Primary Prevention of Cancer Primary Prevention of Cancer Tobacco - - PowerPoint PPT Presentation

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Primary Prevention of Cancer Primary Prevention of Cancer

Tobacco Use Prevention & Cessation Tobacco Use Prevention & Cessation

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Overview Overview

• POLICY OVERVIEW – Joan Stine

Introduction Goals and strategies Public policy

• PROGRESS REPORT – Bob Fiedler

Objectives Progress Report - Data

• STATEWIDE INITIATIVES – Dawn Berkowitz

Quitline (1-800-QUIT-NOW) Youth Initiatives Counter-marketing and media

• COUNTY-LEVEL INITIATIVES – Lawrence Carter

Local Public Health Component initiatives

• POLICY OVERVIEW – Joan Stine

Introduction Goals and strategies Public policy

• PROGRESS REPORT – Bob Fiedler

Objectives Progress Report - Data

• STATEWIDE INITIATIVES – Dawn Berkowitz

Quitline (1-800-QUIT-NOW) Youth Initiatives Counter-marketing and media

• COUNTY-LEVEL INITIATIVES – Lawrence Carter

Local Public Health Component initiatives

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POLICY OVERVIEW POLICY OVERVIEW

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Goals Goals

Substantially reduce tobacco use by

Maryland adults and youth.

Substantially reduce Maryland youth and

adult exposure to secondhand smoke.

Substantially reduce tobacco use by

Maryland adults and youth.

Substantially reduce Maryland youth and

adult exposure to secondhand smoke.

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Strategies Strategies

• Establish a public policy framework that:

1.

Consistently seeks to discourage the initiation of tobacco use;

2.

Encourages those who use tobacco to quit; and

3.

Complements and supports programmatic efforts to reduce the use of tobacco products.

• Implement and sustain a comprehensive

programmatic framework that discourages the initiation of tobacco use and encourages cessation.

• Establish a public policy framework that:

1.

Consistently seeks to discourage the initiation of tobacco use;

2.

Encourages those who use tobacco to quit; and

3.

Complements and supports programmatic efforts to reduce the use of tobacco products.

• Implement and sustain a comprehensive

programmatic framework that discourages the initiation of tobacco use and encourages cessation.

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Maryland Policy Environment Maryland Policy Environment

Creating/ Sustaining Programmatic Framework

General Fund support for initial tobacco use prevention

and cessation program (1993)

‘Cigarette Restitution Fund’ as recipient of all tobacco-

related litigation proceeds

‘Minimum’ program funding for Governor’s annual budget

• f $21 million (subject to ‘holdbacks’ and budget cuts)

Statutory CDC ‘Best Practices’ Program Structure

Statewide Public Health Component Surveillance & Evaluation Component Counter-marketing/Media Component Administrative Component Local Public Health Component

Creating/ Sustaining Programmatic Framework

General Fund support for initial tobacco use prevention

and cessation program (1993)

‘Cigarette Restitution Fund’ as recipient of all tobacco-

related litigation proceeds

‘Minimum’ program funding for Governor’s annual budget

• f $21 million (subject to ‘holdbacks’ and budget cuts)

Statutory CDC ‘Best Practices’ Program Structure

Statewide Public Health Component Surveillance & Evaluation Component Counter-marketing/Media Component Administrative Component Local Public Health Component

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Maryland Policy Environment Maryland Policy Environment

Maryland, Pre-Settlement:

• Retailers must be licensed
• Sale of clove cigarettes banned
• Minimum age to purchase/possess

tobacco products – 18 years old

Federal, Post-FDA Legislation:

• FDA ban on fruit, candy, or clove

flavored cigarettes

Maryland, Pre-Settlement:

• Retailers must be licensed
• Sale of clove cigarettes banned
• Minimum age to purchase/possess

tobacco products – 18 years old

Federal, Post-FDA Legislation:

• FDA ban on fruit, candy, or clove

flavored cigarettes

Maryland, Post-Settlement:

• Cigarettes must be ‘fire-safe’
• Ban on the sale of single cigarettes
• Minimum package size, 20 cigarettes
• Ban on Internet/Telephone sales of

cigarettes

• Ban on vending machine sales except

at adult locations

• Maryland ban on ‘candy-like’ products

containing tobacco

• Three (3) increases in excise tax since

settlement, now $2 per pack

Maryland, Post-Settlement:

