Continuing the Journey to a Tobacco-Free Kansas
Jeffrey Willett, Ph.D.Vice President for Programs
Infertility, impotence and pregnancy complications placenta previa, placental
abruption, premature birth, low-birth-weight infants, stillbirth, and infant death
Peptic ulcers
Periodontitis
Lower survival rate after surgery Delayed wound healing,
reduced immune response, infections, postoperative pneumonia
Smoking and Disease
Cancers Oral cavity, pharynx, larynx,
esophagus, lung, bladder, stomach, cervix, kidney, pancreas, acute myeloid leukemia
Vascular disease Coronary heart disease and
stroke, atherosclerosis, abdominal aortic aneurysm
Respiratory disease chronic obstructive pulmonary
disease, chronic coughing and wheezing, upper and lower respiratory tract infections, reduced lung function
Secondhand Smoke and Disease
• Causes 53,000 deaths per year– Immediate adverse effects on CVS– CHD and lung cancer
• No risk-free level of exposure
• Children at increased risk– sudden infant death syndrome (SIDS), – acute respiratory infections, – ear problems, – more severe asthma.
Environment
Host• Tobacco User • Potential User
Agent•Tobacco Products
Vector •Tobacco Companies•Tobacco Retailers
AddictionDiseaseDeath
In 2010, tobacco companies spent $8.5 billion nationally on marketing.
90% of tobacco marketing goes to the retail environment. Retail tobacco marketing includes paying retailers to prominently display tobacco products, in-store advertising, price discounts and other in-store promotions.
Stores are the main channel of communication for tobacco companies to reach new and current customers.
Studies have identified a clear link between retail tobacco marketing and youth smoking behaviors.
There are apparent discrepancies between self-reported youth purchase behaviors and retail sales to minor compliance data.
Tobacco companies pay retailers to put their products in the most visible location in the store: at the point of sale where they are prominently displayed.
Contracts with retailers give the tobacco industry direct control over how products are displayed and promoted at the point of sale.
Copyright ©2010 American Public Health Association
Frieden, T. R. Am J Public Health 2010;100:590-595
The health impact pyramid
fluoridated water
immunizations
treatment of hypertension
dietary counseling
Tobacco control - health impact pyramidIncreasing Individual E
ffort Need
ed
Percentage of U.S. Adults Who Currently Smoke, NHIS 1999-2010“Best Practices” Period
Tobacco Master
Settlement Agreement
Quitline Established in
Every State
48.6% of U.S. Covered by Smoke-Free
Laws1
47 States Raise
Cigarette Taxes2
States Invest$8 Billion in
Tobacco Prevention Programs2
Sources: 1 – American Nonsmokers Rights Foundation; 2 – Campaign for Tobacco Free Kids
Tobacco Industry
Marketing
Nicotine Addiction
and Product Design
Percentage of U.S. Adults Who Currently Smoke, NHIS 1999-2010“Best Practices” Period
Tobacco Master
Settlement Agreement
Quitline Established in
Every State
48.6% of U.S. Covered by Smoke-Free
Laws1
47 States Raise
Cigarette Taxes2
States Invest$8 Billion in
Tobacco Prevention Programs2
Sources: 1 – American Nonsmokers Rights Foundation; 2 – Campaign for Tobacco Free Kids
Tobacco Industry
Marketing
Nicotine Addiction and
Product Design
Healthy People 2020 Goal – 12%
Tobacco Use in Kansas
3,800 Kansas adults die each year from their own smoking
54,000 Kansas kids now under 18 will ultimately die prematurely from
smoking
$927 million in annual health care costs in Kansas are directly caused by smoking of which $196 million is
covered by the state Medicaid program
Health and Economic Impact
Current Smoking – Kansas and US* (2011)
Source: Behavioral Risk Factor Surveillance System*Median for 50 states and D.C.
Healthy People 2020 Goal – 12%
Current Smoking – Kansas and US* (2011)
Source: Behavioral Risk Factor Surveillance System*Median for 50 states and D.C.
Current Smoking – Kansas and US* (2011)
Source: Behavioral Risk Factor Surveillance System*Median for 50 states and D.C.
Percentage of Kansas HS Students Who Currently Smoke, 2000-2010
Youth Tobacco Survey: 2000, 2002, 2010; Youth Risk Behavior Surveillance System: 2005, 2007, 2009
Current Tobacco Use by Gender Kansas High School Students
Source: 2010 Kansas Youth Tobacco Survey
1. Clear public health threat2. Evidence-based interventions3. Tobacco-related revenue
Tobacco Use – A Winnable Battle
Comprehensive Smoke-Free Air Laws 2010 Kansas Indoor Clean Air Act
Raising the Retail Price of Tobacco Products KS cigarette excise tax = $0.79 (36th in nation) National average = $1.49
Funding Comprehensive Tobacco Control Programs KS state funding = $1.0 million (37th in nation) CDC recommendation = $32 million Tobacco revenues = $60 million MSA / $100 million
tobacco taxes Tobacco Cessation
Limited Medicaid coverage American Lung Association gave KS an “F”
Core Tobacco Control Strategies
“Statewide efforts should include implementing
evidence-based policy
interventions to decrease tobacco
use initiation, increase
cessation, and protect people
from exposure to secondhand
smoke.”
Community programs are essential for
advancing and implementing
powerful tobacco control interventions.
Community Supportive of
Tobacco Control
Community Education
Decision MakerEducation
Community Mobilization
Community Change