campaign for tobacco-free kids changing tobacco policy to reduce heart disease & stroke nichole...

Campaign for Tobacco-Free Kids www.tobaccofreekids.org

CHANGING TOBACCO POLICYTO REDUCE

HEART DISEASE & STROKE

Nichole Veatch, Vice-President, ResearchCampaign for Tobacco-Free Kids

Washington, DCOctober 21, 2015


• Tobacco is the leading preventable cause of death, killing more than 480,000 Americans each year– Nearly 150,000 of these deaths are from heart disease and stroke

• Tobacco causes nearly 90% of lung cancer deaths, 30% of all cancer deaths, and nearly 1/3 of deaths from heart disease

• More than 2,500 kids try their first cigarette every day– Another 580 kids become regular daily smokers every day; one-third will

die from smoking-related diseases

• Tobacco use costs the U.S. approximately $170 billion in health care expenditures annually

Tobacco’s Toll in U.S.


Secondhand Smoke CausesHeart Disease & Stroke

CDC: “Exposure to secondhand smoke has immediate adverse effects on the cardiovascular system and can cause coronary

heart disease and stroke.”• Nonsmokers who are exposed to secondhand smoke at home

or at work increase their risk of developing heart disease by 25–30%.

• Secondhand smoke increases the risk for stroke by 20−30%.• Secondhand smoke causes nearly 34,000 premature deaths

from heart disease each year in the United States among nonsmokers.

• Secondhand smoke exposure causes more than 8,000 deaths from stroke annually.

Source: CDC, Health Effects of Secondhand Smoke


Source: CDC, Health Effects of Cigarette Smoking

• Just 1 year after quitting smoking, risk for a heart attack drops sharply.

• Within 5 years after quitting smoking, risk for stroke could fall to about the same as a nonsmoker’s.

Quitting SmokingCuts Cardiovascular Risks


Evidence Based Policy Solutions

• Public Policies That Protect Children, Help Smokers Quit, and Restrain the Tobacco Industry

– Tobacco Taxes– Smoke-Free Laws– Media Campaigns– Comprehensive Tobacco Prevention and Cessation

Programs – FDA Regulation of Tobacco


Tobacco Excise Taxes“Raising prices on cigarettes is one of the most effec tive tobacco control interventions.”

“The evidence is sufficient to conclude that increases in the prices of tobacco products, including those resulting from excise tax increases, prevent initiation of tobacco use, promote cessation, and reduce the prevalence and intensity of tobacco use among youth and adults.”

— 2014 Surgeon General’s Report, The Health Consequences of Smoking: 50 Years of Progress

6


Federal Cigarette Excise Tax + Average State Cigarette Tax

198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015

$0.00

$0.50

$1.00

$1.50

$2.00

$2.50

$3.00Federal Cigarette TaxState Average Cigarette Tax

federal rate ($1.01) +current state average

($1.60*):$2.61 per pack

1996 federal rate (24¢) + state average

(33¢):57¢ per pack

2001 federal rate (34¢) + state average

(43¢): 77¢ per pack

October 2015* Includes state cigarette tax rates in effect as of October 1, 2015.


Smoke-Free Laws

• “. . . smokefree legislation at the state and local levels is a key component of a comprehensive tobacco control strategy.” (2014 Surgeon General’s Report)

• The Surgeon General’s Report calls for “complete protection of the entire U.S. population from exposure to tobacco smoke through comprehensive smokefree indoor air policies.” (2014 Surgeon General’s Report)

8


Source: American Nonsmokers’ Rights Foundation

Percent of Population Covered By Smoke-Free Laws (Workplaces, Restaurants & Bars)

19901991

19921993

19941995

19961997

19981999

20002001

20022003

20042005

20062007

20082009

20102011

20122013

20142015

0

10

20

30

40

50

60

70

80

2015: 49.5%24 states and hundreds of

communities are smoke-free

1996: < 1%Comprehensive smoke-free laws

in 7 communities nationwide

11/27/2002: 3%DE becomes 1st smoke-free state

in all workplaces, restaurants and bars


Statewide ban motivatingMinnesota smokers to quit

By JOSEPHINE MARCOTTY, Star Tribune December 11, 2007

The state-wide smoking ban is having an unadvertised consequence: More smokers are trying to quit.

Since the ban went into effect Oct. 1, the state's two largest health plans and the anti-tobacco organization ClearWay have seen a sharp spike in the number of people using nicotine replacement products and smoking cessation counseling programs.

Blue Cross and Blue Shield of Minnesota said that between September and October the number of people who enrolled for its telephone hotline counseling service jumped to 525, an increase of 43 percent. Compared to October 2006, the number of over-the-counter products like the patch and nicotine gum that it provided to members tripled to a total of 10,000 claims.

"It's doing what we like it to do," said Marc Manley, medical director for population health at Blue Cross. "Helping people decide to quit."

Medica, Minnesota's second-largest health plan, said it has also seen a 40 percent increase in the number of members seeking counseling.