• Cigarettes must be ‘fire-safe’
• Ban on the sale of single cigarettes
• Minimum package size, 20 cigarettes
• Ban on Internet/Telephone sales of

cigarettes

• Ban on vending machine sales except

at adult locations

• Maryland ban on ‘candy-like’ products

containing tobacco

• Three (3) increases in excise tax since

settlement, now $2 per pack

Policy Framework Achievements - Cigarettes

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Maryland Policy Environment Maryland Policy Environment

Maryland, Pre-Settlement:

Minimum age to purchase or possess

tobacco products – 18 years old

Maryland, Pre-Settlement:

Minimum age to purchase or possess

tobacco products – 18 years old

Maryland, Post-Settlement:

One (1) increase in excise tax, now

15% of wholesale price (equivalent to $0.33 per pack of cigarettes)

Maryland, Post-Settlement:

One (1) increase in excise tax, now

15% of wholesale price (equivalent to $0.33 per pack of cigarettes)

¢ Policy Framework Achievements – Cigars & Other Products

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Maryland Policy Environment Maryland Policy Environment

Maryland, Pre-Settlement:

Regulatory ban on smoking inside 85%

• f worksites

Regulatory ban on smoking inside

restaurants not possessing liquor license, designated smoking areas in remainder

Maryland, Pre-Settlement:

Regulatory ban on smoking inside 85%

• f worksites

Regulatory ban on smoking inside

restaurants not possessing liquor license, designated smoking areas in remainder

Maryland, Post-Settlement:

Statutory ban on smoking at all indoor

worksites

Statutory ban on smoking inside all

restaurants

Statutory ban on smoking inside all

bars

Provision for “waivers” expires 2011

Maryland, Post-Settlement:

Statutory ban on smoking at all indoor

worksites

Statutory ban on smoking inside all

restaurants

Statutory ban on smoking inside all

bars

Provision for “waivers” expires 2011

¢ Policy Framework Achievements – Secondhand Smoke

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Cancer Plan Policy Goals Cancer Plan Policy Goals

Enhanced access to

cessation Services

Comprehensive Clean

Indoor Air Legislation

Increase excise tax on

cigarettes to $1.50

Enhanced access to

cessation Services

Comprehensive Clean

Indoor Air Legislation

Increase excise tax on

cigarettes to $1.50

• Fund Program at least at

minimum CDC recommended levels

• Enhance program

activities

• Continuous Evaluation of

State and local program

• Civil youth access

enforcement legislation

• Fund Program at least at

minimum CDC recommended levels

• Enhance program

activities

• Continuous Evaluation of

State and local program

• Civil youth access

enforcement legislation

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Program I mpact and Sustainability Program I mpact and Sustainability

$13.79 $2.00 $0.89 $0.23 $0.31 $0.49 $0.02 $0.10

$0 $2 $4 $6 $8 $10 $12 $14 $16

Medical Costs MD Excise Tax Settlement Revenue CDC Minimum CDC Recommended CDC Upper MD Statutory Minimum Maryland's FY2009 Investment in Tobacco Control

Per Pack of Cigarettes Sold in FY 2009

Selected Costs and Expenditures Calculated Per Pack of Cigarettes Sold in Maryland (FY 2009)

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STATUS REPORT:

TOBACCO USE I N MARYLAND

Bob Fiedler

STATUS REPORT:

TOBACCO USE I N MARYLAND

Bob Fiedler

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Behavior Target: Reduce Cigarette Smoking Behavior Target: Reduce Cigarette Smoking

2008 Objectives for Cigarette Smoking

• Reduce Middle School

smoking to less than 6.2%

2000 MYTS Baseline – 7.3%

• Reduce High School smoking

to less than 20.3%

2000 MYTS Baseline – 23.7%

• Reduce Adult smoking to

less than 15.0%

2000 MATS Baseline – 16.9%, 2008 12.4%, - 26.6% 2000 BRFSS Baseline – 20.5%

2008 Objectives for Cigarette Smoking

• Reduce Middle School

smoking to less than 6.2%

2000 MYTS Baseline – 7.3%

• Reduce High School smoking

to less than 20.3%

2000 MYTS Baseline – 23.7%

• Reduce Adult smoking to

less than 15.0%

2000 MATS Baseline – 16.9%, 2008 12.4%, - 26.6% 2000 BRFSS Baseline – 20.5%

2008 Actual

3.5% 15.3% 14.9%

2008 Actual

3.5% 15.3% 14.9%

Relative Change

• 52.1%
• 35.4%
• 27.3%

Relative Change

• 52.1%
• 35.4%
• 27.3%

Sources: Maryland Youth and Adult Tobacco Surveys, 2000 and 2008. Behavioral Risk Factor Surveillance System (BRFSS) 2000, 2008.

