Tobacco Health Effects and

Best Practices in Tobacco Control

Tobacco Use: Scope of the Problem

Tobacco use is the leading preventable cause of disease and premature death in the U.S. and the world

1,400 deaths in Montana each year 430,000 deaths annually in U.S.

1,200 each day 5 million world wide

Scope of the Problem Cont.

There are approximately 1.25 billion smokers in the world, and 800 million of these live in the developing world.

By 2020 10 million people in the world will die of tobacco related illnesses

Montana Youth Tobacco Use

Ever tried a cigarette

Ever smoked daily *Chew/dip/snuff *Cigars, cigarillos *Any tobacco use

*past 30 days

1999 200570.3 55.4

23.2 15.215.2 8.220.4 17.645.0 31.4

Adults

In Montana 21.1% of all adults smoke cigarettes and 6% use spit

tobacco

The Real Marlboro Man

Everyone Has To Die Sometime...But Not Like This

Smoking related illness and death can occur at any age. The young man in thisphoto started smoking at age 13. He died at age 34 from lung cancer brought on by smoking.

Each year, secondhand cigarette smoke is responsible for:• 37,000 deaths from heart disease in adults• 3,000 deaths from lung cancer in adults• 13,000 deaths from other cancers in adults• 300,000 cases of lung infections, such as

pneumonia and bronchitis, in infants and young children

200 death per year in Montana

Secondhand Cigarette Smoke

Secondhand Smoke Effects

What can be done about this?

Best Practices for Comprehensive Tobacco

Control Programs

Goal of comprehensive tobacco control programs is to reduce disease, disability, and death related to tobacco use by:

Preventing the initiation of tobacco use among young people

Promoting quitting among young people and among adults

Eliminating nonsmokers’ exposure to environmental tobacco smoke

Identifying and eliminating the disparities related to tobacco use and its effects among different population groups

Comprehensive,Sustainable and Accountable

CDC recommends a minimum of $9.3 million for prevention programs in MT

Currently, there is about $6.3 million each year allocated specifically for prevention

In order for a program to be successful, it must include essential components

Nine Components of Comprehensive Tobacco Control

Community Programs

Chronic Disease Programs

School Programs Enforcement

Statewide Programs

Counter-Marketing Cessation Programs Surveillance and

Evaluation Administration and

Management

1. Community Programs to Reduce Tobacco Use

To achieve individual behavior change that supports the nonuse of tobacco, communities must change the way tobacco is promoted, sold and used while changing peoples knowledge, attitudes and practices.

Community Components Continued

Programs involve: People in their homes Work sites Schools Places of worship Entertainment Civic organizations etc.

Examples of Programs

Engaging young people to plan and conduct events and campaigns

Educational Programs for medical personnel, schools, daycares, & city officials

Secondhand smoke campaigns

Examples continued

Smoking cessation programs by drug and alcohol prevention agencies in addition to medical facilities

Include Native American Community and educate about tobacco use and media literacy

Role of Health Communication

2. Chronic Disease Programs to Reduce the Burden of Tobacco-Related Diseases

Even if current tobacco use stopped, the residual burden of disease among past users would cause disease for decades to come

Communities can focus attention directly on tobacco related disease to prevent them and detect them early and addressing additional risk factors

Examples of Chronic Disease programs Community interventions that link tobacco

control interventions with cardiovascular disease prevention

Develop counter-marketing to increase awareness of ETS as a trigger for asthma

Train dental providers to counsel their patients on the role of tobacco use in the development of oral cancer

Expand cancer registries to monitor tobacco related cancers

Role of Health Communications

3. School Programs School program activities include

implementing CDC’s Guidelines for School Health Programs

This includes: tobacco-free policies, evidence-based curricula, teacher training, parental involvement, cessation services and linking efforts with local community coalitions and statewide media and educational campaigns

Example of School based programs Best Practices curriculum such as

Implementations of Life Skills Training or Towards No Tobacco Use

Linking school-based efforts with local coalitions and counter advertising programs.

