Tobacco 21 in Kansas: Measuring the Impact KANSAS PREVENTION CONFERENCE SEPTEMBER 23, 2018

Transcription

1 Tobacco 21 in Kansas: Measuring the Impact KANSAS PREVENTION CONFERENCE SEPTEMBER 23, 2018

2 Learning Objectives 1. Participants will understand what the Tobacco 21 policy is and where it has been adopted in Kansas. 2. Participants will learn about a new study in Kansas evaluating the effects of the Tobacco 21 policy and will view data comparisons of youth in locations with and without Tobacco 21 legislation. 3. Participants will be given resources to implement advocacy approaches for local tobacco control.

3 Tobacco and Health Cigarettes are the only consumer product that, when used as intended, kill up to one-third of regular users. According to a 2014 U.S. Surgeon General s Report, tobacco products siphon off $289 billion in healthcare and lost productivity costs and lead to 500,000 deaths each year. Over 11% of youth have used tobacco products in the past 30 days. Cost of Smoking

4 Youth Tobacco Use is Common In Kansas,12% of youth aged have smoked cigarettes. In Kansas, 9% of youth aged have used smokeless tobacco. In Kansas,18% of youth aged have vaped (used e-cigarettes).

5 Addiction Occurs Early During the late teens and early 20s: The brain is still developing. The probability of nicotine addiction is especially high. 90% of adult smokers start by the age of 19. Source: Institute of Medicine, 2015.

6 Addiction Continues into Adulthood In Kansas, 17% of adults are smokers. Most smokers want to quit - 68% reported they wanted to quit completely.

7 Tobacco 21: What is it?

8 Tobacco 21 The sale and purchase of tobacco products, including alternative nicotine delivery devices and paraphernalia, limited to those 21 and over Tobacco 21 is a policy that: Raises the tobacco sales age from 18 to 21 Prevents addiction and saves lives Has been passed in communities throughout the country

9 Tobacco 21 Protects Youth Reducing older teens access to tobacco helps keep it out of the hands of younger teens. Kids who use tobacco commonly get it from people years of age. 21-year-olds are far less likely than 19-year-olds to socialize with younger teens. People who have not used tobacco by age 21 are unlikely to ever start. Source: Institute of Medicine, 2015.

10 Tobacco 21 has been successful In 2005, Needham, Massachusetts became the 1 st location in the U.S. to pass Tobacco 21 Needham, MA: : Teen smoking reduced from 13% to 7% (46% decrease) : 16 surrounding communities - Teen smoking reduced 15% to 12% (20% decrease). Smoking rate for adults is 8%, which is 56% lower than the state wide average. Rate of smoking during pregnancy is 90% lower than for the state wide average. Lung cancer is 24% lower among males and 33% lower among females compared to the state wide average.

11 Tobacco 21 Pays Off Institute of Medicine study estimated that Tobacco 21 would reduce smoking among year old by 25% and among year olds by 15%. Retail Impact of Tobacco Sales Age to 21 Years. Only estimated a 2% decrease in annual total tobacco sales due to Tobacco 21. A sales age of 21 across the U.S. would save society an estimated $212 billion over a 50-year period Institute of Medicine, Ahmad, 2005.

12 Tobacco 21: Where has it been done?

13 Tobacco 21 is the law in many U.S. states & localities 6 states have enacted Tobacco 21 laws. 200 Cities in 13 states have enacted Tobacco 21 policies. 61,559,126 people live in Tobacco 21 communities organizational endorsements.

14 Most Adults Favor Tobacco 21 75% of adults favor Tobacco21 Somewhat Oppose 14% Somewhat Favor 25% Strongly Oppose 11% Strongly Favor 50% Somewhat Oppose 16% Somewhat Favor 25% Strongly Oppose 11% Strongly Favor 48% 73% of current and former smokers favor Tobacco21

15 T21 Policy Evaluation Purpose Conduct a three-year study of tobacco use, attitudes and awareness of the Tobacco 21 initiative in targeted schools that are within and outside of cities with Tobacco 21 policies to assess any impact of the policy.