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Adult Use of Tobacco Products Adult Use of Tobacco Products

20.5% 5.9% 1.1% 21.9% 5.9% 1.0% 19.5% 17.7% 5.1% 1.1% 14.9% 4.0% 1.3%

0% 5% 10% 15% 20% 25% 30% 35% Cigarette Cigar Smokeless

2000 2002 2004 2006 2008

20.5% 5.9% 1.1% 21.9% 5.9% 1.0% 19.5% 17.7% 5.1% 1.1% 14.9% 4.0% 1.3%

0% 5% 10% 15% 20% 25% 30% 35% Cigarette Cigar Smokeless

2000 2002 2004 2006 2008

Sources: Behavioral Risk Factor Surveillance System (BRFSS) 2000-2008, Maryland Adult Tobacco Survey (MATS) 2000-2008.

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Adult Cigarette Smoking State Rankings Low to High, 2000 and 2008 Adult Cigarette Smoking State Rankings Low to High, 2000 and 2008

0% 5% 10% 15% 20% 25% 30% 35%

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51

'2000 '2008

0% 5% 10% 15% 20% 25% 30% 35%

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51

'2000 '2008 Sources: Behavioral Risk Factor Surveillance System (BRFSS) 2000, 2008.

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Current Adult Cigarette Smoking by Jurisdiction & Region Current Adult Cigarette Smoking by Jurisdiction & Region

12.6% 11.5% 10.8% 10.5% 5.8% 22.6% 20.4% 20.3% 19.3% 17.9% 17.7% 16.7% 16.7% 16.1% 16.1% 16.0% 15.6% 15.3% 14.6% 13.7% 13.0% 12.2% 11.4% 7.2% 18.0% 17.4% 15.9% 14.9% 12.7% 10.0% 0% 5% 10% 15% 20% 25% 30% 35% 40%

Somerset Allegany Caroline Cecil Talbot Worcester Wicomico Baltimore City Kent Charles Calvert

• St. Mary's

Dorchester Queen Anne's Baltimore Co. Washington Prince George's Frederick Anne Arundel Harford Garrett Carroll Montgomery Howard Upper Eastern Shore Lower Eastern Shore Southern Maryland Western Maryland Metro Baltimore Suburban Washington

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Adult Cigarette Smoking By Age Group - 2008 Adult Cigarette Smoking By Age Group - 2008

27.8% 20.5% 24.7% 22.9% 17.9% 7.4% 19.0% 17.2% 13.7% 17.7% 13.8% 8.3%

0% 5% 10% 15% 20% 25% 30% 35% 18-24 25-34 35-44 45-54 55-64 65+

27.8% 20.5% 24.7% 22.9% 17.9% 7.4% 19.0% 17.2% 13.7% 17.7% 13.8% 8.3%

0% 5% 10% 15% 20% 25% 30% 35% 18-24 25-34 35-44 45-54 55-64 65+

Sources: Behavioral Risk Factor Surveillance System (BRFSS)2000, 2008.

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Adult Cigarette Smoking By Race - 2008 Adult Cigarette Smoking By Race - 2008

17.2% 21.7% 21.0% 7.9% 16.4% 15.8%

0% 5% 10% 15% 20% 25% 30% 35% Hispanic Black/ African-American White

17.2% 21.7% 21.0% 7.9% 16.4% 15.8%

0% 5% 10% 15% 20% 25% 30% 35% Hispanic Black/ African-American White

Sources: Behavioral Risk Factor Surveillance System (BRFSS) 2000, 2008.

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Adult Cigarette Smoking By Educational Attainment - 2008 Adult Cigarette Smoking By Educational Attainment - 2008

34.3% 28.8% 21.7% 10.6% 29.0% 21.7% 17.8% 7.0%

0% 5% 10% 15% 20% 25% 30% 35% Less than HS Grad HS Grad/ GED Some College College Grad

34.3% 28.8% 21.7% 10.6% 29.0% 21.7% 17.8% 7.0%

0% 5% 10% 15% 20% 25% 30% 35% Less than HS Grad HS Grad/ GED Some College College Grad

Sources: Behavioral Risk Factor Surveillance System (BRFSS) 2000, 2008.

