best practices for tobacco control. background

Best Practices for Tobacco Control

Background

32,844

2,214

2268

3,436

3,597

5,445

7,735

7,854

10,596

33,437

43,100

All Other Causes

Suicide

Nephritis, Nephrotic Syndrome and Nephrosis

Alzheimers Disease

Pneumonia and Influenza

Diabetes Mellitus

Chronic Lower Respiratory Diseases

Accidents

Cerebrovascular Diseases

Malignant Neoplasms

Diseases of the Heart

0 10,000 20,000 30,000 40,000 50,000

LEADING CAUSES OF DEATH, TEXAS, 2001

Actual Causes of Death, Texas 2001

218

1,052

1,405

1,807

2,214

2,851

3,736

11,132

18,649

24,899

0 5000 10000 15000 20000 25000 30000

Fire

AIDS

Homicide

DWI**

Suicide

Drugs*

Auto Accidents

Alcohol*

Overweight/Obesity

Tobacco

Economic Cost

In 1998/1999, Texas Smoking-Attributable Costs = $10.09 billion Direct Medical expenditures - $4.55

billion Lost Productivity costs - $5.54 billion

In 1998, about 15% ($1,265,000,000 or $543.87 per recipient) of all Texas Medicaid expenditures were spent on smoking-related illnesses and diseases. (includes state and federal contributions to Medicaid)

Tobacco Industry Expenditures In 2005 the tobacco industry spent

$13.36 billion on advertising and promotion in the U.S. (more than $36.6 million per day)

Approximately $884.7 million was spent in Texas in 2005 (over $2.4 million every single day)

Texas Tobacco Settlement 1998 - Texas became the 3rd state

to settle with the tobacco industry Settlement represented

compensation for the state’s cost of tobacco-related disease

Texas to receive $17.3 billion over 25+ years

FY 00 -01 $1.8 billion available from the

settlement in FY 00-01 Texas Department of Health

appropriated the interest from a $200 million endowment ($9 million) per year to implement programs to reduce the use of tobacco products

Special attention to populations targeted by the tobacco industry

Texas Tobacco Task Force ReportProgram Elements and Best Practices

Community & School Programs

Media Campaigns Cessation Enforcement Efforts Targeted to

Diverse/Special Populations

Surveillance & Evaluation Research

Funding for Comprehensive Tobacco Prevention and Cessation Programs (media, provider reminder systems, telephone quitline…)

Tobacco Excise Tax Increases

Restrictions on Secondhand Smoke

Coverage for Smoking Cessation

Healthcare Provider Reminder Systems

Recommended Tobacco Interventions

Latest Results From 2000 to 2006, current use of any

tobacco products in the comprehensive program area showed a 42% reduction among middle school students (from 24.8% to 14.3%) and a 36% reduction among high school students (from 40.7% to 26.2%)

The prevalence of adult smoking in the comprehensive program area decreased 26.4% (from 21.6% in 2000 to 15.9% in 2004)

Smoking Rates for Harris & Jefferson Counties 2000-2005

Reducing tobacco use requires a comprehensive & sustained approach. Gains in Harris County regressed as

resources/efforts were reduced.

10.011.012.013.014.015.016.017.018.019.020.0

2000 2001 2002 2003 2004 2005

Year

Pre

vale

nce

Jefferson Harris

Heart Attack Deaths Decline 3 Times Faster in County with Anti-Tobacco Campaign

Heart Attack Death Rates, age-adjusted

0

20

40

60

80

100

120

140

2000 2001 2002 2003

Per

100k p

op

ula

tio

n

Harris County Jefferson County TEXAS

ROI Results from the Comprehensive Pilot Initiative (Cont.)In 2003, single year program costs

of $11.3 million ($2.71 per capita) implementing comprehensive tobacco programming in Houston and Beaumont/Port Arthur resulted in:

over 29,800 fewer adult smokers in 2003

savings of over $252 million in medical care and productivity costs over 5 years.

Projected Financial Returns from Statewide Investment in Tobacco Control

$3 per capita spending of $68.3 million for statewide program in 1 year would yield:

~164,000 fewer smokers statewide After 5 years, the single year investment of $68.3 million would achieve a cost savings of over $1.4 billion in medical care and productivity costs

Center for Health Research, Kaiser Permanente Northwest, June 2006

Tobacco Excise Tax Increases

Tobacco Price Increase Findings (Community Guide)

Results in decreases in both the number of people who use tobacco and the quantity they consume.

A 10% increase in the price of tobacco products will result in a 3.7% decrease in the number of adolescents who use tobacco and 4.1% decrease in the amount of tobacco used by the general population.

Increases in the price of tobacco products also reduce tobacco use in older adults

Restrictions on Secondhand Smoke

Second-Hand Smoke (SHS) Public Health Issue

Contains over 4,000 chemicals including 43 known carcinogens

Group A Carcinogen (like asbestos and benzene) Health Effects: Adults

Lung cancer Coronary heart disease

Health Effects: Children Lower respiratory tract infections in children < 18

months old each year Middle ear infections Asthma SIDS

Smoking Ban Findings (Community Guide) Smoking bans in workplaces observed

average of 72% reduction in exposure to components of ETS.

Effective in a wide variety of public and private workplaces and healthcare settings.

Studies evaluating smoking bans also observed reductions in the amount smoked.

PM 2.5 Austin Texas

0

0.2

0.4

0.6

0.8

1

1.2

Bar

A

PM

2.5 Before Sept 1 2005

After Sept 1 2005

Smokefreee Laws =Reduced Profits for Big Tobacco

“Financial impact of smoking bans will be tremendous – three to five fewer cigarettes per day per smoker will reduce annual manufacturer profits a billion dollars plus per year.”

Philip Morris internal document. A Smokers’ Alliance: draft. Bates Nos. 2025771934-

2025771937