Welcome to s 9 th Annual Best Practices Conference Medical and Clinical Interventions and Systems Change to Support Smoking Cessation January 22, 2015 Turf Valley Resort Ellicott City, MD
Overview of the Conference Theme: Medical and Clinical Interventions and Systems Change to Support Smoking Cessation Welcome & Introductions Maryland Tobacco Data Updates: Current Statewide Adult and Youth Tobacco Use Prevalence Keynote Presentations: Dr. Chad Morris, Ph.D. National Lessons Learned: Integrating Tobacco Cessation into Behavioral Health Practices Dr. Nancy Rigotti, M.D. Integrating Tobacco Cessation into Health Care Delivery Systems: Strategies for Inpatients, Outpatients, and Populations
Lunchtime Updates Current and Upcoming Legislation Kathleen Hoke, JD & William Tilburg, JD, Legal Resource Center for Public Health Policy, University of Maryland, Baltimore, Francis King Carey School of Law Updates on DHMH Initiatives Dawn Berkowitz, MPH, CHES, Director, Center for Tobacco Prevention & Control, Maryland Department of Health and Mental Hygiene 4 th Annual Fax to Assist Award of Recognition Presented by Dr. Carlo DiClemente, Director, MDQuit
Afternoon Workshops Early Afternoon Workshops (1:30pm to 2:30pm) Workshop A: Best Practices in Smoking Cessation in Medical Settings Nancy Rigotti, MD, Panel Moderator Workshop B: Peer Mentors to Promote Smoking Cessation in Persons with Serious Mental Illness Faith Dickerson, PhD Workshop C: Youth Prevention: Products and Trends among Middleand High-School Youth Carlo DiClemente, PhD
Afternoon Workshops Late Afternoon Workshops (2:30pm to 3:30pm) Workshop D: Challenges, Barriers, and Promising Practices for Behavioral Health Smoking Chad Morris, PhD, Panel Moderator Workshop E: FDA Regulation of Tobacco Products Kathleen Hoke, JD and William Tilburg, JD Workshop F: Tobacco Use and Cessation Among LGBT Populations Erik Augustson, PhD
CEUs We would like to thank Michelle Darling and her staff at the Maryland Behavioral Health Administration s OWDT for sponsoring 6 Continuing Education Units (CEUs) for this conference. Please turn in your evaluation of the conference in order to receive your CEU certificate. All participants will receive 6 CEUs for attending.
OWDT - BHA s CEUs The Office of Workforce Development and Training (OWDT) for the Behavioral Health Administration (BHA) is approved to grant Continuing Education Units by the organizations listed below: Alcohol and Drug Counselors The Maryland Board of Professional Counselors and Therapists and the Maryland Addictions Professional Certification Board (MAPCB). Social Workers and Certified Professional Counselors The Maryland State Board od Social Work Examiners has approved all OETAS courses for Category 1 CEU. Psychologists The State Board of Examiners of Psychologists.
Folders Housekeeping Agenda Bios of Keynote Presenters & Select Articles Evaluation Housekeeping Sheet Map of Conference Venue MDQuit Staff Restrooms
Clicker Technology Overview We would like to share information using our clicker technology. Immediate Audience Response Device Anonymous Radio Frequency- you don t have to point it at anything! Just hit the number / letter you choose & it will appear in the LCD screen You can change your response by just hitting a different number but only one response will record per person!
Current Statewide Adult & Youth Tobacco Use Prevalence: Maryland Adult & Youth Tobacco Data Carlo C. DiClemente, Ph.D. Director of MDQuit
The century-long epidemic of cigarette smoking has caused an enormous avoidable public health tragedy. Since the first Surgeon General s report in 1964 more than 20 million premature deaths can be attributed to cigarette smoking. (U.S. Surgeon General s Report, 2014)
Effects of Smoking (DHHS, 2014)
How many U.S. deaths per year can be attributed to cigarette smoking? 1. 180,000 2. 280,000 3. 380,000 4. 480,000 0% 0% 0% 0% 1 2 3 4
Annual U.S. Deaths Attributable to Smoking Other Diagnoses 61,141 Other Vascular Diseases 11,500 Lung Cancer 130,659 About 480,000 U.S. Deaths Attributable Each Year to Cigarette Smoking (DHHS, 2014) Cerebrovascular Disease (Stroke) 15,300 Other Heart Disease 25,500 COPD 100,600 Coronary Heart Disease 99,300 Other Cancers 36,000 * Average annual number of deaths 2000 2004 (CDC, 2012) (CDC, 2013)
Approximately how many U.S. adults currently smoke cigarettes? 1. 10% 2. 14% 3. 18% 4. 22% 0% 0% 0% 0% 1 2 3 4
U.S. Adult Tobacco Use According to most recent estimates*, 17.8% of all adults in the United States currently smoke cigarettes. This equates to roughly 42 million adults who smoke today. *Estimates based on 2013 National Health Interview Survey (NHIS) data
