Upload
christopher-harrington
View
218
Download
2
Tags:
Embed Size (px)
Citation preview
U.S. Department of Health and Human Services
Tobacco Control:
A Winnable Battle
U.S. Department of Health and Human Services Centers for Disease Control and Prevention
The 50th Anniversary Surgeon General’s Report (SGR) has added new health consequences of smoking
Source: The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014
The list grows for health consequences of secondhand smoke exposure
Source: The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014
Tobacco use is still the leading preventable cause of disease and death in the U.S.
42.1 million U.S. adults smoke Tobacco causes nearly 1 in 5 deaths in U.S.
• >480,000 deaths/year, >1,300/day For each death, it is estimated that 30 more suffer
tobacco-related illnesses Annual costs: $133 billion in medical expenses plus
$156 billion in lost productivity Many Americans left unprotected, especially
service industry workers• 24 states still lack comprehensive smoke-free laws
Tobacco Deaths Compared to other Causes
Source: World Health Organization
Source: The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014
Tobacco Use and Chronic Disease
Sources: Adapted from Warner 1985 with permission from Massachusetts Medical Society, ©1985; U.S. Department of Health and Human Services 1989; Creek et al. 1994; U.S. Department of Agriculture 2000; U.S. Census Bureau 2013; U.S. Department of the Treasury 2013. *Adults ≥18 years of age as reported annually by the Census Bureau.
Adult Per Capita Cigarette Consumption and Major Smoking-and-Health Events—United States, 1900-2013
Note: Estimates since 1992 include some-day smoking.Sources: 1955 data from Current Population Survey (CPS); 1965-2013 data from National Health Interview Survey (NHIS)
0
10
20
30
40
50
60
Men Women
Year
Pe
rce
nt
(%)
54.2%
2013
24.5%
20.5%
15.3%
Current cigarette smoking among adults aged
≥18 years, by sex—U.S., 1955-2013
Cigarette Smoking Among Adults aged ≥18, by Race/Ethnicity – United States,
2002-2013
Source: National Survey on Drug Use and Health, 2002-2013.
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 20130
10
20
30
40
50
60
28
22.7
28.2
23.025.0
16.8
38.436.5
19.4
8.5
White, Non-Hispanic Black, Non-Hispanic Hispanic
American Indian/Alaska Native, Non-Hispanic Asian, Non-Hispanic
Year
Pe
rce
nt
(%)
Smoking Prevalence(percent)10.0 – 12.9
13.0 – 15.9
16.0 – 18.9
19.0 – 21.9
22.0 – 24.9
WY
OR
ID
MT
WA
ND
IA
SD
MN
OH
MI
IN
PA
ME
NY
IL
WI
VT
D.C.
NJ
MDDE
NH
CTRI
MA
AZ
UTNV
CA
TX
AROK
LA
KS
NE
CO
NM
MO
TN
AL
KY
MS GA
FL
WV VA
NC
SC
AK
HI
* Persons who have smoked at least 100 cigarettes in lifetime and currently report smoking every day or some days. Source: Behavioral Risk Factor Surveillance System (BRFSS)
25.0 – 27.3
Current cigarette smoking* among adults aged
≥ 18 years, by state—U.S., 2013
Heart disease deaths are closely aligned with smoking
Source: Vital Records; National Center for Health Statistics, CDC, 2011- 2013
Impact of a Comprehensive Approach:Adult Cigarette Smoking Rates in NYC
1994—2013
Source: CDC. Decline in Smoking Prevalence -- New York City, 2002—2006. MMWR. 2007. 56(24);604-608; and https://a816-healthpsi.nyc.gov/epiquery/
0
5
10
15
20
25
Perc
en
t of
ad
ult
s w
ho s
moke
cig
are
ttes
3-yr. average
21.6% 21.5% 21.7%
21.6%
19.2%18.3%
18.9%
17.5%16.9%
15.8%
City and State tax increases
Smoke-freeworkplace
TV ad campaign
15.8%
14.0%14.8%
15.5%
16.1%
NYS and Federal tax
increaseNYS tax increase
Free patch
programs start
Long-term impact of a comprehensive approach:Lung and bronchus cancer incidence rates in CA
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.
