Tobacco Use in CO Who are the current smokers? Moving the Mark - - PowerPoint PPT Presentation

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Tobacco Use in CO Who are the current smokers? Moving the Mark - - PowerPoint PPT Presentation

Jun 04, 2023 218 likes •720 views

Tobacco Use in CO Who are the current smokers? Moving the Mark Revisited May 1, 2017 Amy Anderson, MPH Renee Calanan, PhD Behavioral Risk Factor S urveillance S ystem (BRFS S ) Random-digit dialed landline and cell phone survey

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Tobacco Use in CO

Who are the current smokers?

Moving the Mark Revisited May 1, 2017 Amy Anderson, MPH Renee Calanan, PhD

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SLIDE 2

Behavioral Risk Factor S urveillance S ystem (BRFS S )

  • Random-digit dialed landline and cell phone survey
  • English or S

panish

  • Adults aged 18+ living in Colorado
  • S

ample: 11,500-13,500 weighted to be representative of the adult population in Colorado

Healthy Kids Colorado S urvey (HKCS )

  • Paper survey voluntarily completed by high school students
  • Random sample of schools and classrooms
  • S

ample: 15,000-25,000 weighted to be representative of all high school students (grades 9-12) in Colorado

Pregnancy Risk Assessment Monitoring S ystem (PRAMS )

  • Mailed paper survey with telephone follow-up if no response
  • Random sample of women who had a recent live birth
  • S

ample: 1,700-2,000 weighted to be representative of all women who had a recent live birth in Colorado

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Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em

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As of 2015, t here were approximat ely 600,000 adult Coloradans who current ly smoke cigaret t es.

Current cigarette smoking among adults

Colorado and U.S., 1998-2015

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Current t obacco use among adults

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Current t obacco use among high school st udent s

Dat a on current elect ronic vapor product use is not available in 2013. Dat a S

  • urce: Healt hy Kids Colorado S

urvey, 2013 and 2015

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Source: Rate per capita calculated by the CO Department of Public Health using tax revenue data from the CO Department of Revenue and population estimates from the State Demographer's Office 6

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Perceived risk of* and access t o✝ cigaret t es among high school st udent s

* among all high school students

✝ among underage high school students

Dat a S

  • urce:

Healt hy Kids Colorado S urvey, 2015

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Current t arget populat ion:

Adult s aged 18-24 wit hout a college educat ion

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2013-2015

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SLIDE 9

Current t arget populat ion: Pregnant women

* Among t hose who smoked 3 mont hs before pregnancy Dat a S

  • urce: Pregnancy Risk Assessment Monit oring S

yst em, 2014

*

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SLIDE 10

Successes

  • Overall decrease in cigarette smoking among youth

and adults

  • CO has lower prevalence than U.S

.

Challenges

  • Decreasing trend in sales but small increase 2015-2016
  • Rise of e-vapor products
  • Among high school students:

○ 30%

use tobacco products

○ 1/ 6 report no or slight risk of smoking 1+ pack/ day ○ More than half report easy access to cigarettes

  • High prevalence of smoking among priority populations:

○ Adults aged 18-24 without college education ○ Pregnant women

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Who are the current smokers?

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Prevalence by demographics and demographics of current smokers Disparit ies Burden

Who is more likely to smoke? Who are the current smokers?

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S t at ement on st ruct ural inequit y

The Colorado Depart ment of Public Healt h and Environment acknowledges t hat social, economic and environment al inequit ies result in adverse healt h out comes and have a great er impact t han individual choices. Reducing healt h disparit ies t hrough syst ems change can help improve

  • pport unit ies for all Coloradans.

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Current smoking among adult s by sex S ex of current smokers

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Current smoking among adult s by age Age of current smokers

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Current smoking among adult s by race/ et hnicit y Race/ et hnicit y

  • f current

smokers

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Current smoking among Hispanic adult s by pref erred language* Pref erred language* of Hispanic current smokers

*Language survey was completed in

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Current smoking among adult s by sexual

  • rient at ion

S exual

  • rient at ion of

current smokers

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Current smoking among adult s by socioeconomic st at us (S ES ) S ES

  • f current

smokers

*Low S ES : uninsured, income below 200% FPL, no HS diploma/ GED, or unable t o work

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Current smoking among adult s by povert y level Povert y level

  • f current

smokers

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Current smoking among adult s by educat ion level Educat ion level

  • f current

smokers

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Current smoking among adult s by insurance t ype Insurance t ype

  • f current

smokers

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Current smoking among adult s by employment st at us Employment st at us of current smokers

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Current smoking among adult s by indust ry Indust ry of current smokers

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Current smoking among adult s by

  • ccupat ion

Occupat ion of current smokers

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Current smoking among adult s by housing t ype Housing t ype of current smokers

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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S ummary - Who are t he smokers?