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Adult Cigarette Smoking By Annual Income - 2008 Adult Cigarette Smoking By Annual Income - 2008

33.3% 27.8% 23.6% 25.4% 16.2% 11.3% 19.4% 22.0% 21.1% 26.3% 0% 5% 10% 15% 20% 25% 30% 35%

< $15,000 $15k - $24,999 $25k - $34,999 $35k - $49,999 $50,000+

33.3% 27.8% 23.6% 25.4% 16.2% 11.3% 19.4% 22.0% 21.1% 26.3% 0% 5% 10% 15% 20% 25% 30% 35%

< $15,000 $15k - $24,999 $25k - $34,999 $35k - $49,999 $50,000+ Sources: Behavioral Risk Factor Surveillance System (BRFSS) 2000, 2008.

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Underage Use Of Tobacco Products Underage Use Of Tobacco Products

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Current Cigarette Smoking Current Cigarette Smoking

16.7% 23.0% 20.5% 11.7% 18.7% 21.9% 19.5% 8.5% 14.7% 17.7% 7.5% 15.3% 14.9%

0% 5% 10% 15% 20% 25% 30% 35% Middle School High School Adults

2000 2002 2004 2006 2008

16.7% 23.0% 20.5% 11.7% 18.7% 21.9% 19.5% 8.5% 14.7% 17.7% 7.5% 15.3% 14.9%

0% 5% 10% 15% 20% 25% 30% 35% Middle School High School Adults

2000 2002 2004 2006 2008

Sources: Behavioral Risk Factor Surveillance System (BRFSS) 2000-2008, Maryland Youth Tobacco Survey (MYTS) 2000-2008.

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Current Cigarette Smoking by Underage HS Youth, by Jurisdiction & Region Current Cigarette Smoking by Underage HS Youth, by Jurisdiction & Region

10.9% 11.1% 12.6% 12.9% 16.2% 16.2% 16.8% 17.2% 17.3% 17.8% 17.8% 18.3% 18.3% 19.7% 21.5% 21.8% 22.8% 23.2% 23.3% 23.5% 23.9% 25.1% 25.2% 25.8% 11.7% 16.4% 16.7% 19.9% 23.1% 23.4%

0% 10% 20% 30% 40% 50% 60%

Prince George's Montgomery Howard Baltimore City Frederick Calvert Charles

• St. Mary's

Harford Wicomico Carroll Anne Arundel Baltimore Co. Dorchester Somerset Cecil Allegany Washington Worcester Queen Anne's Talbot Caroline Kent Garrett Suburban Washington Metro Baltimore Southern Maryland Lower Eastern Shore Upper Eastern Shore Western Maryland

2008

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Current Cigar Smoking Current Cigar Smoking

4.6% 12.5% 5.9% 3.5% 11.0% 5.9% 2.9% 9.2% 5.1% 4.2% 15.4% 4.0%

0% 5% 10% 15% 20% 25% 30% 35% Middle School High School Adults

2000 2002 2004 2006 2008

4.6% 12.5% 5.9% 3.5% 11.0% 5.9% 2.9% 9.2% 5.1% 4.2% 15.4% 4.0%

0% 5% 10% 15% 20% 25% 30% 35% Middle School High School Adults

2000 2002 2004 2006 2008

Sources: Behavioral Risk Factor Surveillance System (BRFSS) 2000-2008, Maryland Youth Tobacco Survey (MYTS) 2000-2008.

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Current Use of Smokeless Tobacco Current Use of Smokeless Tobacco

2.1% 4.7% 1.1% 2.1% 5.2% 1.0% 1.9% 4.8% 1.1% 1.7% 5.2% 1.3%

0% 5% 10% 15% 20% 25% 30% 35% Middle School High School Adults

2000 2002 2004 2006 2008

2.1% 4.7% 1.1% 2.1% 5.2% 1.0% 1.9% 4.8% 1.1% 1.7% 5.2% 1.3%

0% 5% 10% 15% 20% 25% 30% 35% Middle School High School Adults

2000 2002 2004 2006 2008

Sources: Behavioral Risk Factor Surveillance System (BRFSS) 2000-2008, Maryland Youth Tobacco Survey (MYTS) 2000-2008.

