Tobacco Control Update

1. Tobacco Control Update The 10th Maryland State Council on Cancer Control Cancer Conference November 12, 2003

2. Cigarette Restitution FundProgram - Tobacco • Administration • Media and Counter-marketing • Statewide Programs • Local Public Health Component • Surveillance and Evaluation

3. Purpose of Maryland’s Smoking Stops Here Program • Making an impact on our youth is the purpose of Maryland’s Anti-Tobacco Program. • It is not about cessation. The addictive nature of tobacco products makes it near impossible to get someone to stop smoking. • Maryland’s Anti-Tobacco Program is about preventing our youth from starting down the deadly road.

4. Who are we targeting? • Youth (13-17) • Young Adults (18-24) • Parents with minors in household • Pregnant women • Special populations - African Americans, Latinos, Asians

5. Ultimate Goal To get Marylanders to join together to take action that ultimately will minimize the exposure of our youth/young adults to tobacco products, smoking and the dangers of secondhand smoke.

6. SSH Successes to Date • Over 105 non-profit organizations and coalitions signed on to support the program • Over 101,235 visitors to Smoking Stops Here Web site • Over 21,545 Marylanders have pledged to take action against tobacco. Many of them are youth and young adults • Participated in over 175 community meetings and 630 community events

7. What are we doing now? • Empowering community groups • Increasing youth participation • Integrating Smoking Stops Here into college campuses • Increasing exposure through healthcare and athletics • Promoting visibility through businesses and media

8. Smoking Stops…In the Community Empowered community groups to: • Post activities and cessation classes on Web site • Get permission to post decals on schools • Initiate policy and create signs for playing fields • Create Smoke Free bingo and pass out information in faith based establishments • Place license plate frames on county vehicles

9. …At School • Increase youth participation • Work with youth coalitions to • Support S.A.S.S. and T.R.A.S.H. groups activities • Create youth activity sheet • Display signs/posters • Promote Smoking Stops Here contests and events • Propose Smoking Stops Here community service credit for fall • Create Youth PSA Contest

10. …At College • Integrate Smoking Stops Here into college campuses • Establish campus contacts • Create college-specific banners • Counter Industry with spring activity • Develop Web site story and highlights

11. …In Health Care • Increase visibility in hospitals and clinics • Utilize health coalition contacts • Enhance Web site with health professional stories and information

12. …At Play • Increase exposure through athletics • In collaboration with local health department and communities • Execute sponsorship program with minor league baseball • Create “Get Involved” activity sheet • Distribute HERE gear and signage • Set up displays at select events • Work with Comcast Sportsnet to develop unique professional athlete PSA campaign • Work with Cal Ripken’s Aberdeen Ironbirds to develop kid-focused grassroots program • Anne Arundel County Rec & Parks signage

13. …At Work • Promote visibility through businesses • Develop HERE Club Card Program • Develop presentations for prospective businesses • Recruit businesses to join HERE Club Card program • Distribute decals for display • Distribute P.O.P. materials • Maintain list of businesses for Web site posting

14. ...In the Media • Promote visibility through media relations • Promote campaign’s grassroots education and community event sponsorships • Interviews with College Stations • Counter Industry Events • Smoke-Free Business-Sponsored Events • Web Site Monthly Features

15. HERE Co-Sponsored Events • Identify highly visible events • Participate in events targeting youth and young adults • Place special emphasis on sponsoring events in all four regions • Coordinate activities with local health departments and community groups • Deploy street teams to educate population, distribute HERE gear and literature, and collect pledges

16. Web Site • All calls to action send people to http://www.SmokingStopsHere.com • Informative • Frequently updated • Easy to navigate

17. DHMH College Initiatives • Selected due to recent statistics tobacco on rise in colleges • Formed Maryland Colleges and Tobacco Control Partnership and conducted Summit • Fostering student based tobacco control coalitions • Provided funding for prevention, cessation, tobacco free policy and social norms • Addressing campus policy, tobacco sales, and restricting current smoking policies

18. DHMH Tobacco Free Sports Initiatives • Selected to target youth and young adults through prevention, cessation, and positive role models • Several sports teams and public fields have adopted smoke-free policies • Teams are active in county tobacco prevention and cessation activities • Expanding effort to focus on Maryland’s Recreation and Parks Departments

19. Statewide Youth Movement Against Tobacco Use T.R.A.S.H. (Teens Rejecting Abusive Smoking Habits) • Ten groups funded by Legacy across the State • Grants focus on youth empowerment • Each group elects a youth advisory board • Conduct poster contests, counter-marketing activities, radio and video PSA’s, and peer education