Disparities

  • Adults <65 years
  • Males
  • Native American & Black
  • English-speaking Hispanic
  • LGB
  • Low S

ES

  • <College degree
  • <200%

FPL

  • Uninsured & Medicaid
  • Unemployed & unable to

work

  • Renters

Burden

  • Adults 25-64
  • Males
  • White & Hispanic
  • English-speaking Hispanic
  • Heterosexual
  • Low S

ES

  • High school grads & some

college

  • Private insurance &

Medicaid

  • Employed

○Construction workers

  • Homeowners

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Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em

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SLIDE 28

Current smoking among adult s by region

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Where do current smokers live?

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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What else do we know about smokers?

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Healt h care access and ut ilizat ion

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, (year)

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Healt h behaviors

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Chronic healt h condit ions

Age-adj ust ed t o t he 2000 st andard US populat ion Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Ment al Healt h

* S core of 13-24 on 6-it em Kessler scale quest ions **S core of 20-24 on 8-it em Pat ient Healt h Quest ionnaire Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, (year)

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Co-Occurring S ubst ance Use

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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S ummary: What else do we know about current smokers?

Health care access and utilization

  • Less likely to have a regular provider
  • Less likely to have annual wellness visit and be up-to-date on

preventive services Health behaviors

  • Less likely to consume fruits and vegetables
  • More likely to consume sugary drinks
  • Less likely to meet physical activity recommendations

Chronic health conditions

  • More likely to be diagnosed with COPD, arthritis, cancer,

cardiovascular disease, and depression

  • More likely to have multiple chronic conditions

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em

36

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SLIDE 37

S ummary: What else do we know about current smokers?

Mental health

  • More likely to have psychological distress or depression
  • More likely to have 4+ adverse childhood experiences

Co-occurring substance use

  • More likely to use marij uana
  • More likely to be a heavy drinker or binge drink
  • More likely to use chewing tobacco

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em

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Who are the current smokers:

1.Working in construction 2.18-24 without any college education 3.Low SES

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Who are t he current smokers who are working in const ruct ion*?

✝

* Includes t hose who are employed or out of work for <1 year

✝ Unemployed means t hey have been out of work for <1 year and indicat ed

const ruct ion as most recent indust ry of employment Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2014 & 2015

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Who are t he current smokers who are 18-24 wit hout any college educat ion?

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Who are t he current smokers who are low S ES *?

*Low S ES : uninsured, income below 200% FPL, no HS diploma/ GED, or unable t o work Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

41

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Questions? renee.calanan@state.co.us amy.anderson@state.co.us

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Extra Slides

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Quit at t empt in t he past 12 mont hs

High school students Adults

Dat a S

  • urces: Healt hy Kids Colorado S

urvey, 2015 Behavioral Risk Fact or S urveillance S yst em, 2015

44

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S econdhand smoke exposure

Exposed in home or car in past 7 days

  • Children aged 1-14 years with a smoker in the household

15.7%

Exposed in home while someone was smoking in past 7 days

  • High school students

16.2%

Exposed in car while parent was smoking in past 7 days

  • High school students

14.1%

Exposed in home

  • Adults who live in multiunit housing

46.5%

Health care provider advised about child’s exposure

  • Pregnant women and women who recently gave birth

31.3%

Health care provider advised about child’s exposure

  • Caregivers of children aged 1-14 years

32.4%

Dat a S

  • urces: Child Healt h S

urvey, 2015 Healt hy Kids Colorado S urvey, 2015 Pregnancy Risk Assessment Monit oring S yst em, 2014

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Current smoking among high school st udent s by region

Dat a S

  • urce: 2015 Healt hy Kids Colorado S

urvey

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Chronic healt h condit ions

Crude prevalence Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

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Dual use of cigaret t es and marij uana

3.9%

  • f adults (approx. 150,000)
  • Average age: 38 years
  • Mostly male (62%

)

  • Half have no post-high school education (52%

)

  • Nearly ¾ are low S

ES (72% )

  • 17%

are lesbian, gay, or bisexual

  • Higher among those who are unemployed or

unable to work

Dat a S

  • urce: Behavioral Risk Fact or S

urveillance S yst em, 2015

48

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SLIDE 49

Adult cigaret t e smoking (% ) -- CO and select st at es, 2011-2015

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