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Underage Maryland

Public Middle & High School Youth, By Grade

Current Cigarette Smoking

Underage Maryland

Public Middle & High School Youth, By Grade

Current Cigarette Smoking

2.6% 5.7% 13.6% 18.8% 21.9% 24.0% 29.8% 1.5% 3.4% 5.7% 20.7% 17.8% 13.2% 11.6% 0% 5% 10% 15% 20% 25% 30%

6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade

2000 2008

Sources: Maryland Youth Tobacco Survey (MYTS) 2000-2008.

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Underage Maryland

Public Middle & High School Youth, By Grade

Current Cigarette Smoking

Underage Maryland

Public Middle & High School Youth, By Grade

Current Cigarette Smoking

1.8% 3.1% 6.2% 10.7% 13.6% 16.1% 20.6% 1.5% 3.4% 5.7% 20.7% 17.8% 13.2% 11.6% 0% 5% 10% 15% 20% 25% 30%

6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade

2006 2008

Sources: Maryland Youth Tobacco Survey (MYTS) 2000-2008.

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Current Use of ‘Flavored’ Cigar Product, 2008 Current Use of ‘Flavored’ Cigar Product, 2008

2.1% 9.7% 1.6% 9.9% 8.6% 9.7%

0% 5% 10% 15% 20% 25% 30% 35%

Middle School High School Adult HS Black/African‐ American HS Hispanic HS White

Sources: Maryland Adult Tobacco Survey (MATS), 2008 and , Maryland Youth Tobacco Survey (MYTS), 2008.

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Current Use of ‘Flavored’ Cigar Product By Current Cigar Smokers, 2008 Current Use of ‘Flavored’ Cigar Product By Current Cigar Smokers, 2008

37.0% 58.7% 40.7% 46.9% 28.7% 63.0% 41.3% 59.3% 53.1% 71.3% 0% 20% 40% 60% 80% 100%

High School Adult HS Black/ African‐ American HS Hispanic HS White Unflavored Only Flavored

Sources: Maryland Adult Tobacco Survey (MATS), 2008 and Maryland Youth Tobacco Survey (MYTS), 2008.

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Underage Youth Reporting Current Alcohol Drinking by Smoking Status Underage Youth Reporting Current Alcohol Drinking by Smoking Status

27.0% 80.6% 26.8% 79.9% 0% 20% 40% 60% 80% 100% Non‐Smokers Current Smokers

% D r a n k A l c o h o l P a s t 3 0 D a y s 2006 2008

Sources: Maryland Youth Tobacco Survey (MYTS) 2006 and 2008.

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Statewide I nitiatives

Dawn Berkowitz

Statewide I nitiatives

Dawn Berkowitz

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Elements of Statewide Tobacco Program Elements of Statewide Tobacco Program

• Maryland Tobacco Quitline: 1-800-QUI T-NOW
• Legal Resource Center for Tobacco Regulation, Litigation & Advocacy
• Maryland Resource Center for Quitting Use & I nitiation of Tobacco
• Maryland Teens Rejecting Abusive Smoking Habits – TRASH
• Students Together Organizing Prevention Strategies – STOPS
• CRF – Counter-marketing and Media Component
• Maryland Tobacco Quitline: 1-800-QUI T-NOW
• Legal Resource Center for Tobacco Regulation, Litigation & Advocacy
• Maryland Resource Center for Quitting Use & I nitiation of Tobacco
• Maryland Teens Rejecting Abusive Smoking Habits – TRASH
• Students Together Organizing Prevention Strategies – STOPS
• CRF – Counter-marketing and Media Component

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1-800-QUIT-NOW 1-800-QUIT-NOW

• Free to Maryland residents ages 18 and older
• Open from 8:00 a.m. until midnight 7 days a week
• Primarily English/Spanish, others available
• Services Include:
• Referral to local health dept. cessation programs (2,207 referred in 2009)
• Brief counseling session at first call
• 4-session counseling upon enrollment
• Free NRT with 4-session counseling as available (6,067 shipments in 2009)
• Free Quit-Kit for smokers
• Information for non-smokers to assist smokers
• Fax referral system from health care providers( 156 providers in 2009)
• 99% satisfaction rate (independent evaluation)
• Free to Maryland residents ages 18 and older
• Open from 8:00 a.m. until midnight 7 days a week
• Primarily English/Spanish, others available
• Services Include:
• Referral to local health dept. cessation programs (2,207 referred in 2009)
• Brief counseling session at first call
• 4-session counseling upon enrollment
• Free NRT with 4-session counseling as available (6,067 shipments in 2009)
• Free Quit-Kit for smokers
• Information for non-smokers to assist smokers
• Fax referral system from health care providers( 156 providers in 2009)
• 99% satisfaction rate (independent evaluation)

