A Needs Assessment of Mineral County, Nevada Regarding Adult Smoking

Danielle PooleHealth Educator

Department of Public Health for Nevada

April 23rd 2014

Outline• Background information• Prevalence• Demographic information• Objective• Evidence-based interventions• Existing interventions• Proposed interventions• Potential partners

Background Information

• Why is tobacco use an issue?1. Negative health effects caused by smoking2. Deaths caused each year by smoking3. Financial impacts of smoking on our country’s

economy

1. Major negative health effects caused by smoking• Cancer• Heart disease and stroke• Respiratory diseases• Pregnancy problems

2. The number of deaths caused each year by smoking• Worldwide, tobacco use causes nearly 6 million deaths

per year (WHO, 2011)• Cigarette smoking is responsible for more than 480,000

deaths per year in the United States (USDHHS, 2014)3. The financial impacts of smoking on our country’s

economy• More than $300 billion a year for US• $170 billion in healthcare (Xu X, 2015)• $156 lost in productivity (USDHHS, 2014)

• The state of Nevada had received grant money to target Mineral county because of its high prevalence of adult cigarette smokers

• A needs assessment of Mineral county has been conducted to address (1) demographics, (2) existing interventions, (3) other possible interventions, and (4) potential partners in the county to help with the effort to decrease smoking rates

Prevalence

http://www.countyhealthrankings.org/app/nevada/2015/measure/factors/9/map

State: Nevada

County: Mineral

Percentage of Adult Smokers: 27%

This percentage comes from the adult population that currently smokes every day or most days and has smoked at least 100 cigarettes in their lifetime (County Health Rankings, 2015).

Where is the information coming from?

• Prevalence data is taken from the Behavioral Risk Factor Surveillance System (BRFSS)

• BRFSS is a random national telephone survey• The data represents the total population over 18

years of age residing in homes that have a land line telephone

(County Health Rankings, 2015)

DemographicsMineral County Nevada

Population 4,614 2,790,136

% Below 18 years of age 18.7% 23.7%

% 65 and older 23.9% 13.7%

% Non-Hispanic African American

3.8% 8.1%

% American Indian and Alaskan Native

16.5% 1.6%

% Asian 2.4% 8.1%

% Native Hawaiian/Other Pacific Islander

0.2% 0.7%

% Hispanic 10.6% 27.5%

% Non-Hispanic white 65.9% 52.2%

% Not proficient in English 0.3% 6.2%

% Females 50.8% 49.6%

% Rural 31.9% 5.8%

http://www.countyhealthrankings.org/app/nevada/2015/rankings/mineral/county/outcomes/overall/additional

Objective

• Where does Mineral County stand? – 27% adult smokers

• Goal of Healthy People 2020? – Reduce to 12% adult cigarette smokers

(Healthy People 2020, 2014)

***A goal of more than half of adult smokers to cease their unhealthy behavior!

Evidence-based Interventions• Increasing the price of tobacco products– Proved to be effective because of reduced consumption

and use, increased users that quit, reduced initiation of young people, and reduced illnesses & deaths (The Community guide, 2014)

• Mass-reach health communication interventions– Targeting audiences through all media forms in order to

“change knowledge, beliefs, attitudes, and behaviors affecting tobacco use” (The Community guide, 2014)

• Mobile phone-based cessation interventions– For those interested in quitting, information and support

are sent via text to those signed up and the information changes over the course of the intervention (The Community guide, 2014)

• Quit-line interventions– Follow-up counseling calls for those interested in quitting,

support is given by cessation specialists who follow standards over needed period of time (The Community guide, 2014)

• Smoke-free policies– Public and private rules and regulations that prohibit smoking in

both indoor and outdoor places (The Community guide, 2014)• Provider-oriented interventions

– Doctors continually ask patients about smoking habits, educate patients about the risks, recommend cessation, and sometimes that is enough to convince patient to stop

• Community mobilization to restrict minors’ access to tobacco products– Creating and enforcing stronger laws in order to reduce use and

accessibility of tobacco for youth (The Community guide, 2014)

Existing Interventions

http://www.stateoftobaccocontrol.org/state-grades/nevada/

Existing Interventions • Increasing price?– Nevada has not increased the tax on tobacco since 2005!– Nevada is ranked 35th with a tax of $0.80 (Ann Boonn, 2015)

• Smoke-free policies?– Nevada prohibits smoking in most places except for bars and

casinos– Smoking is allowed in bars and casinos depending on age

restrictions and areas where children are allowed(State of Tobacco Control, 2015)

• Quit-line?– CDCs recommended spending: $3.65/smoker– Nevada spending: $0.69/smoke (State of Tobacco Control,

