Maryland Tobacco Control Program Successes. Donald Shell, MD, MA Interim Director DHMH, Center for Health Promotion Education, Tobacco Use Prevention

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1 Maryland Tobacco Control Program Successes Donald Shell, MD, MA Interim Director DHMH, Center for Health Promotion Education, Tobacco Use Prevention

2 Monitoring Changing Tobacco Use Behaviors

3 Good news! Reduction in Cigarette Smoking Significant reduction in cigarette smoking from 2000 to 2010 across all age groups: Nearly 40% decrease among underage high school youth Over 25% decrease among adults Over 33% decrease among pregnant women

4 % Ever Smokers Who Quit Smoking By Age Group (Maryland BRFSS) 100% 90% 80% 70% % 71.8% 74.5% 80.3% 81.1% 89.3% 60% 53.8% 55.2% 59.1% 50% 43.9% 47.2% 40% 34.3% 30% 24.4% 20% 17.5% 10% 0%

5 Maryland Tobacco Quitline Maryland Tobacco Quitline Year 5 Evaluation Report: Quit and Satisfaction 97.7% were satisfied with the Quitline 7-day responder Quit Rate = 32.0% 30-day responder Quit Rate = 27.9%

6 Quitline Promotional Materials

7 Tri-fold Secondhand Smoke Brochures In English and Spanish

8 Secondhand Smoke Prevention Media

9 Quitline Media Upcoming TV media: December 26 th Secondhand smoke prevention Quitline promotion Quitline testimonials

10 On the Horizon Medicaid Match for the Quitline Behavioral Health/Mental Health and Substance Abuse Cessation initiatives ADAA enforcement FDA grant Community Transformation Grant

11 Recent Literature Seven-Year Patterns in US Cigar Use Epidemiology Among Young Adults Aged Years: A Focus on Race/Ethnicity and Brand - AJPH October 2011 Top five smoked brands are cigarillos/little cigars Higher prevalence in younger, male, Black-NH Propensity for risk behavior Current cigarette, marijuana and blunt use

12 The decline in adult cigarette smoking in Maryland has stalled 25% 20% 20.5% 15% 14.9% 15.2% 15.2% 10% 5% 0% Civilian, non-institutionalized adults, aged 18 years of age and over, who currently smoked cigarettes. Source: CDC-Maryland Behavioral Risk Factor Surveillance System Surveys,

13 Local Variation in Tobacco Use Suggests Need for Action Tailored to Community Needs Maryland public high school youth less than eighteen years of age. Source: Maryland Youth Tobacco Survey, 2010 Monitoring Changing Tobacco Use Behaviors: , Maryland Department of Health and Mental Hygiene (November, 2011)..

14 We know what works Sustained funding of comprehensive programs Excise tax increases 100% smoke-free policies Aggressive media campaigns Cessation access Comprehensive advertising restrictions Restricted access to tobacco products (time, place, and manner)

15 Underage Youth Tobacco Use Problem The younger the age of smoking initiation, the greater the risk for nicotine dependence/addiction and lifelong risk of developing smoking-related cancers and disease. Delaying the age of experimentation with tobacco until adulthood will reduce the risk of becoming regular smokers and increase the chances of successfully quitting if they do become a regular smoker.

16 Underage Youth Tobacco Use Problem Fruit and candy flavored tobacco products mask the harsh taste of tobacco, making it easier for youth to begin, and to continue using tobacco at an early age. Raising awareness of these products, as well as reducing the access and attractiveness of tobacco products will help in reducing experimentation.

17 Underage High School Cigarette Smoking Maryland: % 25% 23.0% 20% 15% 18.7% 14.7% 15.3% 14.1% 10% 5% 0% Source: Maryland Youth Tobacco Survey

18 Age of Initiation Initiation of Cigarette Smoking in Maryland 40% 35% 30% 25% 20% 15% 10% 5% 0% % % % 5. 7 % 1. 9 % 0. 7 % < 12 Years Old Years Old Years Old Years Old Years Old 30 Years Old or A ge A t Which Smo ked F irst Who le C igarette Older

19 Underage Youth Risk Behaviors Underage youth who use tobacco are also much more likely to be engaged in other risk behaviors as compared to their nonsmoking peers.

20 Underage Youth Risk Behaviors Nearly 78% of high school smokers are also using alcohol, as compared to 25% of non-smokers. Almost 70% of high school smokers are also using marijuana, as compared to 13% of non-smokers. Many young tobacco users use cigarettes concurrently with cigars or other tobacco products and over 76% of high school cigar smokers are smoking flavored products.

21 High School Youth Tobacco Use by County

22 State Health Improvement Plan (SHIP) Vision Area: Preventing Chronic Disease Objective 32: Reduce Adult Cigarette Smoking Objective 33: Reduce Youth Tobacco Use

23 Comprehensive Cancer Control Plan (CCCP) - Lung Cancer and Tobacco Use - Goals Substantially reduce tobacco use and exposure to secondhand smoke by high-risk Maryland adults and youth. Implement the CDC s Best Practice recommendations (2007) for Maryland s Comprehensive Tobacco Control Program. pter5tobacco.pdf

24 Cancer Plan Objectives Adopt and implement statewide and local policies that combat tobacco-industry marketing strategies used to promote and sustain the use of existing and emerging tobacco products. Reduce current use of tobacco among Maryland high school youth and high-risk adults who do not have a four-year college degree. Increase the percentage of youth not exposed to secondhand smoke indoors and in motor vehicles. Focus Tobacco Program efforts on the most impactful, evidence-based programs and strategies.

25 Strategies to address youth cigar use Objective 1: Adopt and implement statewide and local policies that combat tobacco-industry marketing strategies used to promote and sustain the use of existing and emerging tobacco products. Strategy 1: Amend Maryland s definition of cigarettes to include little cigars. Strategy 5: Adopt State and Local policies that restrict the sale, advertising and promotion of tobacco products.

26 Meeting Overview Morning: Maryland 2010 Data Report American Legacy Foundation Cigar Study FDA Family Smoking Prevention and Tobacco Control Act Review Afternoon: Panel: Evidence-based Strategies to Reducing Tobacco Use LRC, CTFK, OAG Launch of new DHMH media campaign! What can be done at the local level

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