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1-800-QUIT-NOW (FY 2009) 1-800-QUIT-NOW (FY 2009)

• 17,122 calls to Maryland quitline
• 9,176 registered for cessation services
• Demographics of Callers

58.2% female, 41.8% male 47.5% White, 43.9% African-American, 3.1% Hispanic Age Distribution

18 – 24: 9.7% 25 – 30: 11.3% 31 – 40: 19.2% 41 – 50: 30.7% 51 – 60: 21.3% 61 – 70: 6.1% 71 – 80: 1.6%

• 17,122 calls to Maryland quitline
• 9,176 registered for cessation services
• Demographics of Callers

58.2% female, 41.8% male 47.5% White, 43.9% African-American, 3.1% Hispanic Age Distribution

18 – 24: 9.7% 25 – 30: 11.3% 31 – 40: 19.2% 41 – 50: 30.7% 51 – 60: 21.3% 61 – 70: 6.1% 71 – 80: 1.6%

9.7% 11.3% 19.2% 30.7% 21.3% 6.1% 1.6%

0% 10% 20% 30% 40% 50% 18 - 24 25 - 30 31 - 40 41 - 50 51 - 60 61 - 70 71 - 80

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1-800-QUIT-NOW (FY 2009) 1-800-QUIT-NOW (FY 2009)

• Caller insurance status

Uninsured

36.3%

Commercial 28.6% Medicaid

22.8%

Medicare

10.5%

• 38% reported having a chronic disease
• 91.8% were in “preparation” stage
• At 6 months post counseling, 41.9% reported that they had not

used any tobacco products during the preceding 7 days.

• 39.4% reported no tobacco use within the preceding 30 days (as

compared to typically 4 – 7% with no counseling).

• Caller insurance status

Uninsured

36.3%

Commercial 28.6% Medicaid

22.8%

Medicare

10.5%

• 38% reported having a chronic disease
• 91.8% were in “preparation” stage
• At 6 months post counseling, 41.9% reported that they had not

used any tobacco products during the preceding 7 days.

• 39.4% reported no tobacco use within the preceding 30 days (as

compared to typically 4 – 7% with no counseling).

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Legal Resource Center for Tobacco Regulation, Litigation & Advocacy Legal Resource Center for Tobacco Regulation, Litigation & Advocacy

• Drafting ordinances to reduce smoking and smoking related injuries,

with a particular emphasis on laws designed to reduce youth access to tobacco products.

• Providing drafting and other technical support to state and local

legislators interested in sponsoring tobacco control legislation.

• Giving technical advice to community coalitions in advocating for
• rdinances before state and local legislative or regulatory bodies.
• Evaluating alternative strategies for reducing tobacco use based on

study of the experience of other states and localities.

• Advising individuals or groups about their rights with respect to

secondhand smoke in the workplace or in an apartment or condominium setting.

• Delivering resources and advice to local governments when an
• rdinance is challenged.
• Giving legal assistance to lawyers representing local governments.
• Drafting ordinances to reduce smoking and smoking related injuries,

with a particular emphasis on laws designed to reduce youth access to tobacco products.

• Providing drafting and other technical support to state and local

legislators interested in sponsoring tobacco control legislation.

• Giving technical advice to community coalitions in advocating for
• rdinances before state and local legislative or regulatory bodies.
• Evaluating alternative strategies for reducing tobacco use based on

study of the experience of other states and localities.

• Advising individuals or groups about their rights with respect to

secondhand smoke in the workplace or in an apartment or condominium setting.

• Delivering resources and advice to local governments when an
• rdinance is challenged.
• Giving legal assistance to lawyers representing local governments.

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MDQuit.org

Maryland Resource Center for Quitting Use and Initiation of Tobacco

MDQuit.org

Maryland Resource Center for Quitting Use and Initiation of Tobacco

• Linking professionals and providers to state tobacco initiatives,

providing evidence-based, effective resources and tools to local programs

• Creating and supporting an extensive, collaborative network of

tobacco prevention and cessation professionals, and providing a forum for sharing best practices throughout Maryland

• Conducts county needs assessments, best practices

conferences, trainings and presentations, and holds regular advisory board meetings.

