healthy people 2020 - Society for Public Health Education

✯ Conference Abstracts ✯
friday | november 5
A Decade of Progress: Tobacco Control in Mississippi
Roy Hart, MPH, CHES, Director, Office of Tobacco Control,
Mississippi State Department of Health
introduction: During the Healthy People 2010 decade, Mississippi
made substantial progress in all four Healthy People 2010 tobacco priority
areas: tobacco use in population groups, cessation and treatment,
exposure to secondhand smoke, and social and environmental changes.
in the beginning: The Mississippi Attorney General Mike Moore filed
the first lawsuit against 13 tobacco companies; making Mississippi the
first state to insist that cigarette manufacturers reimburse the state for
costs it incurred treating smoking-related illnesses. This resulted in a
$4.1 billion settlement for Mississippi and eventually a Master Settlement
Agreement for 46 states.
changing the culture: A Court-ordered tobacco prevention and
control program was implemented to reduce youth tobacco use. The
Partnership for a Healthy Mississippi was established in 1998 as a pilot
program that utilized CDC’s Best Practices for Tobacco Control Programs
to develop program components which were overseen by a Board of
Directors, including a State Health Officer. At the conclusion of the pilot
program, the Partnership for a Healthy Mississippi began receiving $20
million annually to implement tobacco prevention and control programs
which included: community coalitions, youth programs, school programs,
law enforcement, counter marketing, and surveillance and evaluation.
policy: In 2000 a tobacco-free school law was enacted. The law prohibits
the use and possession of tobacco by students and adults on any
educational property. From 2002 to present thirty-three municipalities
have enacted comprehensive smoke free air ordinances. In 2009 excise
tax on cigarettes was raised from $.18 to $.68. Most recently, in 2010
youth sporting events law was enacted. The law prohibits smoking at
organized youth sporting events.
funding challenges: Mississippi Governor, the Mississippi Healthcare
Trust Fund, and Medicaid filed a lawsuit to rescind the court order
that granted the allotment to the Partnership for a Healthy Mississippi.
The courts ruled in favor of the Governor and the allotments to the Partnership
were directed to the Mississippi Healthcare Trust Fund.
mississippi state department of health oversight: During
the 2007 Mississippi Legislative Session legislation was passed creating
the Office of Tobacco Control within the Mississippi State Department
of Health. This required the establishment of the Mississippi Tobacco
Control Advisory Council to advise the MSDH on the development and
implementation of the program. Eight million dollars was then appropriated
to MSDH for tobacco control. In January 2008, the MSDH Office of
Tobacco Control awarded funds for the following programs: Mississippi
tobacco-free coalitions, targeted interventions, youth programs, cessation
interventions, health communications, surveillance and evaluation.
results: From 1999 to 2009, the rate of current cigarette use among
Mississippi youth dropped nearly 12% from 31.5% to 19.6%.
Put It Out Rockland: A County Health Department’s Collaborative
Efforts to Surpass the Healthy People 2010 Tobacco Goals
Lisa Lieberman, PhD, CHES, Department of Health and Nutrition Sciences,
Montclair State University, Una Diffley, MPH, Rockland County Department
of Health; Sandy King, MPH, Rockland County Department of Health;
Shelley Chanler, MA, CHES, Rockland County Department of Health;
Joan Facelle, MD, MPH, County of Rockland, NY
Rockland County, NY utilized sustained government funding for its
comprehensive tobacco program over the past decade. Master Settlement
Funds, regular county revenues, and funding from the NYS Tobacco
Control Program were used by the Department of Health to create a
comprehensive and sustained program of cessation, prevention, and
policy, built upon ongoing evaluation, logic models and theory. The
Transtheoretical Model underlied the cessation program’s efforts to reach
smokers at their stage of readiness and provide tailored NRT dosing.
Social Cognitive Theory and the Health Belief Model were critical in
designing media and direct messages to address smoking in homes and
cars, and generate support for strong indoor and outdoor air policies.
The program had three overarching objectives: reduce the adult smoking
rate to 12%; reduce the percent of teens who take up smoking by 20%;
and reduce exposure to second-hand smoke by 20%. Interventions were
planned and carried out by the health department: The award winning
PIOR cessation program was offered in collaboration with schools, businesses,
non-profit agencies, and health care institutions; Schools supported
the Reality Check youth empowerment initiative and consistent tobacco
policies; Technical assistance was provided to health care providers to help
their patients quit; Schools, Headstart programs, and health care providers
promoted the EPA’s second-hand smoke campaign; the county legislature
and municipalities promoted strong indoor and outdoor air policies, such
as restricting smoking in cars with minors, and smoke-free parks and
playgrounds. Ongoing evaluation included: an annual countywide telephone
survey, and data from the annual NYS BRFSS; longitudinal evaluation of
the effectiveness of the cessation program; data from the school-based
PRIDE survey; and continuous process evaluation of all activities. The adult
tobacco use rate dropped from 16% in 2003 to 9.7% in 2009, and demonstrated
diminishing differences in tobacco use across various age, ethnic,
and gender groups. Teenage use declined by 17%, and the percent of homes
in which smoking is allowed declined by 27%. The PIOR cessation program
has served over 1000 smokers, with a one year quit rate of 33%. New efforts
based on process and outcome evaluation efforts resulted in the creation of a
one-on-one counseling version of the cessation program. The cost per capita
of tobacco prevention and cessation in Rockland was $4.54.
The Healthy People 2020 Tobacco Use Chapter: Looking Forward
Terry Pechacek, PhD, Associate Director for Science, Office on Smoking and
Health, National Center for Chronic Disease Prevention and Health
Promotion, Centers for Disease Control and Prevention, U.S. Department of
Health and Human Services
The burden of tobacco use results in death, disease, and high financial
costs. In the United States, tobacco use is the leading preventable cause of
death and disease. Smoking and exposure to secondhand smoke cause an
estimated 443,000 deaths each year. An estimated 8.6 million U.S. residents
have a serious illness caused by smoking. Smoking costs $96 billion
in medical costs and $97 million in lost productivity each year.
To address this burden, the CDC’s Office on Smoking and Health is the
leading federal agency for comprehensive tobacco prevention and control.
It is also the lead agency for the national objectives on tobacco use
for Healthy People. Healthy People 2020 is a set of science-based health
objectives for the nation to achieve over the coming decade. It identifies
areas of significant risk to our nation’s health and sets targets to reduce
these risks. The objectives are then used by many different people, states,
communities, and organizations to develop programs to improve health.
The tobacco chapter for Healthy People 2020 has 21 objectives divided
into four focus areas: Tobacco Use, Health Systems Changes, Social and
Environmental Changes, and Products. To crosswalk the objectives from
2010 to 2020, objectives were divided into the following categories:
sophe conference ✯ november 4-6, 2010 15