Primary Prevention of Cancer Tobacco Use Prevention ... · tobacco products – 18 years old Maryland, Pre-Settlement:)Minimum age to purchase or possess tobacco products – 18 years

1

Primary Prevention of CancerPrimary Prevention of CancerTobacco Use Prevention & CessationTobacco Use Prevention & Cessation

2

OverviewOverview

POLICY OVERVIEW – Joan StineIntroductionGoals and strategiesPublic policy

PROGRESS REPORT – Bob FiedlerObjectivesProgress Report - Data

STATEWIDE INITIATIVES – Dawn BerkowitzQuitline (1-800-QUIT-NOW)Youth InitiativesCounter-marketing and media

COUNTY-LEVEL INITIATIVES – Lawrence CarterLocal Public Health Component initiatives

POLICY OVERVIEW – Joan StineIntroductionGoals and strategiesPublic policy

PROGRESS REPORT – Bob FiedlerObjectivesProgress Report - Data

STATEWIDE INITIATIVES – Dawn BerkowitzQuitline (1-800-QUIT-NOW)Youth InitiativesCounter-marketing and media

COUNTY-LEVEL INITIATIVES – Lawrence CarterLocal Public Health Component initiatives

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POLICY OVERVIEWPOLICY OVERVIEW

4

GoalsGoals

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.

5

StrategiesStrategies

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.

6

Maryland Policy EnvironmentMaryland 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 of $21 million (subject to ‘holdbacks’ and budget cuts)

Statutory CDC ‘Best Practices’ Program StructureStatewide Public Health Component Surveillance & Evaluation ComponentCounter-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 of $21 million (subject to ‘holdbacks’ and budget cuts)

Statutory CDC ‘Best Practices’ Program StructureStatewide Public Health Component Surveillance & Evaluation ComponentCounter-marketing/Media Component Administrative Component Local Public Health Component

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Maryland, Pre-Settlement:

Retailers must be licensedSale of clove cigarettes bannedMinimum 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 licensedSale of clove cigarettes bannedMinimum 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 cigarettesMinimum package size, 20 cigarettesBan on Internet/Telephone sales of cigarettesBan on vending machine sales except at adult locationsMaryland ban on ‘candy-like’ products containing tobaccoThree (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 cigarettesMinimum package size, 20 cigarettesBan on Internet/Telephone sales of cigarettesBan on vending machine sales except at adult locationsMaryland ban on ‘candy-like’ products containing tobaccoThree (3) increases in excise tax since settlement, now $2 per pack

Policy Framework Achievements - Cigarettes

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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, Pre-Settlement:Regulatory ban on smoking inside 85% of 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% of 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 worksitesStatutory ban on smoking inside all restaurantsStatutory ban on smoking inside all barsProvision for “waivers” expires 2011

Maryland, Post-Settlement:Statutory ban on smoking at all indoor worksitesStatutory ban on smoking inside all restaurantsStatutory ban on smoking inside all barsProvision for “waivers” expires 2011

¢

Policy Framework Achievements – Secondhand Smoke

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Cancer Plan Policy GoalsCancer 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 Impact and Sustainability

Program Impact 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 ExpendituresCalculated Per Pack of Cigarettes Sold in Maryland (FY 2009)

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STATUS REPORT:TOBACCO USE IN MARYLAND

Bob Fiedler

STATUS REPORT:TOBACCO USE IN MARYLAND

Bob Fiedler

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Behavior Target:Reduce Cigarette SmokingBehavior Target:Reduce Cigarette Smoking

2008 Objectives forCigarette Smoking

Reduce Middle Schoolsmoking 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 forCigarette Smoking

Reduce Middle Schoolsmoking 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%

RelativeChange

- 52.1%

- 35.4%

- 27.3%

RelativeChange

- 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 ProductsAdult 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 SmokingState Rankings Low to High, 2000 and 2008

Adult Cigarette SmokingState Rankings Low to High, 2000 and 2008

0%

5%

10%

15%

20%

25%

30%

35%

0 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%

0 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 Smokingby Jurisdiction & Region

Current Adult Cigarette Smokingby 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

2008

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Adult Cigarette SmokingBy Age Group - 2008

Adult Cigarette SmokingBy 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 SmokingBy Race - 2008

Adult Cigarette SmokingBy 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


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Adult Cigarette SmokingBy Educational Attainment - 2008

Adult Cigarette SmokingBy 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


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Adult Cigarette SmokingBy Annual Income - 2008Adult Cigarette SmokingBy 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+


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Underage Use OfTobacco ProductsUnderage Use OfTobacco Products

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Current Cigarette SmokingCurrent 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%


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 byUnderage HS Youth, by Jurisdiction & Region

Current Cigarette Smoking byUnderage 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 SmokingCurrent 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%


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%


2000 2002 2004 2006 2008


25

Current Use of Smokeless TobaccoCurrent 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%


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%


2000 2002 2004 2006 2008


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Underage MarylandPublic 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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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, 2008Current 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 HSBlack/African‐American

HS Hispanic HS White

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

29

Current Use of ‘Flavored’ Cigar ProductBy Current Cigar Smokers, 2008

Current Use of ‘Flavored’ Cigar ProductBy 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

rank

Alc

ohol

Pas

t 30

Day

s

2006 2008

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

31

Statewide Initiatives

Dawn Berkowitz

Statewide Initiatives

Dawn Berkowitz

32

Elements of Statewide Tobacco ProgramElements of Statewide Tobacco Program

Maryland Tobacco Quitline: 1-800-QUIT-NOW

Legal Resource Center for Tobacco Regulation, Litigation & Advocacy

Maryland Resource Center for Quitting Use & Initiation 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-QUIT-NOW

