

  37. City and State tax increases Smoke-free policy 3-yr. average 3-yr. average 3-yr. average Media campaign 21.5% 21.7% 21.6% 21.5% 18.9% 19.2% 16.9% 18.3% 17.6% 17.5% 15.8% 14.8% 11.2% 8.5% Immediate Impact of a Comprehensive Approach: Youth and Adult Smoking Rates in NYC State and Federal Tax increases 15.8% 14% Percent 8.4% 7% Source: BRFSS 1993 – 2001; NYC Community Health Survey 2002 – 2010; and NYC YRBS 2001 - 2010

  38. Long-term Impact of a Comprehensive Approach:Lung Cancer Incidence Rates in CA California: A 15 year investment of $1.8 billion in tobacco control reduced health care costs by $86 billion Rates are per 100,000 and age-adjusted to the 2000 U.S. standard (19 age groups). * The annual percent change is significantly different from zero (p<0.05). Source: Cancer Surveillance Section. Prepared by: California Department of Public Health, California Tobacco Control Program, 1988-2005. 2010.

  39. Tobacco Industry is Outspending Prevention Efforts >23:1 StateTobacco Revenue (taxes and settlement funds) Federal Cigarette Tax Revenues $25.3 billion Tobacco Industry Marketing & Promotion Spending (2008) $15 billion Total CDC-Recommended Spending Level $10.5 billion State Tobacco Program Budgets $0.45 billion $3.7 billion Source: Campaign for Tobacco Free Kids, Federal Trade Commission, CDC Office on Smoking and Health

  40. State Taxes vs. StateSpending • The average state cigarette excise tax increased from $1.11 at the end of 2007 to $1.46 today • Total state spending on tobacco control decreased from $717 million in FY2008 to $457 million in FY2012 - 36% + 32%

  41. Key CDC Tobacco Prevention Activities • National Tobacco Control Program • Funding and support to 50 states, D.C., U.S. territories, tribes, national organizations. • Community Transformation Grants • Community-level efforts in 61 states and communities • Funded by Affordable Care Act’s Prevention and Public Health Fund • “Next Generation” of Communities Putting Prevention to Work • National Tobacco Education Campaign • TV, radio, print, billboards, theater, bus shelters, and digital ads • Funded by the Prevention and Public Health Fund

  42. Family Smoking Prevention and Tobacco Control Act of 2009 • FDA given authority to regulate sales, advertising, and ingredient content of tobacco • Prohibits candy flavoring and misleading terms • introduces new youth access provisions • Requires new warnings for cigarettes, smokeless tobacco

  43. Legal Challenges • Federal lawsuit challenging FDA’s regulatory authority • Federal lawsuit challenging graphic warning labels • Injunction has placed new warnings on hold for now • Continued lawsuits in states and communities against smoke-free, point of sale policies

  44. A Self-Fulfilling Prophecy? Let’s Help!

  45. Building a Legacy of Tobacco-Free Communities Thank You! Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion

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