2013 Adult Current Smoking Prevalence: National (NHIS) and Maryland (BRFSS) Data Percent (%) Current Smokers 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% National 17.8% Maryland 16.4%
True of False: Current smoking prevalence is higher among adult Maryland males than among adult females. 1. True 2. False 0% 0% 1 2
2013 Adult Smoking Prevalence by Gender: National (NHIS) and Maryland (BRFSS) Data Percent (%) Current Smokers 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% 20.50% National 15.30% 19.40% Maryland 13.70% Males Females
2013 Adult Smoking Prevalence by Education: National (NHIS) and Maryland (BRFSS) Data Percent (%) Current Smokers 35.00% 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% 33.20% 24.30% 22% 23.60% 20.90% 17.70% 9.10% 6.60% Less than HS Graduate HS Graduate Some College College Graduate National Maryland
Hispanic adults in Maryland are smoking cigarettes... 1. At significantly higher rates as Hispanics in the national sample 2. At roughly the same rate as Hispanics in the national sample 3. At significantly lower rates as Hispanics in the national sample 0% 0% 0% 1 2 3
2013 Adult Smoking Prevalence by Race: National (NHIS) and Maryland (BRFSS) Data Percent (%) Current Smokers 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% 26.50% 24.70% 19.40% 18.30% 16.80% 17.40% 12.10% 11.00% 9.60% 9.50% White Black Hispanic Asian Other National Maryland
10 Years of Maryland Adult Cigarette Smoking (BRFSS, 2003-2013) 25 Percent (%) Current Smokers 20 15 10 5 20.1 19.5 18.9 17.7 17.1 14.9 15.2 15.2 19.1 16.2 16.4 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Between October 2013 & June 2014, what percentage of Maryland Quitline callers currently using e-cigarettes reported using e-cigarettes to quit or cut down on other tobacco products? 1. 45% 2. 65% 3. 85% 4. 95% 0% 0% 0% 0% 1 2 3 4
E-Cigarette/Vapor Use by Maryland Adult Quitline Callers (10/1/13 6/30/14) Currently using E-Cig/Vapor 416 Reason Cut down on other tobacco 156 Quit other tobacco 196 Neither 60
Youth Tobacco Use Data
In the U.S., what percentage of current adult smokers began at or before the age of 18? 1. 70% 2. 80% 3. 90% 4. 100% (CTFK, 2013) 0% 0% 0% 0% 1 2 3 4
90% of all adult smokers began at or before the age of 18. (CTFK, 2013)
High School Students
In 2013, how many underage U.S. high school youth in Maryland reported any* past month tobacco use? 1. 8.9% 2. 13.9% 3. 16.9% 4. 20.9% (Data Source: Youth Risk Behavior Survey, 2013) * Includes cigarettes, cigars, bidis, kreteks, pipes, smokeless 0% 0% 0% 0% 1 2 3 4
Maryland High School Youth Tobacco Use In 2013, 16.9% of Maryland high school students reported current (past month) tobacco use. (Data Source: Youth Risk Behavior Survey, 2013) Each Year 4,200 Maryland youth become new daily smokers (CTFK, 2014)
True or False: Maryland High School Youth who identify as Gay, Lesbian, or Bisexual smoke at higher rates than Heterosexual High School Youth. 1. True 2. False Source: 2013 Maryland Youth Risk Behavior Survey 0% 0% 1 2
Current Use of Any Tobacco Product by Sexual Identity Status Maryland High School Students (YTRBS, 2013) 35.6% Percent (%) Current Users 40 30 20 10 0 14.4% Heterosexual Gay, Lesbian, Bisexual
Trends in Maryland High School Youth Tobacco Use (YRBS, 2005-2013) Key: = Decrease = No Change = Increase Source: MD YRBS Report (DHMH, 2014)
Middle School Students
Current Use of Tobacco Products Among Middle School Youth: National (NYTS, 2012) -vs- Maryland (YTRBS, 2013) 15 Percent (%) Current Users 10 5 0 3.5% 3.9% 4.2% 2.8% 3.0% 1.7% Cigarettes Cigars Smokeless Tobacco National Maryland
Where do we go from here? Recognize Maryland s reduction in youth tobacco use rates from 2000 to 2012. Focus on local public health strategies to address cessation and prevention by utilizing efforts that are: school- and community-based, carry enforcement elements, allow for surveillance and evaluation. Consider attending Workshop C! Strengthen and Enforce Smoke/Tobacco-Free Policies Numerous hospital campuses, college/universities, parks, beaches and other recreational venues have gone smoke/tobacco-free in Maryland Consider attending Workshops A & E!
Where do we go from here? Combat the misconception that the tobacco epidemic has been solved with continued evidence-based and innovative strategies. Focus on behavioral health populations, pregnant women, and low socio-economic populations who have been resistant to past efforts. Consider attending Workshops B & D! Explore sub-populations of tobacco users where non-existent and stronger, evidence-based strategies need to be developed Consider attending Workshop F!