20. Legal Resource Center for Tobacco Regulation, Litigation & Advocacy • Statewide organization • Partially funded by the Cigarette Restitution Fund • Provides legal and technical support to local health departments, community coalitions, and individuals working on tobacco control. • Scope of work includes: Sales Practices; Liability; Secondhand Smoke; Licensing; Enforcement

21. Accomplishments • Respond to Service Requests: • Draft and review local tobacco control bills and program procedures • Provide litigation support to county attorneys and others • Prepare public health officials to testify • Train and educate on legal issues (citation authority, scope of laws, best practices, etc.) • Aid in establishing compliance check programs • Answer legal questions from public on topics such as smoke drift in apartments and workplaces. • Create Newsletter and Web page • Work with Tobacco Control Legal Consortium and other national organizations

22. How the Center’s Work Aids Locals • Attorneys have skills that advance local agendas: - understand the current state of laws in each jurisdiction - research laws that exist in other states - can answer legal questions (from process to enforcement) - draft legislation & enact legislation in a legally supported and valid manner so as to avoid legal challenge - empower the community to address legislators • Attorneys have skills to protect local’s work - Strategize, trouble shoot and anticipate arguments to avoid legal problems. - Create effective enforcement programs for passed legislation - Respond to legal threats and defend against challenges.

23. Local Public Health Component FY04 $8,000,000 • School-based • Community • Enforcement • Cessation

24. Local Public Health Component is guided by: • Science • Best Practices • Community Input (Coalitions)

25. Best Practices – School-based • CDC’s Research to Classroom curricula • Link with statewide media and community projects • Target social influences that promote tobacco use among youth • Involve parents and community organizations

26. Best Practices - Community • Increase the number of organizations involved in planning and conducting community level programs • Implement policies that support non-use of tobacco • Serve people in their homes, worksites

27. Best Practices - Cessation • Eliminate cost barriers to treatment for the medically undeserved and uninsured • Implement AHCPR sponsored cessation guidelines

28. Best Practices – Enforcement • Conduct Retailer Compliance Checks • Monitor and Enforce Clean Indoor Act Regulations

29. FY03 Accomplishments – Cessation • Trained 1,017 nurses, health care provides, advocates and community organizations on various cessation models. • 5,550 adults participated in smoking cessation classes, 3,032 received nicotine patches or Zyban.

30. FY03 Accomplishments - Enforcement • 6,148 tobacco retailer compliance checks • 696 citations issued to retailers for sales to minors • 802 youth cited for illegal possession of tobacco products

31. FY03 Accomplishments – School-based • Trained 2,987 teachers, nurses, daycare providers, school and college administrators on available tobacco use prevention and cessation curricula and programs. • 117,212 students received tobacco use prevention instruction. • 37, 553 college students received tobacco use prevention education on campus.

32. FY03 Accomplishments –Community • Five jurisdictions passed local policies to restrict smoking and product placement (Caroline, Anne Arundel, Talbot, Charles, Prince Georges). • 2,278 health care providers, parents and advocates were educated on community based tobacco use prevention programs and strategies. • Twenty community churches were funded to incorporate tobacco prevention and cessation messages into various faith-based programs. • 69 minority organization funded to conduct tobacco control programs.

33. The Changing DialogAbout Smoking in Maryland • 95.3% of adults in Maryland either don’t smoke cigarettes or would like to quit. (84.6% and 10.7% respectively) • Only 3.3% of adults in Maryland currently smoke and do not plan to quit. • 1.4% of Maryland adults currently smoke and are unsure of whether they want to quit or not.

34. Cigarette Smoking is Down • 30.6% decrease among middle school youth (7.2% - 2000, 5.0% - 2002) • 23.5% decrease among high school youth (23.0% - 2000, 17.6% - 2002) • 12.0% decrease among adults (17.5% - 2000, 15.4% - 2002)

35. Cigarette Smoking is DownAmong Minority Populations • 23.1% decrease among middle school youth (6.5% - 2000, 5.0% - 2002) • 21.9% decrease among high school youth (16.0% - 2000, 12.5% - 2002) • 10.3% decrease among adults (18.5% - 2000, 16.6% - 2002)

36. Under-age Smoking Remains a Significant Problem

37. Adult Smoking Remains a Significant Problem

38. Future Tobacco Surveys? • Data on tobacco use behaviors at both state and local levels is essential to the success of Maryland’s tobacco program. • Provides critical data necessary to any evaluation. • Provides data required by the General Assembly. • Provides data required to allocate funds to counties. • Budget for surveys deleted in FY04 and request is consequently now “over-the-mark” for FY05.