• Linking professionals and providers to state tobacco initiatives,

providing evidence-based, effective resources and tools to local programs

• Creating and supporting an extensive, collaborative network of

tobacco prevention and cessation professionals, and providing a forum for sharing best practices throughout Maryland

• Conducts county needs assessments, best practices

conferences, trainings and presentations, and holds regular advisory board meetings.

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TRASH

Maryland Teens Rejecting Abusive Smoking Habits

TRASH

Maryland Teens Rejecting Abusive Smoking Habits

Statewide movement of youth-led coalitions Increase teen awareness of the negative

health effects of using tobacco products

Exposing the deceptive practices of the

tobacco industry

Statewide movement of youth-led coalitions Increase teen awareness of the negative

health effects of using tobacco products

Exposing the deceptive practices of the

tobacco industry

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STOPS

Students Together Organizing Prevention Strategies

STOPS

Students Together Organizing Prevention Strategies

Collaboration of Maryland college and

university tobacco control coalitions

Working together to create tobacco-free

campuses across the state

Student directed with formal advisor Collaboration of Maryland college and

university tobacco control coalitions

Working together to create tobacco-free

campuses across the state

Student directed with formal advisor

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Counter-marketing and Media Component Counter-marketing and Media Component

27.8% 19.9% 31.0% 21.6% 42.4% 30.2% 47.6% 35.8% 0% 10% 20% 30% 40% 50% 60% Middle School High School

2000 2002 2004 2006 2008

Saw NO Tobacco Prevention Ads in Past 30 Days

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Local Public Health Component

Lawrence Carter

Local Public Health Component

Lawrence Carter

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Elements of the Local Public Health Component Elements of the Local Public Health Component

Schoolbased Community Enforcement Cessation Schoolbased Community Enforcement Cessation

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Local Public Health Cessation Accomplishments FY06 – FY09 Local Public Health Cessation Accomplishments FY06 – FY09

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Comparison of Total CRFP Funding to Local Health Departments and Total Cessation Funding, FY06 – FY09 Comparison of Total CRFP Funding to Local Health Departments and Total Cessation Funding, FY06 – FY09

$0.0 $2.0 $4.0 $6.0 $8.0 $10.0 $12.0 $14.0

FY06 FY07 FY08 FY09

Funding, in Millions Total CRFP Funding Total CRFP Cessation Funding

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Cessation Funding Cessation Funding

Clear funding dedication to cessation

services at the local level.

Average of 2 million+ annually 24% of the overall LPHC budget in

FY09

Clear funding dedication to cessation

services at the local level.

Average of 2 million+ annually 24% of the overall LPHC budget in

FY09

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Number of Participants in Smoking Cessation Groups, FY06-FY09 Number of Participants in Smoking Cessation Groups, FY06-FY09

5964 7216 7194 8348 1000 2000 3000 4000 5000 6000 7000 8000 9000 FY06 FY07 FY08 FY09

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Number of Participants Individually Counseled

• n Smoking Cessation, FY06-FY09

Number of Participants Individually Counseled

• n Smoking Cessation, FY06-FY09

11328 14095 16652 23838 5000 10000 15000 20000 25000 FY06 FY07 FY08 FY09

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Ethnic Minorities in Cessation Groups, FY06 - FY09 Ethnic Minorities in Cessation Groups, FY06 - FY09

500 1000 1500 2000 2500 3000 3500 4000

FY06 FY07 FY08 FY09

African American Hispanic/Latino Asian American Native American

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Number of Participants Provided Pharmacotherapy, FY06-FY09 Number of Participants Provided Pharmacotherapy, FY06-FY09

500 1000 1500 2000 2500 3000 3500 4000 4500 5000

FY06 FY07 FY08 FY09 Zyban Nicotine Patches Nicotine Gum Chantix

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Other Key Cessation Accomplishments FY09 Other Key Cessation Accomplishments FY09

32,186 participants counseled on smoking

cessation (groups and individuals).

367 pregnant women counseled on smoking

cessation.

7200 participants provided cessation aids. 1311 healthcare providers trained on Clinical

Practice Guidelines.

29 community organizations funded for

cessation activities.

32,186 participants counseled on smoking

cessation (groups and individuals).

367 pregnant women counseled on smoking

cessation.

7200 participants provided cessation aids. 1311 healthcare providers trained on Clinical

Practice Guidelines.

29 community organizations funded for

cessation activities.

