Tobacco Control Update

The 10th Maryland State Council on Cancer Control

Cancer Conference

November 12, 2003

Cigarette Restitution FundProgram - Tobacco

• Administration• Media and Counter-marketing • Statewide Programs• Local Public Health Component• Surveillance and Evaluation

Purpose of Maryland’s Smoking Stops Here Program

• Making an impact on our youth is the purpose of Maryland’s Anti-Tobacco Program.

• It is not about cessation. The addictive nature of tobacco products makes it near impossible to get someone to stop smoking.

• Maryland’s Anti-Tobacco Program is about preventing our youth from starting down the deadly road.

Who are we targeting?

• Youth (13-17)• Young Adults (18-24)

• Parents with minors in household• Pregnant women• Special populations - African Americans, Latinos,

Asians

Ultimate Goal

To get Marylanders to join together to take action that ultimately will minimize the exposure of our youth/young adults to tobacco products, smoking and the dangers of secondhand smoke.

SSH Successes to Date• Over 105 non-profit organizations and coalitions

signed on to support the program

• Over 101,235 visitors to Smoking Stops Here Web site

• Over 21,545 Marylanders have pledged to take action against tobacco. Many of them are youth and young adults

• Participated in over 175 community meetings and 630 community events

What are we doing now?

•Empowering community groups

•Increasing youth participation

•Integrating Smoking Stops Here into college campuses

•Increasing exposure through healthcare and athletics

•Promoting visibility through businesses and media

Smoking Stops…In the CommunityEmpowered community groups to:

• Post activities and cessation classes on Web site

• Get permission to post decals on schools

• Initiate policy and create signs for playing fields

• Create Smoke Free bingo and pass out information in faith based establishments

• Place license plate frames on county vehicles

…At School• Increase youth participation

• Work with youth coalitions to – Support S.A.S.S. and T.R.A.S.H. groups activities

– Create youth activity sheet

– Display signs/posters

– Promote Smoking Stops Here contests and events

– Propose Smoking Stops Here community service credit for fall

– Create Youth PSA Contest

…At College• Integrate Smoking Stops Here into college

campuses

• Establish campus contacts

• Create college-specific banners

• Counter Industry with spring activity

• Develop Web site story and highlights

…In Health Care

• Increase visibility in hospitals and clinics

• Utilize health coalition contacts

• Enhance Web site with health professional stories and information

…At Play

• Increase exposure through athletics• In collaboration with local health department and

communities– Execute sponsorship program with minor league baseball– Create “Get Involved” activity sheet – Distribute HERE gear and signage– Set up displays at select events– Work with Comcast Sportsnet to develop unique

professional athlete PSA campaign– Work with Cal Ripken’s Aberdeen Ironbirds to develop kid-

focused grassroots program– Anne Arundel County Rec & Parks signage

…At Work• Promote visibility through businesses

• Develop HERE Club Card Program

• Develop presentations for prospective businesses

• Recruit businesses to join HERE Club Card program

• Distribute decals for display

• Distribute P.O.P. materials

• Maintain list of businesses for Web site posting

...In the Media

• Promote visibility through media relations

• Promote campaign’s grassroots education and community event sponsorships

• Interviews with College Stations

• Counter Industry Events

• Smoke-Free Business-Sponsored Events

• Web Site Monthly Features

HERE Co-Sponsored Events• Identify highly visible events

• Participate in events targeting youth and young adults

• Place special emphasis on sponsoring events in all four regions

• Coordinate activities with local health departments and community groups

• Deploy street teams to educate population, distribute HERE gear and literature, and collect pledges

Web Site • All calls to action send people to

http://www.SmokingStopsHere.com– Informative– Frequently updated– Easy to navigate

DHMH College Initiatives• Selected due to recent statistics tobacco on rise in

colleges• Formed Maryland Colleges and Tobacco Control

Partnership and conducted Summit• Fostering student based tobacco control coalitions • Provided funding for prevention, cessation,

tobacco free policy and social norms• Addressing campus policy, tobacco sales, and

restricting current smoking policies

DHMH Tobacco Free Sports Initiatives• Selected to target youth and young adults through

prevention, cessation, and positive role models• Several sports teams and public fields have adopted

smoke-free policies• Teams are active in county tobacco prevention and

cessation activities• Expanding effort to focus on Maryland’s Recreation

and Parks Departments

Statewide Youth Movement Against Tobacco Use

T.R.A.S.H. (Teens Rejecting Abusive Smoking Habits)• Ten groups funded by Legacy across the State• Grants focus on youth empowerment• Each group elects a youth advisory board• Conduct poster contests, counter-marketing

activities, radio and video PSA’s, and peer education

• Statewide organization• Partially funded by the Cigarette Restitution Fund• Provides legal and technical support to local health

departments, community coalitions, and individuals working on tobacco control.

