The Use of Commercial The Use of Commercial Tobacco Among Minority Tobacco Among Minority

PopulationsPopulationsCenters for Disease Control and PreventionCenters for Disease Control and Prevention

Office on Smoking and HealthOffice on Smoking and Health

Sydney LeeSydney Lee

Office on Smoking and Office on Smoking and HealthHealth

Mentors: Michelle Johns and Leah Mentors: Michelle Johns and Leah JohnsonJohnson

Epidemiology BranchEpidemiology Branch Program Services BranchProgram Services Branch Health Communication BranchHealth Communication Branch

Epidemiology BranchEpidemiology Branch

Advances science of tobacco controlAdvances science of tobacco control Coordinates research and Coordinates research and

surveillancesurveillance Evaluates products, tobacco use, Evaluates products, tobacco use,

health effects, economic impacts, health effects, economic impacts, and interventionsand interventions

Program Services BranchProgram Services Branch

Provides training and technical Provides training and technical assistance to 50 states, D.C., 7 US assistance to 50 states, D.C., 7 US Territories, 6 National Networks, Territories, 6 National Networks, and 7 Tribal Support Centersand 7 Tribal Support Centers

Provides leadership for Provides leadership for implementation of comprehensive implementation of comprehensive interventionsinterventions

Directs and manages National Directs and manages National Tobacco Control ProgramTobacco Control Program

Health Communication Health Communication BranchBranch

Develops and disseminates Develops and disseminates information to the public, policy information to the public, policy makers, health professionals, and makers, health professionals, and partnerspartners

Tracks media coverage of tobaccoTracks media coverage of tobacco Provides technical assistance for Provides technical assistance for

tobacco counter-marketing media usetobacco counter-marketing media use Promotes positive change in health Promotes positive change in health

behaviors, policies, and practicesbehaviors, policies, and practices

Goals of OSHGoals of OSH

Prevent initiation of tobacco use Prevent initiation of tobacco use among youthamong youth

Promote tobacco use cessation Promote tobacco use cessation among adults and youthamong adults and youth

Eliminate exposure to secondhand Eliminate exposure to secondhand smokesmoke

Identify and eliminate tobacco-Identify and eliminate tobacco-related disparitiesrelated disparities

Commercial Tobacco UseCommercial Tobacco Use

The leading The leading cause of cause of preventable preventable death in the USdeath in the US

Causes coronary Causes coronary heart disease – heart disease – the leading cause the leading cause of death in USof death in US

8.6 million have 8.6 million have serious illness serious illness caused by caused by smokingsmoking

Health Effects of Health Effects of Commercial TobaccoCommercial Tobacco

Adversely affects almost every organ in Adversely affects almost every organ in the bodythe body

Causes cancer and coronary heart diseaseCauses cancer and coronary heart disease Doubles the chance for having a strokeDoubles the chance for having a stroke Drastically increases the chance for dying Drastically increases the chance for dying

of lung diseaseof lung disease Increases risk for infertility, preterm Increases risk for infertility, preterm

delivery, stillbirth, low birth weight, and delivery, stillbirth, low birth weight, and Sudden Infant Death SyndromeSudden Infant Death Syndrome

Cigarette Smoking Cigarette Smoking PrevalencePrevalence

05

1015202530354045

AI/ AN AfricanAmerican

Hispanic White

Total

Men

Women

CDC MMWR 2004

Percentage of adult cigarette use during the past month

Youth Prevalence RatesYouth Prevalence RatesPercentage of youth age 12-17 who smoked cigarettes in

the past month

0

5

10

15

20

25

30

AI/ AN AfricanAmerican

Hispanic White

TotalMaleFemale

CDC MMWR 2006

Youth SusceptibilityYouth SusceptibilityYouth age 12-17 who had never smoked but were susceptible to start smoking cigarettes

0

5

10

15

20

25

30

35

AI/ AN AfricanAmerican

Hispanic White

TotalMaleFemale

CDC MMWR 2004

The Youth StallThe Youth Stall

27.530.5

34.836.4

34.8

28.5

21.9 2320

0

5

10

15

20

25

30

35

40

1991 1993 1995 1997 1999 2001 2003 2005 2007

1.2 Millio

n

Percent of High School Students Who Reported Current Cigarette Use, 1991-

2007

National Risk Youth Behavior Surveys, 1991-2007

OSH Expert PanelOSH Expert Panel

Panel of tobacco and media expertsPanel of tobacco and media experts Addressing the “Youth Stall”Addressing the “Youth Stall” Experts discuss the issues about Experts discuss the issues about

reaching the youth, understand where reaching the youth, understand where teens are getting messagesteens are getting messages