2015)– HN receptionist did not know how to explain to me where to

access this• Mass-reach health communication interventions?– Health Nurse receptionist of Nevada only listed pamphlets as

means of reaching the community• Mobile phone-based cessation interventions?– Health Nurse receptionist said this was all government run and

did not have much to say about this intervention

• provider-oriented interventions– When people go in to see Wanda Nixon, her

receptionist told her that she asks if patients smoke, advises them to stop, and gives referrals to help quit

• community mobilization to restrict minors’ access to tobacco products– Managed by the government, not much

community effort put in, little information known

Proposed Interventions

There is great need for improvement…• All areas need improvement• There should be more unison and/or communication

between county and state• Those answering phones should have info available or

info on where to go in regards to smoking help• Why isn’t there a health department for Mineral

County?• More “Health nurses” if HD isn’t an option• Increase tax!• Improve media beyond handouts and pamphlets

Potential Partners• American Heart Association Nevada Affiliate Inc.

6370 West Flamingo Road Suite 1 Las Vegas NV 89103-2274 702 367-6490

• American Lung Association NV S Branch PO Box 44137 Las Vegas NV 89116-2137 702 454-2500

• Nevada Tobacco Prevention Coalition

American Heart Association • Mission: – improve lives by eliminating cardiovascular disease and

stroke (AHA, 2015)• Actions: – Smoke-free public places & clean indoor air in public places

(AHA, 2015)• Who to contact: – Christopher Roller• Director of Advocacy and State Health Alliances at

American Heart Association• Why AHA? – Knows the negative health effects of smoking and wishes to

eliminate smoking all together

American Lung Association

• Mission:– Eliminate lung disease in order to improve lung

health eventually saving lives• Actions:– Educate public, research, evidence-based

decisions, overcome health disparities (ALA, 2015)• Why ALA?– They desire to overcome health disparities which

may help when dealing with the large population of American Indian and Alaskan Native population

Nevada Tobacco Prevention Coalition• Mission: – reduce tobacco use and nicotine addiction in order to

improve health of those in Nevada (NTPC, 2015)• Actions: – Increase tobacco control spending & Improve and expand

the Nevada Clean Indoor Air Act• Who to contact:– They have a Facebook page that could be grown more

(only 37 likes)– Contact on Fb or email (no names listed)

• Why NTPC?– Started in Nevada, already has handful of partners, could

contain grassroot members

References• American Heart Association. Retrieved April 20, 2015, from www.heart.org• American Lung Association. Retrieved April 21, 2015, from www.lung.org• Boonn, Ann. (2015, February 5). State Cigarette Excise Tax Rates & Rankings. Retrieved April 23, 2015, from

http://www.tobaccofreekids.org/research/factsheets/pdf/0097.pdf• County Health Rankings. Nevada Adult Smoking. (2015). Retrieved April 21, 2015, from

http://www.countyhealthrankings.org/app/nevada/2015/measure/factors/9/map• Healthy People 2020. Tobacco Use. (2014). Retrieved April 22, 2015, from http://www.healthypeople.gov/2020/topics-

objectives/topic/tobacco-use/objectives• Mineral County Nevada. Mineral County Health Nurse. Retrieved April 22, 2015, from

http://www.mineralcountynv.org/index.php?option=com_content&view=article&id=95:mineral-county-health-nurse&catid=49:mineral-county-departments&Itemid=84

• NV DHHS. Retrieved April 22, 2015, from http://dhhs.nv.gov/• Nevada Tobacco Prevention Coalition. Missions and Priorities. (2015). Retrieved April 21, 2015, from

http://www.tobaccofreenv.org/about/mission-priorities/• State of Tobacco Control. State at a Glance - American Lung Association Nevada. (2015). Retrieved April 20, 2015, from

http://www.stateoftobaccocontrol.org/state-grades/nevada/ • The Community Guide. Reducing Tobacco Use and Secondhand Smoke Exposure. (2014). Retrieved April 23, 2015, from

http://www.thecommunityguide.org/tobacco/index.html• U.S. Department of Health and Human Services. 50 Years of Progress: A Report of the Surgeon General, 2014. (2014).

Retrieved April 20, 2015, from http://www.surgeongeneral.gov/library/reports/50-years-of-progress/50-years-of-progress-by-section.html

• World Health Organization. WHO report on the global tobacco epidemic, 2011. (2011). Retrieved April 21, 2015, from http://www.who.int/tobacco/global_report/2011/en/

• Xu, Xin, Ellen E. Bishop, Sara M. Kennedy, Sean A. Simpson, and Terry F. Pechacek. "Annual Healthcare Spending Attributable to Cigarette Smoking.” American Journal of Preventive Medicine 48.3 (2015).