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Irene Buadoo, MD MPH Montgomery County Department of Health and Human Services Rockville, Maryland

2005 National Conference on Tobacco or Health. Effective Approaches to Comprehensive Tobacco Control in Local Public Health May 6, 2005. Irene Buadoo, MD MPH Montgomery County Department of Health and Human Services Rockville, Maryland. Tobacco control is a major public health issue!.

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Irene Buadoo, MD MPH Montgomery County Department of Health and Human Services Rockville, Maryland

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  1. 2005 National Conference on Tobacco or Health Effective Approaches to Comprehensive Tobacco Control in Local Public Health May 6, 2005 Irene Buadoo, MD MPH Montgomery County Department of Health and Human Services Rockville, Maryland

  2. Tobacco control is a major public health issue!

  3. Discussion • Background • Case Study – Montgomery County, Maryland • Identifying effective approaches • What works? Review of Literature

  4. Challenges • Getting the Big Picture • Figuring out Where you are in tobacco control • Deciding Where you want to go • Prioritizing to get it done

  5. Case Study

  6. Population: Approximately 910,156 residents Adjacent to Washington DC and neighboring Virginia to the west

  7. Montgomery CountyTobaccoUsePrevalence Adult tobacco rates – lowest in the State and below the National rates Youth tobacco rates – lowest in the State and below the National rates

  8. Strategies Coalition of strong tobacco control and public health advocates – Smoke Free Coalition; Community Mobilization A focus on top priorities and what worked in tobacco control.

  9. Strategies: (cont.) Smoke Free Montgomery County, formed in 1994 as the Community Partnership’s Tobacco Control Task Force • Successfully advocated for local legislation / regulation to: • Conduct comprehensive tobacco sales compliance checks – citing both clerks and owners for non-compliance (1999) • Tax non-cigarette tobacco products sold (1999)

  10. Strategies: (cont.) Community Mobilization and Advocacy • Eliminate self service displays of tobacco products • Advocated to make all restaurants or eating establishments smoke-free

  11. Strategies: (cont.) • Youth mobilization effort against tobacco control • Montgomery County Licensure and Regulatory Services Restaurant inspections • Tobacco Enforcement Program

  12. Strategies: (cont.) Tobacco Enforcement Program • Tobacco Enforcement Specialists issue civil citations to retail cigarette license holders and their clerks for tobacco distribution and/or display violations.

  13. Strategies: (cont.) • Establishment of Montgomery County’s Smoke Free Restaurant Law - To protect workers and patrons from harmful secondhand smoke

  14. Identifying Effective Approaches • COMMUNITY-BASED PROGRAMS • Coalition-Building – Purpose: • To involving the community to work together on tobacco control • Creates an awareness of the impact of tobacco and tobacco-related diseases, including cancer.

  15. Next Steps • Develop a needs assessment of your local region – population? Smoking prevalence, Medicaid expenditures on tobacco-related diseases and cancer • Develop an inventory of tobacco use prevention and cessation programs in the county • Assess funding for tobacco control programs?

  16. Next Steps (Cont’d) • Involve target populations in strategic plan – Youth, Young Adults (out of school) African American, Latino, Asian, and Pacific Islanders, special populations, urban youth, etc. • Develop a strategic plan and establish clear goals and objectives

  17. School-Based Programs • Multi-component school-based health curriculum that includes a tobacco use prevention education component. Project TNT and ALERT, Life Skills Training • Teacher Fidelity – Training of teachers to ensure they are teaching the tobacco use prevention component with program fidelity. • Enforcement of no smoking laws on campuses.

  18. School-Based Programs • Consequences for student violation of no smoking laws • Parental involvement

  19. Cessation Programs • Early intervention – for the young adult population, tailor messages and activities for this population, since the adult cessation methods (which is usually late intervention methods) may not work for this population • Late intervention – (counseling, behavioral therapy, directed toward individual smokers increase the likelihood of quitting smoking).

  20. Enforcement Programs • Enforcement of no smoking laws • Promote Clean Indoor Air initiatives, including promotion of smoke free workplaces • Community and coalition involvement in enforcement efforts

  21. Conclusions A comprehensive public health tobacco control program addresses the problem of tobacco use and prevention in multiple ways. Impact is greater if conducted as part of a larger integrated effort to include policy and environmental approaches

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