Reactive vs. ProactiveReactive vs. Proactive OSH uses the suggestions of the panel OSH uses the suggestions of the panel

to develop ideas for future projectsto develop ideas for future projects

Culturally Appropriate Culturally Appropriate WebsiteWebsite

Adding the definition of tobacco to Adding the definition of tobacco to the CDC’s tobacco websitethe CDC’s tobacco website

Tobacco refers to “the use of Tobacco refers to “the use of manufactured, commercial tobacco manufactured, commercial tobacco products including, but not limited products including, but not limited to, cigarettes, smokeless tobacco, to, cigarettes, smokeless tobacco, and cigars” and cigars”

Secondhand Smoke Secondhand Smoke

Information guide for African Information guide for African Americans, American Indians and Americans, American Indians and Alaska NativesAlaska Natives

African American guide is in process African American guide is in process of development using focus groups of development using focus groups for suggestions and approvalfor suggestions and approval

American Indian and Alaska Native American Indian and Alaska Native guide will be developed in the futureguide will be developed in the future

SabemosSabemos Community outreach against Community outreach against

secondhand smoke in the secondhand smoke in the Hispanic/Latino populationHispanic/Latino population

Targeting families with children under Targeting families with children under 1414

Promotoras will go to homes in the Promotoras will go to homes in the Colonia to teach them about secondhand Colonia to teach them about secondhand smoke and how to protect their childrensmoke and how to protect their children

Sabemos will be launched at a health fair Sabemos will be launched at a health fair and then surveys will evaluate and then surveys will evaluate effectivenesseffectiveness

Don’t smoke in your Don’t smoke in your home or carhome or car

Talk to your kids Talk to your kids about the dangersabout the dangers

Keep your home and Keep your home and car smoke-freecar smoke-free

Teach your kids how Teach your kids how to avoid secondhand to avoid secondhand smokesmoke

Support restaurants Support restaurants and businesses that and businesses that are smoke-freeare smoke-free

We Know – Out of respect, there is no

smoking here

Community Case StudyCommunity Case Study

Native youth have highest Native youth have highest prevalence ratesprevalence rates

Have youngest average initiation Have youngest average initiation ageage

Research on Native American youth Research on Native American youth tobacco programstobacco programs

Research is needed to develop Research is needed to develop promising practices promising practices

Methods for Community Methods for Community Case StudyCase Study

In-depth interviewsIn-depth interviews Programs developed or adapted for a Programs developed or adapted for a

native audiencenative audience Tribal Support Centers and Non-TSCs Tribal Support Centers and Non-TSCs Different regions including Oklahoma, Different regions including Oklahoma,

Aberdeen area, California, MichiganAberdeen area, California, Michigan Forming a committee with Forming a committee with

interviewees to help guide researchinterviewees to help guide research

Preliminary ResultsPreliminary Results

Programs reach native audience in Programs reach native audience in many waysmany ways

Group youth into clansGroup youth into clans Learn about historyLearn about history Native imageryNative imagery Traditional gamesTraditional games Youth make decisions about strategies, Youth make decisions about strategies,

write PSAs and material to teach peerswrite PSAs and material to teach peers

Final ThoughtsFinal Thoughts

OSH vs. Tobacco industryOSH vs. Tobacco industry Understand the audienceUnderstand the audience Cultural competencyCultural competency CollaborationCollaboration

Interview QuestionsInterview Questions

Target audience – age, gender, location Target audience – age, gender, location Program Program

LengthLength DevelopmentDevelopment ActivitiesActivities

EvaluationEvaluation Informal – feedback about programInformal – feedback about program Formal – baseline data, outcome evaluationFormal – baseline data, outcome evaluation DisseminationDissemination

AcknowledgementsAcknowledgements

National Indian Health BoardNational Indian Health Board Morehouse School of MedicineMorehouse School of Medicine Ms. RasheedMs. Rasheed Ms. GravesMs. Graves Leah JohnsonLeah Johnson Michelle JohnsMichelle Johns