Media Literacy Training Tobacco Free Schools Policy

Role of Health Communications

4. Enforcement

There are two primary policy areas: restrictions on minors’ access to tobacco and on smoking in public place

Example of Enforcement Policy No one under 18 allowed to purchase

tobacco No one under 18 allowed in any bar or

casino where smoking is allowed No smoking allowed in any restaurants

(some bars and casinos are exempt) No tobacco products allowed on any

public school ground or at public school event

Role of Health Communications

5. Statewide Programs

Statewide programs increase the capacity of local programs by providing assistance on evaluating programs, promoting media advocacy, implementing smoke-free policies, and reducing minors access to tobacco

MTUPP’s role Statewide meetings for Contractors Regional quarterly meetings Advocacy calls on a bi-monthly basis Daily e-mails that provide up to date

information on tobacco issues from around the world

Contracts with Strategicom, M&R Strategic Services, Quitline,etc

6. Counter-Marketing

Marketing strategies to counter pro-tobacco influences and increase pro-health messages and influences throughout a state, region, or local community. Counter marketing consists of a wide range of efforts, including: paid television, radio, billboard, and print

Examples of Counter Marketing

Television spotswww.thetruth.com CDC clips

Print ads

Local Examples of Counter Marketing

More Examples

7. Cessation Programs

Strategies to help people quit smoking can yield significant health and economic benefits. Effective strategies include: brief advice by medical providers, counseling, and pharmacotherapy.

Local Cessation Efforts

Quitline 1-866-485-6868 Information and materials to

medical professionals Hospital-based programs at

Deaconess Billings Clinic and the VA

8. Surveillance and Evaluation A surveillance and evaluation

system monitors programs for accountability for state policymakers and other responsibilities for fiscal oversight. State evaluation efforts should be coordinated with federal tobacco surveillance programs such as SAMHSA’s National Household Survey on Drug Abuse.

Montana Evaluation

Statewide Monitoring and Evaluation Group

TFY Action Plan State Deliverables TFY Quarterly Report Standardized Data Sources

9. Administration and Management

An effective tobacco control program requires a strong management structure to facilitate coordination of all of these program components.

In Montana, it is the Montana Tobacco Use Prevention Program that provides the fiscal and program management.

The ability to “read” or “decode” messages in a

variety of print and electronic media.

Media Literacy:Media Literacy:

Why Teach Media Literacy?

Media is a force that determines culture and peoples’ behavior

Why Teach Media Literacy?Media has a powerful influence on our lives,

and especially in the development of our children. It can shape young people’s beliefs and their sense of self and understanding of the world around them…By empowering our young people with a better understanding of the media, we can help them control their relationship with the vast array of media messages they receive in their everyday environment. Hillary Clinton, 1996 Conference on Media in

Education

Kids watch between 3 and 4 hours of television each day.

QuickTime™ and aCinepak decompressor

are needed to see this picture.

QuickTime™ and aCinepak decompressor

are needed to see this picture.

Direct instruction is the best way to counteract the influence of media

I want to take kids’ natural tendency to rebel, and have them apply it - do some critical thinking - so they’ll make choices to rebel against the people that are selling them addictive lifestyles.

Peter DeBenedittis, Ph.D.

ResearchFour studies in New Mexico indicate:

Statistical analysis of survey results showed that media literacy presentations helped students question the reality of what they saw in the media.

Students were less likely to believe the hyperbole presented in alcohol and tobacco advertising, and they were less likely to identify favorably with the people they saw on TV

Image available at:http://

www.trinketsandtrash.org

Who paid for the media?

Who is being targeted?

What messages and values are expressed?

What kind of lifestyle is presented? Is it glamorized? How?

Deconstruction

Who paid for the media? Why?Who is being targeted?What text, images or sounds lead you to this conclusion?What is the text (literal meaning) of the message?What is the subtext?What kind of lifestyle is presented? Is it glamorized? How?What values are expressed?What tools or techniques of persuasion are used?What story is not being told? In what ways is this a healthy and/or unhealthy media message?

Student Created Ads

Student Created Ads

Websites

Coordinated School Health Program: www.cdc.gov/healthyyouth/CSHP/

Preventing Drug Abuse for Parents and Teachers: http://www.nida.nih.gov/parent-teacher.html

California Based Guide to Healthy Schools and Children http://www.gettingresults.org/

New Mexico Media Literacy Project: http://www.nmmlp.org/

Center for Media Literacy: http://www.medialit.org/Teen Health and the Media:http://depts.washington.edu/thmedia/http://www.optimalhealthconcepts.com/FergusHS.pdfhttp://www.optimalhealthconcepts.com/LewistownDrugs.pdfhttp://www.optimalhealthconcepts.com/Lewistown.htm

Websites

Jackie Lloyd and Ernie Randolfiwww.OptmalHealthConcepts.comPrevention@OptimalHealthConcepts.com

For More Information:

Jackie Lloyd, MSU-B, 657-2927

Katie Mayer, YCCHD, 651-6437