Institute of Medicine Report (2009)Secondhand Smoke Exposure and Cardiovascular

Effects: Making Sense of the Evidence

• IOM reviewed 11 publications looking at the relationship between smoke-free laws and cardiovascular events.

• Data consistently demonstrate that secondhand smoke exposure increases the risk of coronary heart disease and heart attacks.

• Based on the evidence, IOM concluded that smoke-free laws, “do, in fact, decrease the rate of heart attacks.”

Source: IOM Report Brief: Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence


These findings suggest that tens of thousands of heart attacks could be prevented each year, and that states and communities that do not havecomprehensive smoke–free laws could have significant cardiovascular health benefits by doing so.

There’s no time to waste with this many lives at stake. It is time to mount a full-scale assault on the tobacco epidemic and eliminate all exposure to secondhand smoke. Smoke-free laws are one of the most readily available and cost-effective methods for preventing heart attacks, heart-disease related illnesses and deaths, and reducing health care costs.

CDC Statement on IOM Report


Mass Media CampaignsReduce Tobacco Use

To accelerate progress in tobacco control, 2014 Surgeon General’s Report calls for specific actions, including:

“Counteracting industry marketing by sustaining high impact national media campaigns like the CDC’s Tips

from Former Smokers campaign and FDA’s youth prevention campaigns at a high frequency level and

exposure for 12 months a year for a decade or more.”

— 2014 Surgeon General’s Report, The Health Consequences of Smoking: 50 Years of Progress


CDC’s “Tips from Former Smokers”

• First-ever government funded national tobacco education campaign, launched March 2012

• Features real people dealing with serious long-term health effects from smoking and SHS

• 2012 Tips campaign motivated 1.6 million smokers to make a quit attempt

• 2012 Tips campaign helped more than 100,000 U.S. smokers quit for good and saved 17,000 from premature death

• Cost-effective 14cdc.gov/tips


Comprehensive State Prevention and Cessation Programs

• State and Community Interventions

• Public Education Campaigns

• Cessation Services including Quitlines

Three Core Elements Help Prevent Initiation and Encourage and Help People to Quit


NYC Adult Smoking, 2002-2014

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 201410

12

14

16

18

20

22

24

26

28

30

Overall: 35.3% decline

Sm

ok

ing

Pre

va

len

ce

(%

)

NYS tax increase

Federal tax increaseNYS tax

increase

Hard-hittingmediacampaigns

Smoke-freeWorkplaces

Free patch programs start

NYC and NYStax increases

Ad Campaign/Patch Give-away National TIPS Campaign

Age of sale increase (21); comprehensive pricing & enforcement policies

Source: NYC Community Health Survey, 2002-2014


Emerging Issues

• Raising Tobacco Sale Age to 21

• Electronic Cigarettes


Raising the Tobacco Sale Age to 21

• Why Raise Age? • 95% of smokers start before age 21• Nicotine is addictive • Older kids/young adults are source

of cigarettes• Tobacco companies target young

adults

• IOM report released this year concludes that raising the tobacco sale age to 21 will improve public health and save lives.

• One state and at least 90 localities in 8 states have raised the tobacco sale age to 21.


Growing World of E-Cigarettes

(images not to scale)


E-Cigarettes Marketing Mimics the Worst of Cigarette Marketing

TV Ads

CelebrityEndorsements

Cartoons

Kid-Friendly Flavors

MusicSponsorships

NASCAR Car Sponsorships

Branded Items

“Cigarette Girls”Countertop Displays


2011 2012 2013 20140%

2%

4%

6%

8%

10%

12%

14%

16%

18%

1.5%2.8%

4.5%

13.4%

15.8%

14.0%12.7%

9.2%

E-Cigarette Use Cigarette Smoking

High School E-Cigarette Use vs. Cigarette Smoking (past 30 day use)

Source: CDC, National Youth Tobacco Survey (NYTS)


Potential of E-Cigarettes to Benefit Public Health Hinges on Unanswered Questions

1. What are the long-term health effects?2. Will they draw in youth users? How will that impact

use of other tobacco products?3. Can e-cigarettes help smokers quit completely?

Effective regulation is needed to minimize the potential harms of e-cigarettes and maximize any potential

benefits


Federal Regulation and State Activity on E-cigarettes

• FDA’s Proposed “Deeming Rule” issued April 25, 2014 Unsure when will be finalized

• States and localities can take their own action, but should not lose focus on policies that reduce use of traditional tobacco products

• States and Localities Are Taking Policy Action on Electronic Cigarettes Prohibit sales to youth: 48 states Smoke-free: 8 states and 400+ localities Tax: 4 states, Washington, DC and 5 localities Child-proof packaging: 17 states Flavor restrictions: 3 localities(Laws passed as of October 2, 2015)


You Can Help

• Get Involved with State or Local Tobacco Control Coalition

• Learn more at our website: www.tobaccofreekids.org

– Join our email list: tfk.org/join

– Like us on Facebook: facebook.com/tobaccofreekids

– Follow us on Twitter: @tobaccofreekids

http://www.tobaccofreekids.org/

campaign for tobacco-free kids changing tobacco policy to reduce heart disease & stroke nichole...

Documents