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Advancing Tobacco Cessation Policy. David Zauche Senior Program Officer Partnership for Prevention October 13, 2011. Congressional Prevention Caucus. Members. Aspirin Task Force. Partnership for Prevention . Leading By Example. National Chlamydia Coalition. Action To Quit.

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advancing tobacco cessation policy

Advancing Tobacco Cessation Policy

David Zauche

Senior Program Officer

Partnership for Prevention

October 13, 2011


Congressional Prevention Caucus


Aspirin Task Force

Partnership for Prevention

Leading By Example

National Chlamydia Coalition

Action To


National Commission on Prevention Priorities

Health Professionals Roundtable



ActionToQuit urges all sectors – health plans, employers, quitlines, health care systems, and policymakers – to work together to ensure that all tobacco users have access to comprehensive cessation treatments.

what does actiontoquit do
What Does ActionToQuit Do?
  • ActionToQuit Network
  • Daily Listserv
  • Quarterly Educational Webinars
  • Website -
  • Monthly Podcasts
actiontoquit state policy program
ActionToQuit State Policy Program


Cessation Coverage/Treatment for Colorado’s Uninsured


Increasing Cessation Access for All Nevadans (I-CAAN)


Tobacco Cessation Summit & Action Plan

New England:

New England Partnership for Smoking Cessation Policy

New York:

New York Access to Tobacco Use Treatment Strategic Planning Project


Virginia Partnership for Tobacco Use Cessation

actiontoquit state policy program1
ActionToQuit State Policy Program
  • Problem statement:
    • Comprehensive tobacco cessation treatments have been proven to work but policy and health system barriers exist that prevent many smokers from utilizing them.
  • Goal:
    • Develop alliances in states to build their capacity for policy and system change.
    • Long-term Outcome:
    • Increase coverage for and utilization of tobacco cessation services in states.
actiontoquit state policy program2
ActionToQuit State Policy Program
  • Requirements

Each funded project must do three things:

  • Develop state tobacco cessation alliance
  • Hold a state summit meeting for leaders and advocates
  • Create a state action plan to advance cessation policy/services
the tobacco problem
The Tobacco Problem

Around the World and in the USA

tobacco worldwide
Tobacco Worldwide
  • An estimated 1.3 billion people are smokers worldwide
  • Around 5.4 million deaths in 2011 will be caused by tobacco. But tobacco is projected to kill 6.5 million people in 2015 and 8.3 million 2030.
  • Smokers die on average 15 years sooner than nonsmokers.
  • Tobacco use will kill 1 billion people in the 21st century if current smoking trends continue.
smoking in the usa
Smoking in the USA
  • In the United States, smoking accounts for about one in five deaths annually.
  • 42% of American adults smoked in 1965 – 19% today.
  • Of the 45 million Americans currently smoking , half of them will die prematurely from diseases like lung cancer and heart disease.
  • Approximately 70% of smokers have the desire to quit and 40% of smokers try to quit each year.
the high cost of smokers
The High Cost of Smokers
  • American Lung Association - $301 billion (September 2010)
  • Increased hospital days per 1000 employees (800 vs. 381)
  • More health-related absenteeism (6.7 days/year vs. 4.4 days/year)
  • Lost productivity time—up to 4 weeks per year (8% of total work time, in addition to regular breaks)
florida fatalities
Florida Fatalities

Average fatalities per 10 years:

  • Shark attacks – 2 - 3
  • Alligator attacks – 10
  • Lightening strikes – 90
  • Murders – 10,000
  • Tobacco use – 300,000
september 2011 mmwr report
September 2011 MMWR Report

Nearly 1 in 5 adults smokes

(45.3 million total)

Smoking declined from 20.9% in 2005 to 19.3% in 2010

current cigarette smoking prevalence among working adults
Current Cigarette Smoking Prevalence Among Working Adults
  • CDC analyzed National Health Interview Survey (NHIS) data for 2004-2010
  • Overall, age-adjusted cigarette smoking prevalence among working U.S. adults was 19.6%
  • Highest smoking prevalence:
    • Less than high school education (28.4%)
    • No health insurance (28.6%)
    • Living below the federal poverty level (27.7%)
    • Aged 18-24 years (23.8%)
smoking by industry and occupation
Smoking by Industry and Occupation
  • Industries with highest smoking rates
    • Mining (30.0%)
    • Accommodation and Food Services (30.0%)
    • Construction (29.7%)
  • Occupations with highest smoking rates
    • Construction and Extraction (31.4%)
    • Food preparation and serving related (30.0%)
    • Transportation and material moving (28.7%)
  • Implement proven interventions in workplaces with higher smoking prevalences
    • Smoke-free workplace policies
    • Individual, group, and telephone-based counseling
    • Cessation medications
    • Tailored print or web-based education materials
    • Comprehensive insurance coverage for effective cessation treatments
  • Workplace interventions should be tailored to the interests, challenges, and needs of particular industry or occupation groups.
usphs 2008 update
USPHS 2008 Update

Providing tobacco dependence treatments (both medication and counseling) as a paid or covered benefit by health insurance plans has been shown to increase the proportion of smokers who use cessation treatment, attempt to quit, and successfully quit. Therefore, treatments shown to be effective in the Guideline should be included as covered services in public and private health benefit plans.

u s public health service guideline
U.S. Public Health Service Guideline
  • Clinicians should screen all adults for tobacco use and assess willingness to quit
  • Individual, group, and telephone counseling are effective, and their effectiveness increases with treatment intensity
  • Counseling and medication are effective when used by themselves. However, the combination of counseling and medication is more effective than either alone
  • Tobacco dependence is a chronic disease often requiring repeated interventions and multiple quit attempts
coverage makes a difference
Coverage Makes a Difference

Source: USPHS, Treating Tobacco Use an Dependence, 2008

tobacco cessation benefit
Tobacco Cessation Benefit
  • The CDC’s recommended guidelines for smoking cessation benefits include five key actions:
  • Comprehensive tobacco cessation benefits cost between $1.20 and $4.80 per person per year compared to $1,623 per smoker per year in excess medical expenditures alone (not including lost productivity)
  • Tobacco dependence is a chronic, relapsing, and often fatal disorder.
  • Economic costs are enormous.
  • Tobacco cessation treatments are effective and cost-effective.
engaging employers in tobacco control
Engaging Employers in Tobacco Control

The workplace is a key sector in tobacco control and businesses can make a significant contribution to saving lives from tobacco-related illness. On June 8, 2011 Partnership for Prevention and Legacy sponsored an educational webinar for the ActionToQuit Network and other tobacco control leaders nationwide. The program featured two companies, Sprint and Caterpillar, which have made a corporate commitment to tobacco control. Additionally, Ellen Vargyas of Legacy discussed the current debate over tobacco use and hiring policy.

thank you
Thank You!

Partnership for Prevention appreciates all the efforts of leaders in Iowa to advance

tobacco cessation policy!

graphic warning labels
Graphic Warning Labels

In June 2011 the Food and Drug Administration issued a final a rule to modify the required warnings that appear on cigarette packages and in cigarette advertisements. These new required warnings will consist of nine textual warning statements accompanied by color graphics depicting the negative health consequences of smoking.