Tobacco, Alcohol and Drug Use Healthier Community Assessment 2005 101
Tobacco Use Why It Is Important Cigarette smoking is the most preventable cause of disease and death in the United States. 37 Lung cancer is the most frequent cause of cancer deaths. 38 Smoking is a huge risk factor in lung cancer and chronic lung diseases such as emphysema, heart disease and stroke. 39 People who are exposed to environmental tobacco smoke are also more likely to develop heart disease and chronic lung diseases. 40 Quitting smoking can improve overall health and reduce the risk of developing these chronic diseases. Further, smoking has many economic consequences. In 2003 it was estimated that the direct medical costs as well as those due to lost productivity cost $14,652,000,000. 41 The following charts show the smoking habits of residents who currently smoke or have smoked in the past. Figure 87: Current Smoking Status of Adults, Ages 18 and Older, 2001, San Joaquin County and 10 82.7% 83.1% 17.3% 16.9% HEALTHY PEOPLE 2010 OBJECTIVE: No more than 12% of adults ages 18 years and older will smoke cigarettes. Current Smoker Not a Current Smoker Source: 2001 Health Interview Survey, 2005. 2001 N: 372,000 Note: Question was asked of respondents ages 18 or older. 37 Great Valley Center, The State of the Great Central Valley of : Supporting the Economic, Social, and Environmental Well-being of s Great Central Valley, 2003. 38 American Lung Association, Facts about Lung Cancer, retrieved May 6, 2005 from http://www.lungusa.org. 39 40 41 American Lung Association, State of Tobacco Control, 2004. Healthier Community Assessment 2005 102
Tobacco Use (con t) Figure 88: Current Smoking Habits of Adults Who Smoke,* Ages 18 and Older, 2001, and 59.7% 59.7% 31.4% 28.2% 8.9% 12.1% Smoke Every Day Smoke Some Days Do Not Smoke Source: 2001 Health Interview Survey, 2005. 2001 N: 160,000. * Asked of adults ages 18 or older who have smoked at least 100 cigarettes (or refused or did not know if they had). Figure 89: Do you now smoke cigarettes or use smokeless tobacco everyday, some days or not at all? Figure 90: Do you now smoke cigarettes or use smokeless tobacco everyday, some days or not at all? Not At All 82.9% Everyday 13.9% Some Days 3.2% Not At All 79.7% Everyday 13.4% Some Days 6.9% N=427 N=1,944 Source: Healthier Community Assessment, Telephone Survey, 2004. Source: Healthier Community Assessment, Face-to-Face Survey, 2004. Healthier Community Assessment 2005 103
Tobacco Use (con t) What The Data Tell Us In 2001, neither nor met the Healthy People 2010 Objective that no more than 12% of adults will smoke cigarettes. In both and, approximately 17% of adults were current smokers, and approximately 83% were not. However, many adults reported that they had quit smoking. Of those who were current smokers or who had been smokers in, almost 6 reported that they no longer smoked, over 9% smoked some days and over 31% smoked every day. Of those who were current smokers or who had been smokers in, almost 6 no longer smoked, over 12% smoked some days and over 28% smoked every day. There were fewer smokers in the 2004 San Joaquin telephone and face-to-face surveys. When asked if they smoked cigarettes or used smokeless tobacco, almost 83% of adults in the telephone survey never smoked, over 3% smoked some days and almost 14% smoked every day. Similarly, when adults were asked this same question in a face-to-face survey, almost 8 never smoked, almost 7% smoked some days and over 13% smoked every day. Healthier Community Assessment 2005 104
Alcohol Consumption Why It Is Important Some research suggests that moderate drinking may be beneficial for the heart and circulatory system and may protect against type 2 diabetes. 42 In the United States, moderate drinking is usually defined as no more than two drinks per day for men and no more than one drink per day for women. 43 However, heavy drinking is detrimental to health and is a major cause of preventable death in the nation. It can damage the liver and heart and increase the chances of developing breast and some other cancers. 44 Heavy drinking is often called binge drinking which is defined as having five or more drinks on one occasion. The cost of alcohol abuse is more than $180 billion annually. 45 The following charts show the percentage of adults who drank alcohol in the past month, the average number of drinks residents drink per day and the number of times residents have engaged in binge drinking in the past month. Figure 91: age of Adults, Ages 18 and Older, Who Drank Alcohol in the Past Month, 2001, and 56.5% 59. Source: 2001 Health Interview Survey, 2005. 2001 N: 372,000. Note: Question was asked of respondents ages 18 or older. 42 Harvard School of Public Health, Nutrition Source: Alcohol, 2003. 43 44 45 Healthier Community Assessment 2005 105