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17 KCTC Survey Administration Funded by Kansas Department for Aging and Disability Services, Behavioral Health Services Available annually free of charge to all districts, public and private Available for paper & online administration Target population is students in 6 th, 8 th, 10 th, and 12 th grades.

18 2018 KCTC County Participation

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20 KCTC Tobacco-Related Questions Lifetime Use (cigarettes, smokeless tobacco, electronic cigarettes, cigars/cigarillos/little cigars) Past 30-day Use Laws and Norms Favorable to Use (caught by police; neighbors think it would be wrong) Perceived Availability of Cigarettes (how easy would it be to get) Family History of Smoking (brothers or sisters who smoke) Peer Use (cigarettes, e-cigarettes) Risk of Harm from Cigarette, e-cigarette Use Parental attitudes (cigarettes, e-cigarettes) Favorable attitudes (cigarettes, e-cigarettes) Rewards (seen as cool) When I am an adult I will smoke cigarettes Early Initiation of Cigarette, Electronic Cigarette Use (how old were you when you first ) Source of Acquisition (cigarettes, electronic cigarettes)

21 Tobacco 21 Insert Knowledge of legal age to purchase Perception of minimum age to purchase Intentions of trying Intentions of quitting Promotion of cigarettes/e-cigarettes Specific questions related to cigars/cigarillos Risk of harm Source of acquisition Age of initiation Favorable attitudes toward use Peer use

22 T21 Policy Evaluation Study Design Originally, 34 buildings participating in T21 study Quasi-Experimental Design: 33 T21 buildings in experimental design(13 HS; 20 MS) 29 Non-T21 buildings (10 HS; 19 MS)

23 Criterion for Study Inclusion Inclusion Criteria 2014 KCTC participation of 50% or higher Matching Criteria Same grade composition Enrollment size Similar tobacco use Free/Reduced Lunch Secondary Selection Smokeless tobacco Ethnicity Race Participation Register and administer the 2018 KCTC Student Survey

24 T21 Policy Evaluation Matched Pairs of School Districts Building Type Female Male White Black Grade 6 Grade 8 Grade 10 Grade Day Cigarette Use Sample Size Non-T21 Matched Building ,642 T21 Selected Building ,312

25 Preliminary Data Knowledge of Legal Age to Purchase 60% 50% 53.33% 40% 36.73% 30% 26.65% 20% 16.98% 10% 0% Age 16 Age 17 Age 18 Age 19 Age 20 Age 21 I don't know Non-T21 T21

26 Preliminary Data- Opinion of Legal Age to Purchase 35% Do you think the minimum age to buy tobacco products should be 21? 34.0% 32.7% 32.6% 29.2% 30% 25% 20% 15% 10% 5% 21.5% 17.6% 17.1% 15.2% 0% Definitely yes Probably yes Probably not Definitely not Non-T21 T21

27 Preliminary Data Prevalence/Lifetime Use 20% 18% 16% 14% 17.3% 15.2% 12% 10.8% 10% 8% 6% 4% 2% 6.1% 5.8% 9.5% 0% Smokeless tobacco Cigarettes E-cigarettes Non-T21 T21

28 Preliminary Data Prevalence/Past 30-Day Use 15% 13% 11% 9% 9.2% 7% 5% 3% 1% 2.7% 2.7% 2.1% 2.4% 2.5% 2.5% 5.5% -1% Smokeless tobacco Cigarettes Cigars, cigarilos, or little cigars E-cigarettes Non-T21 T21

29 Preliminary Data Average Age of First Use 20.0% 12.6% 13.3% 14.3% 13.6% 13.6% 14.3% 10.0% 0.0% Cigarettes E-cigarettes Cigars or Cigarillos Non-T21 T21

30 Promotion of Cigarettes

31 Promotion of Electronic Cigarettes

32 Preliminary Data - Source of Acquisition of Cigarettes 30% 25% 20% 15% 10% 10.0% 8.3% 17.8% 15.7% 7.4% 5.6% 19.0% 13.5% 15.3% 13.9% 13.9% 11.6% 10.2% 9.6% 14.4% 13.9% 5% 0% I bought them at a vape shop or tobacco / smoke shop I bought them at a convenience store, drug store, or gas station I bought them on the Internet I gave someone else money to buy them for me I borrowed (bummed) them from someone else A person 18 or older gave them to me I took them from a store or family member I got them some other way NON-T21 T21

