Campaign for Tobacco-Free Kids CHANGING TOBACCO POLICY TO REDUCE HEART DISEASE & STROKE Nichole...
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Transcript of Campaign for Tobacco-Free Kids CHANGING TOBACCO POLICY TO REDUCE HEART DISEASE & STROKE Nichole...
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
CHANGING TOBACCO POLICYTO REDUCE
HEART DISEASE & STROKE
Nichole Veatch, Vice-President, ResearchCampaign for Tobacco-Free Kids
Washington, DCOctober 21, 2015
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
• Tobacco is the leading preventable cause of death, killing more than 480,000 Americans each year– Nearly 150,000 of these deaths are from heart disease and stroke
• Tobacco causes nearly 90% of lung cancer deaths, 30% of all cancer deaths, and nearly 1/3 of deaths from heart disease
• More than 2,500 kids try their first cigarette every day– Another 580 kids become regular daily smokers every day; one-third will
die from smoking-related diseases
• Tobacco use costs the U.S. approximately $170 billion in health care expenditures annually
Tobacco’s Toll in U.S.
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Secondhand Smoke CausesHeart Disease & Stroke
CDC: “Exposure to secondhand smoke has immediate adverse effects on the cardiovascular system and can cause coronary
heart disease and stroke.”• Nonsmokers who are exposed to secondhand smoke at home
or at work increase their risk of developing heart disease by 25–30%.
• Secondhand smoke increases the risk for stroke by 20−30%.• Secondhand smoke causes nearly 34,000 premature deaths
from heart disease each year in the United States among nonsmokers.
• Secondhand smoke exposure causes more than 8,000 deaths from stroke annually.
Source: CDC, Health Effects of Secondhand Smoke
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Source: CDC, Health Effects of Cigarette Smoking
• Just 1 year after quitting smoking, risk for a heart attack drops sharply.
• Within 5 years after quitting smoking, risk for stroke could fall to about the same as a nonsmoker’s.
Quitting SmokingCuts Cardiovascular Risks
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Evidence Based Policy Solutions
• Public Policies That Protect Children, Help Smokers Quit, and Restrain the Tobacco Industry
– Tobacco Taxes– Smoke-Free Laws– Media Campaigns– Comprehensive Tobacco Prevention and Cessation
Programs – FDA Regulation of Tobacco
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Tobacco Excise Taxes“Raising prices on cigarettes is one of the most effec tive tobacco control interventions.”
“The evidence is sufficient to conclude that increases in the prices of tobacco products, including those resulting from excise tax increases, prevent initiation of tobacco use, promote cessation, and reduce the prevalence and intensity of tobacco use among youth and adults.”
— 2014 Surgeon General’s Report, The Health Consequences of Smoking: 50 Years of Progress
6
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Federal Cigarette Excise Tax + Average State Cigarette Tax
198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015
$0.00
$0.50
$1.00
$1.50
$2.00
$2.50
$3.00Federal Cigarette TaxState Average Cigarette Tax
federal rate ($1.01) +current state average
($1.60*):$2.61 per pack
1996 federal rate (24¢) + state average
(33¢):57¢ per pack
2001 federal rate (34¢) + state average
(43¢): 77¢ per pack
October 2015* Includes state cigarette tax rates in effect as of October 1, 2015.
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Smoke-Free Laws
• “. . . smokefree legislation at the state and local levels is a key component of a comprehensive tobacco control strategy.” (2014 Surgeon General’s Report)
• The Surgeon General’s Report calls for “complete protection of the entire U.S. population from exposure to tobacco smoke through comprehensive smokefree indoor air policies.” (2014 Surgeon General’s Report)
8
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Source: American Nonsmokers’ Rights Foundation
Percent of Population Covered By Smoke-Free Laws (Workplaces, Restaurants & Bars)
19901991
19921993
19941995
19961997
19981999
20002001
20022003
20042005
20062007
20082009
20102011
20122013
20142015
0
10
20
30
40
50
60
70
80
2015: 49.5%24 states and hundreds of
communities are smoke-free
1996: < 1%Comprehensive smoke-free laws
in 7 communities nationwide
11/27/2002: 3%DE becomes 1st smoke-free state
in all workplaces, restaurants and bars
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Statewide ban motivatingMinnesota smokers to quit
By JOSEPHINE MARCOTTY, Star Tribune December 11, 2007
The state-wide smoking ban is having an unadvertised consequence: More smokers are trying to quit.
Since the ban went into effect Oct. 1, the state's two largest health plans and the anti-tobacco organization ClearWay have seen a sharp spike in the number of people using nicotine replacement products and smoking cessation counseling programs.
Blue Cross and Blue Shield of Minnesota said that between September and October the number of people who enrolled for its telephone hotline counseling service jumped to 525, an increase of 43 percent. Compared to October 2006, the number of over-the-counter products like the patch and nicotine gum that it provided to members tripled to a total of 10,000 claims.
"It's doing what we like it to do," said Marc Manley, medical director for population health at Blue Cross. "Helping people decide to quit."
Medica, Minnesota's second-largest health plan, said it has also seen a 40 percent increase in the number of members seeking counseling.