51

Local Public Health School based Accomplishments FY02 – FY09 Local Public Health School based Accomplishments FY02 – FY09

52

144,426 205,594 352,626 309,295 257,918 351,344 450,972 389,563

• 50,000

100,000 150,000 200,000 250,000 300,000 350,000 400,000 450,000 500,000 FY02 FY03 FY04 FY05 FY06 FY07 FY08 FY09

Chart A - Total Students Educated by Fiscal Year (PreK - College)

144,426 205,594 352,626 309,295 257,918 351,344 450,972 389,563

• 50,000

100,000 150,000 200,000 250,000 300,000 350,000 400,000 450,000 500,000 FY02 FY03 FY04 FY05 FY06 FY07 FY08 FY09

Chart A - Total Students Educated by Fiscal Year (PreK - College)

53

93,334 2,056,257 84,530 24,173 203,444

• 500,000

1,000,000 1,500,000 2,000,000 2,500,000 Pre-K K-12 Public K-12 Private K-12 Alternative College

Chart B - FY02-FY09 Students Educated (Pre-K through College)

93,334 2,056,257 84,530 24,173 203,444

• 500,000

1,000,000 1,500,000 2,000,000 2,500,000 Pre-K K-12 Public K-12 Private K-12 Alternative College

Chart B - FY02-FY09 Students Educated (Pre-K through College)

54

Students Educated (Pre-K through College) Students Educated (Pre-K through College)

10,838 16,490 20,410 19,232 19,008 39,843 37,803 39,820 College 8,741 3,875 2,471 2,181 3,895 2,750 260

• K-12

Alternative

17,702 18,703 13,342 9,164 13,382 9,822 2,415

• K-12

Private 335,330 398,546 301,759 216,795 259,502 287,296 152,423 104,606 K-12 Public 16,952 13,358 13,362 10,546 13,508 12,915 12,693

• Pre-K

FY09 FY08 FY07 FY06 FY05 FY04 FY03 FY02

55

$2,282,983.13 $2,283,725.04 $2,242,702.48 $1,991,164.73 $1,745,468.74 $2,742,521.33

$- $500,000.00 $1,000,000.00 $1,500,000.00 $2,000,000.00 $2,500,000.00

Chart C - FY02 - FY06 School-based Total Expenditures

FY02 FY03 FY04 FY05 FY06 FY07

$2,282,983.13 $2,283,725.04 $2,242,702.48 $1,991,164.73 $1,745,468.74 $2,742,521.33

$- $500,000.00 $1,000,000.00 $1,500,000.00 $2,000,000.00 $2,500,000.00

Chart C - FY02 - FY06 School-based Total Expenditures

FY02 FY03 FY04 FY05 FY06 FY07

56

Effective school programs that produce a reduction in tobacco use among youth have been inclusive of the CDC’s Guidelines for School Health Programs to Prevent Tobacco Use and Addiction; Effective school programs that produce a reduction in tobacco use among youth have been inclusive of the CDC’s Guidelines for School Health Programs to Prevent Tobacco Use and Addiction;

1.

Tobacco free Policy

1.

Evidence Based Curriculum

2.

Teacher Training

3.

Family I nvolvement

4.

Tobacco Cessation

1.

Tobacco free Policy

1.

Evidence Based Curriculum

2.

Teacher Training

3.

Family I nvolvement

4.

Tobacco Cessation

57

Other Key School based Accomplishments FY09 Other Key School based Accomplishments FY09

1,655 students were counseled on

smoking cessation.

76,074 students were reached in Peer

Support programs.

18,023 private school children were

educated on tobacco use prevention.

1,655 students were counseled on

smoking cessation.

76,074 students were reached in Peer

Support programs.

18,023 private school children were

educated on tobacco use prevention.

58

How do we move forward in a different economic environment

?

How do we move forward in a different economic environment

?

59

Local Public Health Funding Local Public Health Funding

FY02-FY10

0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 FY02 FY03 FY04 FY05 FY06 FY07 FY08 FY09 FY10 in Million Dollars

FY02-FY10

0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 FY02 FY03 FY04 FY05 FY06 FY07 FY08 FY09 FY10 in Million Dollars

60

Challenges as we move forward Challenges as we move forward

Maintaining commitment and passion Maintaining a comprehensive

framework

Maintaining partnerships and

collaboration

Performance/efficiency Program compliance Maintaining commitment and passion Maintaining a comprehensive

framework

Maintaining partnerships and

collaboration

Performance/efficiency Program compliance

61

Keep Tobacco Control Important Keep Tobacco Control Important