Tobacco Use Reduction as a National and Regional Priority

1. Tobacco Use Reduction as a National and Regional Priority Tobacco-free College Campuses: Promoting a Culture of Health Patrick O’Carroll, MD, MPH Assistant Surgeon General and Regional Health Administrator Region X , U.S. Department of Health & Human Services Tacoma, Washington, Dec 7, 2012

2. Impact Evaluation Implementation: How do you do it? Intervention Evaluation: What works? Risk FactorIdentification: What is the cause? Public Health Approach Surveillance: What is the problem? Problem Response

3. What is the problem? • Tobacco is the leading cause of preventable death in the United States • Tobacco kills ~443,000 Americans each year—about 1 of every five deaths • Lung cancer is the leading cause of cancer death among both men and women in U.S. • Late 1800’s: Lung cancer was rare • Cigarette smoking causes $96B in medical costs and $97B in lost productivity each year

4. What is the problem? • Each day, over 3,800 young people under 18 years of age smoketheir first cigarette, and over 1,000 youth become daily smokers. • The vast majority of Americans who begin daily smoking during adolescence are addicted to nicotine by young adulthood. • Despite progress, nearly one in four U.S. high school seniors and one in three young adults under age 26 smoke.

5. What is the problem? • Nearly all tobacco use begins in childhood and adolescence • 88% of adult cigarette smokers who smoke daily started smoking by the age of 18 • 99% of first use by 26 years of age!

6. Impact Evaluation Implementation: How do you do it? Intervention Evaluation: What works? Risk FactorIdentification: What is the cause? Public Health Approach Surveillance: What is the problem? Problem Response

7. Impact Evaluation Implementation: How do you do it? Intervention Evaluation: What works? Risk FactorIdentification: What is the cause? Public Health Approach Surveillance: What is the problem? Problem Response

8. What works? • Four foundational documents: • Best Practices for Comprehensive Tobacco Control Programs (2007) • Guide to Community Preventive Services • Treating Tobacco Use and Dependence: 2008 Update • Report on the Global Tobacco Epidemic, 2008: The MPOWER Package • Tobacco control programs must be comprehensive sustained, and accountable

9. Impact Evaluation Implementation: How do you do it? Intervention Evaluation: What works? Risk FactorIdentification: What is the cause? Public Health Approach Surveillance: What is the problem? Problem Response

10. How do you do it? • The Family Smoking Prevention and Tobacco Control Act, giving the FDA authority to regulate the manufacturing, marketing and sale of tobacco products (2009) • Ending the Tobacco Epidemic: A Tobacco Control Strategic Action Plan for the US Department of Health and Human Services (2010) • Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General (2012)

11. Impact Evaluation Implementation: How do you do it? Intervention Evaluation: What works? Risk FactorIdentification: What is the cause? Public Health Approach Surveillance: What is the problem? Problem Response

12. YOUTH andTOBACCO Town Hall Meeting Region X , U.S. Department of Health & Human Services (Alaska, Idaho, Oregon, and Washington) University of WashingtonSeattle, Washington, June 14, 2012

13. A Challenge for Region X:Tobacco-free College Campuses across the Entire Pacific Northwest

14. Tobacco Use Reduction as a National and Regional Priority Tobacco-free College Campuses: Promoting a Culture of Health Patrick O’Carroll, MD, MPH Assistant Surgeon General and Regional Health Administrator Region X , U.S. Department of Health & Human Services Tacoma, Washington, Dec 7, 2012