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Institute of Medicine Report (2009)Secondhand Smoke Exposure and Cardiovascular
Effects: Making Sense of the Evidence
• IOM reviewed 11 publications looking at the relationship between smoke-free laws and cardiovascular events.
• Data consistently demonstrate that secondhand smoke exposure increases the risk of coronary heart disease and heart attacks.
• Based on the evidence, IOM concluded that smoke-free laws, “do, in fact, decrease the rate of heart attacks.”
Source: IOM Report Brief: Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
These findings suggest that tens of thousands of heart attacks could be prevented each year, and that states and communities that do not havecomprehensive smoke–free laws could have significant cardiovascular health benefits by doing so.
There’s no time to waste with this many lives at stake. It is time to mount a full-scale assault on the tobacco epidemic and eliminate all exposure to secondhand smoke. Smoke-free laws are one of the most readily available and cost-effective methods for preventing heart attacks, heart-disease related illnesses and deaths, and reducing health care costs.
CDC Statement on IOM Report
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Mass Media CampaignsReduce Tobacco Use
To accelerate progress in tobacco control, 2014 Surgeon General’s Report calls for specific actions, including:
“Counteracting industry marketing by sustaining high impact national media campaigns like the CDC’s Tips
from Former Smokers campaign and FDA’s youth prevention campaigns at a high frequency level and
exposure for 12 months a year for a decade or more.”
— 2014 Surgeon General’s Report, The Health Consequences of Smoking: 50 Years of Progress
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
CDC’s “Tips from Former Smokers”
• First-ever government funded national tobacco education campaign, launched March 2012
• Features real people dealing with serious long-term health effects from smoking and SHS
• 2012 Tips campaign motivated 1.6 million smokers to make a quit attempt
• 2012 Tips campaign helped more than 100,000 U.S. smokers quit for good and saved 17,000 from premature death
• Cost-effective 14cdc.gov/tips
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Comprehensive State Prevention and Cessation Programs
• State and Community Interventions
• Public Education Campaigns
• Cessation Services including Quitlines
Three Core Elements Help Prevent Initiation and Encourage and Help People to Quit
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
NYC Adult Smoking, 2002-2014
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 201410
12
14
16
18
20
22
24
26
28
30
Overall: 35.3% decline
Sm
ok
ing
Pre
va
len
ce
(%
)
NYS tax increase
Federal tax increaseNYS tax
increase
Hard-hittingmediacampaigns
Smoke-freeWorkplaces
Free patch programs start
NYC and NYStax increases
Ad Campaign/Patch Give-away National TIPS Campaign
Age of sale increase (21); comprehensive pricing & enforcement policies
Source: NYC Community Health Survey, 2002-2014
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Emerging Issues
• Raising Tobacco Sale Age to 21
• Electronic Cigarettes
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Raising the Tobacco Sale Age to 21
• Why Raise Age? • 95% of smokers start before age 21• Nicotine is addictive • Older kids/young adults are source
of cigarettes• Tobacco companies target young
adults
• IOM report released this year concludes that raising the tobacco sale age to 21 will improve public health and save lives.
• One state and at least 90 localities in 8 states have raised the tobacco sale age to 21.
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Growing World of E-Cigarettes
(images not to scale)
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
E-Cigarettes Marketing Mimics the Worst of Cigarette Marketing
TV Ads
CelebrityEndorsements
Cartoons
Kid-Friendly Flavors
MusicSponsorships
NASCAR Car Sponsorships
Branded Items
“Cigarette Girls”Countertop Displays
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
2011 2012 2013 20140%
2%
4%
6%
8%
10%
12%
14%
16%
18%
1.5%2.8%
4.5%
13.4%
15.8%
14.0%12.7%
9.2%
E-Cigarette Use Cigarette Smoking
High School E-Cigarette Use vs. Cigarette Smoking (past 30 day use)
Source: CDC, National Youth Tobacco Survey (NYTS)
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Potential of E-Cigarettes to Benefit Public Health Hinges on Unanswered Questions
1. What are the long-term health effects?2. Will they draw in youth users? How will that impact
use of other tobacco products?3. Can e-cigarettes help smokers quit completely?
Effective regulation is needed to minimize the potential harms of e-cigarettes and maximize any potential
benefits
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
Federal Regulation and State Activity on E-cigarettes
• FDA’s Proposed “Deeming Rule” issued April 25, 2014 Unsure when will be finalized
• States and localities can take their own action, but should not lose focus on policies that reduce use of traditional tobacco products
• States and Localities Are Taking Policy Action on Electronic Cigarettes Prohibit sales to youth: 48 states Smoke-free: 8 states and 400+ localities Tax: 4 states, Washington, DC and 5 localities Child-proof packaging: 17 states Flavor restrictions: 3 localities(Laws passed as of October 2, 2015)
Campaign for Tobacco-Free Kids www.tobaccofreekids.org
You Can Help
• Get Involved with State or Local Tobacco Control Coalition
• Learn more at our website: www.tobaccofreekids.org
– Join our email list: tfk.org/join
– Like us on Facebook: facebook.com/tobaccofreekids
– Follow us on Twitter: @tobaccofreekids