The Burden of Tobacco, Tobacco Control, and Advocacy: Policy Strategies for Oral Health. Robert McMillen, PhD

Size: px

Start display at page:

Download "The Burden of Tobacco, Tobacco Control, and Advocacy: Policy Strategies for Oral Health. Robert McMillen, PhD"

Franklin Bennett
5 years ago
Views:

1 The Burden of Tobacco, Tobacco Control, and Advocacy: Policy Strategies for Oral Health Robert McMillen, PhD

3 Tobacco Products

4 Smokeless Tobacco and Health Cancer Oral Disease Reproductive and Developmental Risks

5 What s in Cigarette Smoke? More than 7,000 chemicals and 70 carcinogenic compounds in cigarette smoke > 70 Cancer-causing chemicals Formaldehyde Benzene Polonium Vinyl chloride Toxic metals: Chromium Arsenic Lead Cadmium Poison Gases: Carbon monoxide Hydrogen cyanide Butane Ammonia

6 More than 480,000 people who die each year from their own cigarette smoking or exposure to secondhand smoke. More than 5 million kids under 18 alive today who will ultimately die from smoking 16 million people in the U.S. who currently suffer from smoking-caused illness Source: Tobacco Free Kids

9 Reproductive Health Risks for Women Who Smoke Infertility Conception delay Pregnancy complications Menstrual irregularity Earlier menopause

10 Prenatal/Neonatal Outcomes Miscarriage Cancers Fetal death Pre-term deliveries LBW baby Ectopic pregnancy SIDS Placenta previa and placental abruption Birth Defects (cleft lip/palate, heart defects, webbing)

11 Burden of Secondhand Smoke

12 Long Term Effects of SHS Exposure Increased risk of cancers Adult leukemia and lymphoma associated with exposure to maternal smoking before age 10 Increased risk of heart disease Adult cardiovascular disease begins & progresses silently during childhood. Increased risk of neurocognitive problems incidence of learning disabilities, ADD/ADHD, behavioral difficulties

13 SHS and Children: Short Term Health Effects Respiratory tract infections such as pneumonia & bronchitis Decreased pulmonary function Tooth decay House fires

14 Heart Attacks and Strokes Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence Institute of Medicine, 2010 Data from eleven quasi-experimental studies consistently demonstrates that secondhand smoke exposure increases the risk of coronary heart disease and heart attacks and that smoking bans reduce heart attacks.

Among the findings: There is substantial evidence that except for nicotine, under typical conditions of use, exposure to potentially toxic substances from e-cigarettes is significantly lower compared

15 Among the findings: There is substantial evidence that except for nicotine, under typical conditions of use, exposure to potentially toxic substances from e-cigarettes is significantly lower compared with combustible tobacco cigarettes. There is substantial evidence that e-cigarette aerosols can induce acute endothelial cell dysfunction, although the long-term consequences are uncertain. There is substantial evidence that heart rate increases after nicotine intake from e-cigarettes. There is substantial evidence that some chemicals present in e-cigarette aerosols (e.g., formaldehyde, acrolein) are capable of causing DNA damage and mutagenesis.

16 Injury Risks of E-Cigarettes There is conclusive evidence that e-cigarette devices can explode and cause burns and projectile injuries. Such risk is significantly increased when batteries are of poor quality, stored improperly or are being modified by users. There is conclusive evidence that intentional or accidental exposure to e-liquids (from drinking, eye contact, or dermal contact) can result in adverse health effects including but not limited to seizures, anoxic brain injury, vomiting, and lactic acidosis. There is conclusive evidence that intentionally or unintentionally drinking or injecting e-liquids can be fatal.

17 Total Annual Public And Private Health Care Expenditures Caused By Smoking: Approximately $170 Billion Annual Health Care Expenditures Solely From Secondhand Smoke Exposure: $6.03 Billion Productivity Losses Caused By Smoking Each Year: $151 Billion Source: Tobacco Free Kids

18 Reducing Tobacco Use

19 Tobacco Use As an Infectious Disease

20 Tobacco Use As an Infectious Disease

21 Strategies for Reducing Tobacco Use Financial Disincentives Smoke-free Policies Tobacco 21 Hard Hitting Media Campaigns Access to Cessation Services Tobacco-Free Pharmacies Restrictions on Flavors Packaging and Warnings

22 Financial Disincentives Minimum packaging requirements Minimum pricing State and Federal Tobacco Taxes Tax equity among all tobacco & nicotine products: Not just on cigarettes, other tobacco products and e-cigarettes The federal cigarette tax increased by 62 cents to $1.01 per pack on April 1, 2009, with increases in other tobacco taxes.

23 Price Elasticity

24 Financial Disincentives Minimum packaging requirements Minimum pricing State and Federal Tobacco Taxes Tax equity among all tobacco & nicotine products: Not just on cigarettes, other tobacco products and e-cigarettes The federal cigarette tax increased by 62 cents to $1.01 per pack on April 1, 2009, with increases in other tobacco taxes.

26 Smoke-free Policies Indoor public places Multi-unit Housing Public Housing Tobacco Policy Disclosure Laws Smoke-free Cars for Children Smoke-free Hotels and Rental Cars Tobacco-free Beaches Tobacco-free Universities Tobacco-free Hospital

Cars for Children Smoke-free Hotels and Rental Cars

28 Smoke-free Policies Indoor public places Multi-unit Housing Public Housing Tobacco Policy Disclosure Laws Smoke-free Cars for Children Smoke-free Hotels and Rental Cars Tobacco-free Beaches Tobacco-free Universities Tobacco-free Hospital

29 Tobacco 21

32 Hard Hitting Media Campaigns TIPS from Former Smokers The Real Cost of Smoking The Truth Initiative

35 Impact

37 Access to Cessation Services Brief counseling by a health care provider Individual, group, or telephone counseling Behavioral therapies Treatments with more person-to-person contact and more intensity Medications Nicotine replacement products Prescription non-nicotine medications

38 Dose Response Relationship Between Number of Tobacco Cessation Advice-Sites and Likelihood of Quit Attempts To assess national rates of quit attempts by adults as associated with reports of counseling by medical and dental providers in clinical office settings Data from the 2001 and 2002 National Social Climate Survey of Tobacco Control

40 Access to Cessation Services Brief counseling by a health care provider Individual, group, or telephone counseling Behavioral therapies Treatments with more person-to-person contact and more intensity Medications Nicotine replacement products Prescription non-nicotine medications

41 Tobacco Free Pharmacies Counties and Municipalities in Massachusetts California New York

2009. Banned the sale, distribution and manufacture of cigarettes that

43 Restrictions on Flavors The Family Smoking Prevention and Tobacco Control Act (FSPTCA), also known as the Tobacco Control Act, became law on June 22, Banned the sale, distribution and manufacture of cigarettes that contain flavors other than tobacco or menthol on September 22, 2009 TobaccoFreeCA

44 Packaging and Warnings

45 Strategies for Implementing these Policies Local and statewide coalitions Champions Advocacy In the clinic and public advocacy

46 Successes

47 Concerns

48 mstobaccodata.org

Reducing Tobacco Smoke Exposure: The Role of Quitlines

Reducing Tobacco Smoke Exposure: The Role of Quitlines Robert McMillen, PhD AAP Julius B. Richmond Center of Excellence & Mississippi State University dedicated to eliminating children s exposure to tobacco