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Crisis as Opportunity
NAQCNCTOH, June 9th, 2009
Phoenix, AZ
Jeannette Noltenius PhD, National Coordinator
Crisis as Opportunity
Crisis as Opportunity
Future clienteleNew ProductsNational Legislation What can be done? Parity,
Inclusion and Renewed Advocacy
Projections by Race and Projections by Race and HispanicHispanic
2000 2010 2020 2030 2040 2050
Total 282,125 308,936 335,805 363,584 391,946 419,854
White alone 228,548 244,995 260,629 275,731 289,690 302,626
Black alone 35,818 40,454 45,365 50,442 55,876 61,361
Asian alone 10,684 14,241 17,988 22,580 27,992 33,430
All Other Races 7,075 9,246 11,822 14,831 18,388 22,437
Hispanic (of any race) 35,622 47,756 59,756 73,055 87,585 102,560
White alone not Hispanic 195,729 201,112 205,936 209,176 210,331 210,283
(In Thousands. As of July 1 Resident Population) US Census Bureau
Minority Populations’ Combined Percentage of Total US Population
31.6
36.2
40.2
44.3
48.4
52.3
0
10
20
30
40
50
60
2000 2010 2020 2030 2040 2050
The Elderly PopulationThe Elderly Population(persons age 65 and over)(persons age 65 and over)
Year NumberNumeric Change from
Previous Decade % of U.S. Population
1970 20,065,502 3,858,265 9.9
1980 25,549,427 5,483,925 11.3
1990 31,241,831 5,692,404 12.6
2000 35,061,247 3,819,416 12.4
2010 40,243,713 5,182,466 13.0
2020 54,631,891 14,388,178 16.3
2030 71,453,471 16,821,580 19.7
2040 80,049,634 8,596,163 20.4
2050 86,705,637 6,656,003 20.7
Cigarette Smoking* Trends: Adults, 1983-2002
*Smoking on 1 or more of the previous 30 days.Source: National Health Interview Surveys, 1983-2002, selected years, aggregate data
American Indian/Alaska Native
African American
Hispanic/LatinoAsian/Pacific Islander
White
HP 2010Goal(12%)
0
10
20
30
40
50
60
1983-1985
1987-1988
1990-1991
1992-1993
1994-1995
1997-1998
1999-2000
2001-2002
Years
Pe
rce
nt
01020304050607080
Cambod
ian
Chines
e
Hmon
g
Korea
n
Laotia
n
South
Asia
n
Vietnam
ese
Pre
vale
nce
Smoking Prevalence Ranges for Asian American Men
Rod Lew, APPEAL, CDC Disparities Call Presentation
What are the implications?
70% of Hispanic/Latinos are low and intermittent smokers
80-90% of African Americans Menthol
Youth Groups, pods, work settings, communities
+ Low SES, Mental Health Issues + unemployment, lower educational attainment
Other Implications
Safety Net Community Health Clinics, they reach low SES & minorities= 7,000 points of service
Institutionalization at the CHC level Build relationships to assure fax
referral success and quits Share resources=get results
33% of the total Adult Market and 40-50% of Adolescent Market
www.trinketsandtrash.org
e cigarrettes
• “Finally you can quit smoking cigarettes by smoking”!
www.ecigarrettes.com
Disolvable Strips and Orbs
• http://tobaccoproducts.org/index.php/Camel_Sticks,_Camel_Orbs_and_Camel_Strips
Federal Legislators burn the midnight oil!
Recent Federal Legislation
CHIPRA and its impact $ 1.00 hike Stimulus Package = lost opportunity Federal Budget = No $ for Cessation HIT, Health Information Technology (Is the tobacco Question prominent,
is fax referral included in HIT, EMR? Parity for Mental Health (cessation
treatment covered or discussed?)
Congress is negotiating various proposals
“Family Smoking Prevention and Tobacco Control Act”
o FDA authority to Regulate content, flavors packaging;
o Restrict tobacco marketing and sales to kids;
o Require changes in tobacco products to make them less toxic and less addictive;
o Stop tobacco companies from misleading the public about the health consequences of using their products;
o What about Harm reduction and its impact on this field? Are you involved?
Change in the Number of Uninsured, By Income 2009-2019
(in millions)
2009 2019 2019 2019
BaselineBest Case
Intermediate Case
Worst Case
<200% FPL 31.1 34.7 36.5 37.6
200-399% FPL
12.5 14.8 16.8 18.2
>400% FPL 5.5 7.5 8.9 9.9
All Incomes 49.1 57.0 62.2 65.7
20
John Holahan, Bowen Garrett, Irene Headen, and Aaron Lucas Heath Care Reform the Cost of Failure
Urban Institute 2009 www.rwjf.org/healthreform/products
Health Care Reform Legislation
Many Players: check your state delegation!!!!!
Many Options (Single payer, multiple payers,
Will Cessation be covered? What is being planned? Will Community Health Centers
Expand? HRSA work with them? Are you one of the players?
Increased taxes at the State LevelBudget Cuts
What are the implications? Who will support the Quitlines? Have you built allies who will
advocate for you and the tobacco programs?
Physician Associations AMA, etc.? What are your links to community
groups and minorities?
4- Prongs Policy Change Model
1. Need to advocate within every community where tobacco is not a high priority
2. Within the mainstream tobacco control movement where minorities are not a high priority (Parity Kit )
3. With policymakers where neither tobacco nor emerging communities is a priority
4. Against the tobacco industry where priority populations are one of the highest priorities
Community Stages of Readiness Model
Why Parity?• Parity: “being equal in the process,
as well as the outcomes attained in tobacco control.”
• Concept based on inequities in history of tobacco control and institutional inequities
• Parity requires systems changes within each institution
Rod Lew, APPEAL, www:appealforcommunities.org
Train Advocacy Skills = Not lobbying
Train at state level with all communities to build Advocates
Minority/Priority Communities Faith Communities Youth Advocates Business groups Local officials who have seen the benefits Present a benefit/cost analysis Put the HUMAN FACE on the EX Smoker!
Thank you, Muchas Gracias
Jeannette Noltenius, National Coordinator
National Latino Tobacco Control Network
www.latinotobaccocontrol.org www.tobaccopreventionnetworks.org