Legal Resource Center for Tobacco Regulation, Litigation & Advocacy

Maryland Resource Center for Quitting Use & Initiation of Tobacco

Maryland Teens Rejecting Abusive Smoking Habits – TRASH

Students Together Organizing Prevention Strategies – STOPS

CRF – Counter-marketing and Media Component

33

1-800-QUIT-NOW1-800-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 call4-session counseling upon enrollmentFree NRT with 4-session counseling as available (6,067 shipments in 2009)

Free Quit-Kit for smokersInformation for non-smokers to assist smokersFax 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 call4-session counseling upon enrollmentFree NRT with 4-session counseling as available (6,067 shipments in 2009)

Free Quit-Kit for smokersInformation for non-smokers to assist smokersFax referral system from health care providers( 156 providers in 2009)

99% satisfaction rate (independent evaluation)

34

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 Distribution18 – 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 Distribution18 – 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

35

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

Caller insurance statusUninsured 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 statusUninsured 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).

36

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 ordinances 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 ordinance 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 ordinances 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 ordinance is challenged.

Giving legal assistance to lawyers representing local governments.

37

MDQuit.orgMaryland Resource Center for Quitting Use and Initiation of Tobacco

MDQuit.orgMaryland 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.

38

TRASHMaryland Teens Rejecting Abusive Smoking Habits

TRASHMaryland 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

39

STOPSStudents Together Organizing Prevention Strategies

STOPSStudents 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

40

Counter-marketing and Media ComponentCounter-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 School2000 2002 2004 2006 2008

Saw NO Tobacco Prevention Ads in Past 30 Days

41

Local Public Health Component

Lawrence Carter

Local Public Health Component

Lawrence Carter

42

Elements of the Local Public Health Component

Elements of the Local Public Health Component

Schoolbased Community EnforcementCessation

Schoolbased Community EnforcementCessation

43

Local Public HealthCessation AccomplishmentsFY06 – FY09

Local Public HealthCessation AccomplishmentsFY06 – FY09

44

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

Fund

ing,

in M

illio

ns

Total CRFP Funding Total CRFP Cessation Funding

45

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

46

Number of Participants in Smoking

Cessation Groups, FY06-FY09

Number of Participants in Smoking

Cessation Groups, FY06-FY09

5964

7216

7194

8348

0

10002000

30004000

50006000

70008000

9000

FY06 FY07 FY08 FY09

47

Number of Participants Individually Counseled on Smoking Cessation, FY06-FY09

Number of Participants Individually Counseled on Smoking Cessation, FY06-FY09

1132

8

1409

5

1665

2

2383

8

0

5000

10000

15000

20000

25000

FY06 FY07 FY08 FY09

48

Ethnic Minorities in Cessation Groups,

FY06 - FY09

Ethnic Minorities in Cessation Groups,

FY06 - FY09

0

500

1000

1500

2000

2500

3000

3500

4000

FY06 FY07 FY08 FY09

African AmericanHispanic/LatinoAsian AmericanNative American

49

Number of Participants Provided Pharmacotherapy, FY06-FY09

Number of Participants Provided Pharmacotherapy, FY06-FY09

0500

100015002000250030003500400045005000

FY06 FY07 FY08 FY09

ZybanNicotine PatchesNicotine GumChantix

50

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 HealthSchool based AccomplishmentsFY02 – FY09

Local Public HealthSchool based AccomplishmentsFY02 – 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 24,173203,444

-

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 24,173203,444

-

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)

10,83816,49020,41019,23219,00839,84337,80339,820College

8,7413,8752,4712,1813,8952,750260-K-12 Alternative

17,70218,70313,3429,16413,3829,8222,415-K-12 Private

335,330398,546301,759216,795259,502287,296152,423104,606K-12 Public

16,95213,35813,36210,54613,50812,91512,693-Pre-K

FY09FY08FY07FY06FY05FY04FY03FY02

55

$2,28

2,983

.13

$2,28

3,725

.04

$2,24

2,702

.48

$1,99

1,164

.73

$1,74

5,468

.74

$2,74

2,521

.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

$2,28

2,983

.13

$2,28

3,725

.04

$2,24

2,702

.48

$1,99

1,164

.73

$1,74

5,468

.74

$2,74

2,521

.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 Involvement

4. Tobacco Cessation

1. Tobacco free Policy

1. Evidence Based Curriculum

2. Teacher Training

3. Family Involvement

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 M

illio

n Do

llars

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 M

illio

n Do

llars

60

Challenges as we move forward

Challenges as we move forward

Maintaining commitment and passionMaintaining a comprehensive frameworkMaintaining partnerships and collaboration Performance/efficiency Program compliance

Maintaining commitment and passionMaintaining a comprehensive frameworkMaintaining partnerships and collaboration Performance/efficiency Program compliance

61

Keep Tobacco Control Important

Keep Tobacco Control Important

Documents

Primary Prevention of Cancer Tobacco Use Prevention ... · tobacco products – 18 years old Maryland, Pre-Settlement:)Minimum age to purchase or possess tobacco products – 18 years