MPOWER
Source: WHO Report on the Global Tobacco Epidemic, 2008 - The MPOWER package.
We know what works
Sustained funding of comprehensive programs
Excise tax increases 100% smoke-free policies Aggressive media
campaigns Cessation services access Comprehensive advertising
restrictions
Tobacco Industry is Outspending Prevention Efforts 18:1
Campaign for Tobacco Free Kids, Federal Trade Commission, 2012 Tax Burden on Tobacco Report, CDC's Best Practices for Comprehensive Tobacco Control Programs.
Best Practices 2014
http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm
National Recommended Funding Levels, by Program Component
National Recommended
InvestmentTotal
State and Community
Interventions
Mass-Reach Health Communication
InterventionsCessation
InterventionsSurveillance
and EvaluationInfrastructure,
Administration, and Management
Total Level ($ millions) $3,306.3 $1,071.0 $532.0 $1,271.9 $287.7 $143.7
Per Person $10.53 $3.41 $1.69 $4.05 $0.92 $0.46
Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs — 2014. Atlanta: U.S.Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic DiseasePrevention and Health Promotion, Office on Smoking and Health, 2014.
When tobacco control funding increases, high school smoking decreases
Source: Project ImpacTEEN; University of Illinois at Chicago; State University of New York at Buffalo; Youth Risk Behavior Survey, 1993-2009.
* Adjusted to 2009 CPI.† High school students (grades 9-12) who smoked on 1 or more of the 30 days preceding the survey.
When cigarette prices increase, cigarette sales decrease
Source: ImpacTeen Chartbook: Cigarette Smoking Prevalence and Policies in the 50 States.
Increased tobacco excise taxesincrease price
10% increase in cigarette prices 4% drop in adult cigarette consumption*
Youth much less likely to start smoking when prices are high
Adjust taxes to offset inflation and tobacco industry attempts to control retail prices• E.g., promotional discounts for retailers who reduce
cigarette prices Tobacco taxes are the single most effective component of
a comprehensive tobacco control program
*Chaloupka FJ, Straif K, Leon ME. Effectiveness of tax and price policies in tobacco control. Tobacco Control 2011;20(3):235–8. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of theSurgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention,National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
Smoke-free policies save lives Prevent heart attacks
• Up to 17% average reduction in heart attack hospitalizations in places that enact comprehensive smoke-free laws
Help motivate smokers to quit Worker safety issue – not “personal nuisance”
• All workers deserve equal protection• Only way to protect non-smokers from secondhand
smoke Smoke-free workplace laws don’t hurt business No trade-off between health and economics
State Smoke-Free Air Laws – Effective March, 2015
Centers for Disease Control and Prevention’s State Tobacco Activities Tracking and Evaluation (STATE) System. Available at: http://apps.nccd.cdc.gov/statesystem/Default/Default.aspx. Washington, DC is included in states. California’s law includes exemptions that preclude it from being considered smoke-free.
Source: CDC STATE System
Comprehensive Smoke-Free Laws
United States2000-2014
How far we have come
Aggressive media campaigns work
Media campaigns work to: Reduce youth initiation Encourage cessation Increase negative attitudes toward
tobacco use Increase support for policy change
The impact of cessation services
Currently: 42.1 million U.S. smokers• 70% of adult cigarette smokers want to quit• More than 50% try to quit each year, 4 – 6% succeed.• Only 2% call state or national quitlines• Medicaid coverage for cessation varies widely among
states
Tobacco cessation can be achieved through:• Significant tax and price increases• Comprehensive smoke-free policies• Aggressive counter-advertising
State and federal policy activities (2009 – 2013)
Excise Tax Increases
• 25 cigarette tax increases Smoke-Free Policies
• 26 states and DC have achieved comprehensive status Federal Legislation
• Federal excise tax increase
• Family Smoking Prevention and Tobacco Control Act
• Prevent All Cigarette Trafficking (PACT) Act
• Affordable Care Act
This is a Winnable Battle
U.S. Department of Health and Human Services Centers for Disease Control and Prevention
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.