Tobacco and Health Among Wyoming Adults 2009 BRFSS

1. Tobacco and HealthAmong Wyoming Adults2009 BRFSS Menlo Futa, WY Department of Health Mary Adams, On Target Health Data LLC

2. Behavioral Risk Factor Surveillance System Random digit dial telephone survey of WY adults age 18 and older Topics include health behaviors, health conditions, health care access, preventive health services Examples: tobacco/alcohol use, physical activity, diabetes, obesity, lack of health insurance, mammograms/Pap smears What is BRFSS?

3. Primary purpose is to support WDH programs, especially in chronic disease and health promotion Data is collected every month and analyzed on calendar year basis All 50 states conduct BRFSS Wyoming participation since 1994 Annual sample size between 2,000 and 8,000 What is BRFSS? (cont)

4. Background • Currently 5 tobacco questions on core BRFSS questionnaire: • 2 smoking prevalence • serious quit attempt in past 12 months • time since last smoked regularly • smokeless tobacco prevalence • One state-added question -- other tobacco use

5. Most results are from 2009 when 6,058 interviews were conducted (land line interviews) Data are weighted to be representative of the Wyoming adult population Data on race and county were combined for 2005-2009 to increase sample size Depression data and some trends include 2010 preliminary results (N=5,839) Methods

6. People living in institutions such as prisons, dorms, or nursing homes were not included People without phones or only cell phones were not included Data is self-reported Response rates are declining and there is no way to tell if those not responding are similar to those who do respond Limitations

7. Major changes coming in 2011 • Weighting method will correct for additional factors (education and marital status) • Cell phone only adults will be incorporated • Biggest impact will be on smoking prevalence • HP 2010 and HP 2020 objectives

8. Results

9. Current Tobacco Use by Gender 2009 WY BRFSS Source: 2009 BRFSS.

10. Smoking by Age Group2009 WY BRFSS

11. Male Smokeless by Age Group2009 WY BRFSS

12. Current Smoking by Education2009 WY BRFSS

13. Male Smokeless by Education2009 WY BRFSS

14. Current Smoking by Marital Status2009 WY BRFSS

15. Male Smokeless by Marital Status2009 WY BRFSS

16. Current Smoking TrendWY BRFSS 1994-2010 Dotted line is trend line

17. Daily Smoking TrendWY BRFSS 1996-2010 Dotted line is trend line

18. Male Smokeless Tobacco Use TrendWY BRFSS 1996-2010 Dotted line is trend line

19. Effect of Weighting Method on Smoking2008-2009 WY BRFSS New weight adjusts for more demographic variables than usual weight. Cell phones not included in 2008.

20. Effect of Weighting Method on Smokeless (Males)2008-2009 WY BRFSS New weight adjusts for more demographic variables than usual weight. Cell phones not included in 2008.

21. Effect of Weighting Method on Quit 1+ Day2008-2009 WY BRFSS New weight adjusts for more demographic variables than usual weight. Cell phones not included in 2008. Measure is daily smokers who quit smoking 1 day or more in past year because they were trying to quit.

22. Tobacco Use by Phone Type2009 WY BRFSS New weight used for all ; includes an extra 252 cell phone interviews.

23. High Risk Groups for Smoking 2009 WY BRFSS Source: 2009 & 2010 BRFSS.

24. High Risk Groups for Male Smokeless Use 2009 WY BRFSS Source: 2009 BRFSS.

25. Current Smoking by Mental HealthPreliminary 2010 WY BRFSS Depression is determined from PHQ-8: Scores of 5-24= any depression, 10-24=moderate depression and 15-24 = moderately severe- severe depression.

26. Smokeless Use (Males) by Mental HealthPreliminary 2010 WY BRFSS Depression is determined from PHQ-8: Scores of 5-24= any depression, 10-24=moderate depression and 15-24 = moderately severe- severe depression. Only any depression has P<0.05 when compared with men with no depression.

27. Comparisons by Smoking and Smokeless Status (Among Males)

28. Smoking Status by Gender 2009 WY BRFSS Source: 2009 BRFSS.

29. Smoking Status by Age 2009 WY BRFSS Source: 2009 BRFSS.

30. Male Smokeless Status by Age 2009 WY BRFSS Source: 2009 BRFSS.

31. Health Status by Category of Smoker2009 BRFSS Some day smokers and smokers who quit in the past year are not shown; data available on request.

32. Health Status by Male Smokeless Use2009 BRFSS Only disability has P<0.05.

33. Health Care Access by Category of Smoker2009 BRFSS Some day smokers and smokers who quit in the past year are not shown; data available on request.

34. Health Care Access by Male Smokeless Use 2009 BRFSS Insurance status and other measures of access not shown had P>0.05.

35. Chronic Conditions by Category of Smoker2009 BRFSS Some day smokers and smokers who quit in the past year are not shown; data available on request.

36. Chronic Conditions by Male Smokeless Use 2009 BRFSS

37. Smoking Status by CVD 2009 WY BRFSS Source: 2009 BRFSS. CVD= heart disease or stroke

38. Other Risk Factors by Category of Smoker2009 BRFSS Some day smokers and smokers who quit in the past year are not shown; data available on request. Smoking is one of the CVD and cancer risk factors.

39. Other Risk Factors by Male Smokeless Use2009 BRFSS Smokeless use is a cancer RF; other RF have P>0.05.

40. Smoking and Smokeless

41. Tobacco Type Used by Gender 2009 WY BRFSS Source: 2009 BRFSS.

42. Smokeless Use by Smoking Status2009 WY BRFSS

43. Dual Users (Smokeless & Cigarettes) TrendWY BRFSS 1996-2010 Adults who smoke and use smokeless tobacco. Dotted line is trend line for men

44. Quit Data

45. Daily Smokers Who Quit 1+ Days in Past YearWY BRFSS 2000-2010

46. Serious quit attempt associations • Very few associations • Maybe those who get more physical activity • Maybe some regional differences: higher in SW and lower in Central • Maybe women slightly more than men and younger smokers more than older smokers. • Maybe those with a chronic condition

47. Other Comparisons

48. Smoking Prevalence by State, 2009

49. Male Smokeless Prevalence by State, 2009

50. County & Race2005-2009 BRFSS