Comprehensive Local Tobacco

Control Programs

Putting Together the Local

Tobacco Control and

Prevention Puzzle

■ Tobacco use is America’s

single most preventable cause

of death and disease

■ It is also the largest modifiable

risk factor for chronic disease

■ Tobacco-related illness eats up

75% of healthcare dollars spent

in the U.S.

Why Tobacco Control?

Source: Anderson, G. et al. (2004)

■ In 2004, tobacco addiction

cost the nation almost $200

billion in medical expenses

and lost productivity

■ In 2005, the Society of

Actuaries estimated that the

effects of exposure to

secondhand smoke cost the

U.S. $10 billion per year

Source: CDC (2007)

Why Tobacco Control? (continued)

1-4

■ Local governments have a statutory responsibility to

address tobacco use as a dominant threat to the

health of their communities, especially among

vulnerable populations:

● Those experiencing tobacco-related disparities

● Youth

● Persons with lower levels of education

● People with substance abuse issues

Local Responsibility

■ Response to the tobacco

problem varies widely

depending on availability of

funds

■ Local politics and pressure from

the tobacco industry have also

influenced the degree of

government involvement

Local Response

■ Gives the U.S. Food and Drug

Administration (FDA) the authority to

regulate tobacco

■ Will greatly change the tobacco

marketing and sales environment in this

country

■ Taking full advantage of the provisions

of the FDA legislation will strengthen

local tobacco control programs

2009 Family Smoking and Prevention

Tobacco Control Act

■ New restrictions on tobacco marketing to children

■ Enhanced enforcement of the federal prohibition on

sales to persons younger than 18

■ No vending machine sales or self-service displays of

cigarettes or smokeless tobacco except in adult-

only facilities

■ No branded product tie-ins, such as T-shirts, with

purchases

2009 Family Smoking and Prevention

Tobacco Control Act—Provisions

■ No free samples of cigarettes or smokeless

tobacco products, except in certain

restricted situations

■ No outdoor advertising within 1,000 feet or

schools, parks, or playgrounds

■ No sponsorship of athletic or cultural

events by tobacco product manufacturers,

distributors, or retailers

■ All advertising at point of sale must be

black text on white background only

Source: CTFK, Campaign for Tobacco Free Kids (2009)

2009 Family Smoking and Prevention

Tobacco Control Act—Provisions (cont.)

■ Effective community programs involve and influence

people in their homes, work places, schools, and

public places.

■ Community interventions influence societal

organizations, systems, networks, and social norms to

help many people make behavior changes

Sources: CDC (2007); CDC (2000b)

Community Interventions: Rationale

■ To achieve individual behavior change,

whole communities must change the way

tobacco products are marketed, sold,

and used

■ Changing policies takes the involvement

of community partners and buy-in from

local decision-makers

■ Local coalitions have been a powerful

and effective tool

SMOKE FREE CHATTANOOGA COALITION

Community Involvement

■ Establishing partnerships with local organizations

■ Educating decision-makers about changing systems

and environments to de-normalize tobacco use

■ Encouraging policies that support tobacco use

prevention and cessation

Examples of Community Interventions

■ Developing and implementing tobacco-free school

grounds policies

■ Promoting risk-reduction curricula, teacher training,

and in-school cessation support services

School-Based Community

Interventions

■ Media messages can also

have a powerful influence

on public support for

tobacco control policy and

help bolster school and

community efforts

Health Communications: Rationale

Sources: CDC (2000a); CDC (2000b); Farrelly, M. C., Pechacek, T. F., Thomas, K. Y., and

Nelson, D. (2008); Frieden, T. R., Bassett, M. T., Thorpe, L. E., and Farley, T. A. (2008);

Goldman, L. K., and Glantz, S. A. (1998); McAlister, A., Morrison, T. C., Hu, S., Meshack, A. F.,

Ramirez, A., Gallion, K., et al. (2004)

Your

Message

Here

2-13

■ More than 2/3 of adult smokers report a desire to quit

■ More than 40% of smokers try to quit each year

■ Current estimates: most smokers who try to quit will

do so several times before succeeding

■ Both tobacco dependence and desire to quit appear

to be prevalent across racial and ethnic groups

Source: Fiore, M. (2008)

Cessation Interventions: Rationale

2-17

■ Supporting evidence-based tobacco cessation

interventions in the community

■ Promoting systems-level changes to more effectively

track tobacco use by patients and to more

consistently refer tobacco users to cessation services

■ Increasing the use of culturally sensitive, linguistically

appropriate cessation interventions for specific

underserved populations

Examples of Cessation Strategies

More Spending = Less Smoking

Sm

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I. The message is:

We as community must change the culture of acceptance (or tolerance)

of tobacco use and secondhand smoke in order to make real progress.

―Top 5 Reasons We Should

Care About Tobacco Use

and Prevention‖

•What should the culture of tobacco in Chattanooga be in 3 years, or 5

years? What role do we have to impact that culture….?

•Will we still have smoking on school grounds and properties? (Today

there is a 50‖ feet rule from an entrance, but faculty and staff can smoke

on grounds and students report observing this.) After regular hours, the

guidance is more lax.

• Knox County established all school property as tobacco-free in January

of 2008. A School Board member stated: ―Popular teachers who smoke

and serve as role models to students could unintentionally encourage

students to smoke‖.

II. “If nothing changes, nothing changes.”

■ Youth, especially 12-17, and 18-24 are the primary targets of tobacco

advertising (9.6 billion per year). Most youth when they first try tobacco

don’t plan to continue for life, but only to ―experiment‖ but find themselves

hooked in a very short smoking experience – sometimes only a few

episodes.

■ In TN, 46.9% of 18-24 years olds smoke (38% for U. S. A.): 25.5% of TN High

School students, 20% for entire country.

■ Our community example, our parental examples and our voluntary public

policies matter.

III. ―Tobacco is not a product of choice, it is a

product of addiction.‖

■ ―Consumption of tobacco products will be prohibited on company property,

including offices, sidewalks, parking lots, streets and all VW vehicles.‖ And

Volkswagen will provide smoking cessation assistance to employees.

■ One fact to remember: For every $1.00 Tennessee takes in revenue, the state

spends at least $8.00 in related healthcare and other costs.

■ The Chattanooga Times’ recent editorial detailed the major reasons Tennessee is

―losing the smoking wars‖. The solutions are not a secret. Many states have

drastically cut smoking rates in both adults and adolescents. The wheel doesn’t

have to be re-invented. But action has to be taken and funding put where it was

intended.

IV. One of our newcomers to the area and a great

corporate example in this area, Volkswagen, has

already – proactively - established a strong

comprehensive workplace tobacco policy.

■ The Campaign for a Healthy and Responsible Tennessee (C.H.A.R.T.), First

Things First, Smoke Free Chattanooga and all our partners need and

welcome your help and input.

■ Objective surveys show Tennesseans overwhelmingly support the law and

better control of tobacco.

■ The facts are on our side. Let’s increase our motivation and willingness to

work to impact - in a major way – the most preventable cause of death and

disease in our nation – more than is caused by alcohol and drugs,

homicides, suicides, motor vehicle accidents and AIDS combined every

year. That’s over 430,000 deaths annually in this country.

V. Get Involved