Alcohol Consumption (con t) Figure 92: Number of Times Respondents Had Five or More Drinks on One Occasion in Past Month, Adults Ages 18 and Older, 2001, and 10 72.6% 73.7% HEALTHY PEOPLE 2010 OBJECTIVE: No more than 6% of adults ages 18 years and older will engage in binge drinking. 13.4% 10.7% 3.6% 5.7% 2.1%* 2.5% 2.7% 2.7% 5.6% 4.6% 0 Times 1 Time 2 Times 3 Times 4 Times 5 or More Times Source: 2001 Health Interview Survey, 2005. * Statistically unstable due to low number of respondents. For 2001 for adults having five or more drinks on one occasion two times, the confidence interval was 0.5% 3.7%. Caution should be used with these data. 2001 N: 210,000. Note: Asked of adults ages 18 or older who have had an alcoholic beverage in the past month. Considering all types of alcoholic beverages, during the past Figure 93: 30 days about how many times did you have more than 5 drinks on one occasion? 10 86.9% 80.6% Telephone Survey (N=428) Face-to-Face Survey (N=1,824) 4.4% 5.6% 2.5% 4.5% 1.9% 1.5% 1.5% 1.7% 4.8% 1.6% 1.3% 1.4% Never 1 Time 2 Times 3 Times 4 Times 5 Times More than 5 times Source: Healthier Community Assessment, Telephone Survey and Face-to-Face Survey, 2004. Healthier Community Assessment 2005 106
Alcohol Consumption (con t) What The Data Tell Us During 2001 in both and, about 6 of adults ages 18 and older reported drinking alcohol in the past month (57% and 59%, respectively). When asked about binge drinking drinking five or more drinks on one occasion the greatest percentage of respondents in both and (73% and 74%, respectively) indicated they did not engage in binge drinking at all in the past month. Similarly in 2004, most respondents to the Healthier San Joaquin telephone and face-to-face survey reported never drinking five or more alcoholic beverages on one occasion in the past month (87% and 81%, respectively). However, in 2001, 27% of CHIS respondents reported binge drinking in the past 30 days, and in 2004, 13% of telephone survey respondents and 19% of faceto-face survey respondents reported binge drinking in the past month. The Healthy People 2010 Objective is that no more than 6% of adults ages 18 years and older will engage in binge drinking. According to the San Joaquin data, this goal was not met. Healthier Community Assessment 2005 107
Adult Drug and Alcohol Related Arrests Why It Is Important The drug and alcohol arrest rate is an indicator of alcohol and drug abuse and related illegal activities. Adults engaging in drinking and driving and illicit drug use put themselves and others at great risk. Illicit drug and alcohol use and abuse is associated with violence, motor vehicle accidents, increasing health care costs and lower worker productivity. 46 The following chart shows the arrest rate per 1,000 adults ages 18 69 for felony and misdemeanor drug arrests, followed by the arrest rate for adults driving under the influence. Figure 94: Adult Felony and Misdemeanor Drug Arrest Rate per 1,000 Adults, Ages 18 69, and 8 Rate per 1,000 6 4 5.9 5.8 4.8 6.2 6.2 6.0 5.5 5.3 5.5 4.8 4.7 4.7 5.9 5.1 5.8 3.9 3.8 3.5 3.5 3.9 2 1999 2000 2001 2002 2003 - Felony - Felony - Misdemeanor - Misdemeanor Source: State of, Department of Justice, Criminal Justice Profile, 2004. Note: Felony drug arrests include felony-level arrests for narcotics, marijuana, dangerous drugs and other drugrelated arrests. Misdemeanor drug arrests include misdemeanor-level arrests for marijuana and other drugs. 46 Great Valley Center, The State of the Great Central Valley of : Supporting Economic, Social, and Environmental Well-being in s Great Central Valley, 2003. Healthier Community Assessment 2005 108
Adult Drug and Alcohol Related Arrests (con t) Figure 95: Adult Misdemeanor Driving Under the Influence Arrest Rate per 1,000 Adults, Ages 18 69, and 12 10 10.1 10.2 11.5 10.5 11.4 Rate per 1,000 8 6 8.4 8.0 7.6 7.5 7.7 4 1999 2000 2001 2002 2003 Source: State of, Department of Justice, Criminal Justice Profile, 2004. What The Data Tell Us In and, the rate of drug-related felony arrests for adults was higher than misdemeanor drug arrests from 1999 to 2003. The felony drug arrest rate in San Joaquin County was consistently higher than that of the state, while the misdemeanor drug arrest rate was consistently lower than s rate. The rate of adults arrested on misdemeanor charges for driving under the influence (DUI) was higher than that of the state over the same time period. Further, while the state DUI rate declined from 1999 to 2003, the rate for increased from 10.1 per 1,000 adults in 1999 to 11.4 in 2003. Healthier Community Assessment 2005 109