33 Preliminary Data - Source of Acquisition of e-cigarettes 30% 26.2% 29.0% 25% 20% 15% 10% 5% 17.1% 15.5% 6.3% 4.4% 8.9% 7.7% 8.0% 17.6% 13.7% 10.0% 5.7% 2.0% 17.0% 11.0% 0% I bought them at a vape shop or tobacco / smoke shop I bought them at a convenience store, drug store, or gas station I bought them on the Internet I gave someone else money to buy them for me I borrowed (bummed) them from someone else A person 18 or older gave them to me I took them from a store or family member I got them some other way NON-T21 T21

34 Preliminary Data- Source of Acquisition of Cigars/Cigarillos/Little Cigars 25% 20% 15% 10% 5% 10.3% 15.2% 24.5% 21.6% 2.6% 6.4% 19.4% 15.2% 10.0% 8.4% 18.1% 15.6% 3.2% 4.0% 13.5% 12.0% 0% I bought them at a vape shop or tobacco / smoke shop I bought them at a convenience store, drug store, or gas station I bought them on the internet I gave someone else money to buy them for me I borrowed (bummed) them from someone else A person 18 or older gave them to me I took them from a store or family member I got them some other way NON-T21 T21

35 Tobacco 21: How do we make it a reality for our community?

36 Make Tobacco 21 the Law We all deserve a future free from addiction.

37 T21 Strategies For Success Plan Partner Persuade

38 T21 Strategies For Success Plan Create a Tobacco 21 strategic plan. Identify key audiences (e.g., elected officials) and their values. For each audience, identify key messages that speak to shared values, key messengers (e.g., youth, parents, health care providers), and opportunities for engagement. Seek input from allies that understand the political environment.

39 T21 Strategies For Success Partner Develop or mobilize a coalition to build-community-wide support. Include diverse youth, adults, organizations, and public health leaders. Train members to implement the strategic plan. Get endorsements for Tobacco 21 from businesses and organizations. Engage community leaders who may be willing to champion the cause.

40 T21 Strategies For Success Persuade Share brief, credible messages that emphasize the benefits of Tobacco 21. Use multiple communication methods. Meet with elected officials individually. Focus on engaging officials who are undecided. Be responsive and appreciative. Make your request clear (e.g., vote yes).

41 Call to Action Find a champion for T21 (on city council). Encourage city council to explore T21. Connect with existing community coalitions, parent groups (such as PTA), youth groups, and community members who will advocate for T21. Contact Jenny Chadwick, with Ginny.Chadwick@tobacco21.org or Scott Hall hall@kcchamber.com Continue local advocacy efforts on reduce tobacco use in public places. Ask local school district(s) if they are participating in KCTC Student Survey If yes, thank them and encourage continued participation. Let them know that the data is valuable to your community. If no, encourage them to participate in KCTC Student Survey (kctcdata.org)

42 Acknowledgements Hongying (Daisy) Dai, Ph.D. Associate Professor, Department of Biostatistics College of Public Health, University of Nebraska Medical Center Delwyn Catley, Ph.D. Research Faculty for Weight Management, Department of Pediatrics Center for Children s Healthy Lifestyles & Nutrition Children s Mercy Kansas City and Professor of Pediatrics at the University of Missouri Kansas City

43 Acknowledgements Dr. Edward Ellerbeck Director of Cancer Control and Population Health Department of Preventive Medicine and Public Health at the University of Kansas Medical Center Dr. Paula Cupertino Associate Professor Department of Preventive Medicine and Public Health at the University of Kansas Medical Center and Director of JUNTOS Center for Advancing Latino Health

44 Acknowledgements Nancy White Kansas Communities That Care (KCTC) Student Survey Coordinator Greenbush The Southeast Kanas Education Service Center Ressa Friggeri Research Specialist Greenbush The Southeast Kanas Education Service Center

45 Contact Information Lisa Chaney Jamie Katz Jamie