• Scope of work includes: Sales Practices; Liability; Secondhand Smoke; Licensing; Enforcement

Legal Resource Center for Tobacco Regulation, Litigation & Advocacy

• Respond to Service Requests:– Draft and review local tobacco control bills and program procedures– Provide litigation support to county attorneys and others– Prepare public health officials to testify– Train and educate on legal issues (citation authority, scope of laws, best

practices, etc.) – Aid in establishing compliance check programs– Answer legal questions from public on topics such as smoke drift in

apartments and workplaces.

• Create Newsletter and Web page• Work with Tobacco Control Legal Consortium and other national

organizations

Accomplishments

• Attorneys have skills that advance local agendas:- understand the current state of laws in each jurisdiction- research laws that exist in other states- can answer legal questions (from process to enforcement)- draft legislation & enact legislation in a legally supported and valid manner so as to avoid legal challenge- empower the community to address legislators

• Attorneys have skills to protect local’s work- Strategize, trouble shoot and anticipate arguments to avoid legal problems.- Create effective enforcement programs for passed legislation - Respond to legal threats and defend against challenges.

How the Center’s Work Aids Locals

Local Public Health Component FY04 $8,000,000

• School-based• Community • Enforcement• Cessation

Local Public Health Component is guided by:

• Science

• Best Practices

• Community Input (Coalitions)

Best Practices – School-based• CDC’s Research to Classroom curricula

• Link with statewide media and community projects

• Target social influences that promote tobacco use among youth

• Involve parents and community organizations

Best Practices - Community• Increase the number of organizations

involved in planning and conducting community level programs

• Implement policies that support non-use of tobacco

• Serve people in their homes, worksites

Best Practices - Cessation• Eliminate cost barriers to treatment for the

medically undeserved and uninsured

• Implement AHCPR sponsored cessation guidelines

Best Practices – Enforcement

• Conduct Retailer Compliance Checks

• Monitor and Enforce Clean Indoor Act Regulations

FY03 Accomplishments – Cessation

• Trained 1,017 nurses, health care provides, advocates and community organizations on various cessation models.

• 5,550 adults participated in smoking cessation classes, 3,032 received nicotine patches or Zyban.

FY03 Accomplishments - Enforcement• 6,148 tobacco retailer compliance checks

• 696 citations issued to retailers for sales to minors

• 802 youth cited for illegal possession of tobacco products

FY03 Accomplishments – School-based• Trained 2,987 teachers, nurses, daycare

providers, school and college administrators on available tobacco use prevention and cessation curricula and programs.

• 117,212 students received tobacco use prevention instruction.

• 37, 553 college students received tobacco use prevention education on campus.

FY03 Accomplishments –Community

• Five jurisdictions passed local policies to restrict smoking and product placement (Caroline, Anne Arundel, Talbot, Charles, Prince Georges).

• 2,278 health care providers, parents and advocates were educated on community based tobacco use prevention programs and strategies.

• Twenty community churches were funded to incorporate tobacco prevention and cessation messages into various faith-based programs.

• 69 minority organization funded to conduct tobacco control programs.

The Changing DialogAbout Smoking in Maryland

• 95.3% of adults in Maryland either don’t smoke cigarettes or would like to quit. (84.6% and 10.7% respectively)

• Only 3.3% of adults in Maryland currently smoke and do not plan to quit.

• 1.4% of Maryland adults currently smoke and are unsure of whether they want to quit or not.

Cigarette Smoking is Down

• 30.6% decrease among middle school youth

(7.2% - 2000, 5.0% - 2002)• 23.5% decrease among high school youth

(23.0% - 2000, 17.6% - 2002)• 12.0% decrease among adults

(17.5% - 2000, 15.4% - 2002)

Cigarette Smoking is DownAmong Minority Populations

• 23.1% decrease among middle school youth

(6.5% - 2000, 5.0% - 2002)• 21.9% decrease among high school youth

(16.0% - 2000, 12.5% - 2002)• 10.3% decrease among adults

(18.5% - 2000, 16.6% - 2002)

Under-age Smoking Remains a Significant Problem

29.8%

24.0%21.9%

18.8%

13.6%

5.7%2.6%

22.6%20.4%

16.8%12.9%

8.1%

4.9%2.2%0%

5%

10%

15%

20%

25%

30%

35%

40%

6thGrade

7thGrade

8thGrade

9thGrade

10thGrade

11thGrade

12thGrade

2000 2002

Adult Smoking Remains a Significant Problem

8.9%

18.0%

24.1%

34.4%

7.9%

17.7%

22.7%24.1%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Not HS Grad HS Grad Some College College Grad

2000 2002

Future Tobacco Surveys?• Data on tobacco use behaviors at both state and local

levels is essential to the success of Maryland’s tobacco program.– Provides critical data necessary to any evaluation.

– Provides data required by the General Assembly.

– Provides data required to allocate funds to counties.

• Budget for surveys deleted in FY04 and request is consequently now “over-the-mark” for FY05.