Tobacco  Use  and  Tobacco  Control  The  BIG  Picture  

In  the  beginning…there  were  no  cigare:es  

h:p://www.cdc.gov/mmwr/preview/mmwrhtml/mm4843a2.htm  

Big  Tobacco  –  A  (very)  brief  history  

•  1889:  James  Buchanan  Duke  formed  American  Tobacco  Company  

•  1906:  tobacco  exempted  from  FDA  regulaTon  •  1913:  RJR’s  “Year  of  the  Camel”    

Big  Tobacco  Now  (U.S.)  •  Convicted  of  racketeering  in  2006  •  $12.4  billion  on  adverTsing  &  promoTons  in  2006  –  DOUBLE  that  spent  in  1997  

•  New  tobacco  and  nicoTne  products    

A  Global  Epidemic  

•  World’s  leading  cause  of  preventable  death  •  PotenTal  for  one  billion  deaths  in  the  21st  century  •  China,  Russia,  US,  Japan  and  Indonesia  top  5  

 

“The  most  important  market  that  we  are  seeking  to  penetrate  is  of  course  China.”  

 Hermann  Waldemer,  Philip  Morris  InternaTonal  CFO  (2009)  h:p://www.tobaccofreekids.org/research/factsheets/pdf/0366.pdf  h:p://www.tobaccofreekids.org/research/factsheets/pdf/0366.pdf  

InternaTonal  Tobacco  Control  

“End  Game”  Approach  taken  by  New  Zealand.    In  2011  the  government  commi:ed  to  a  goal  of  achieving  a  smoke  free  New  Zealand  by  2025.  

U.S.  signed  in  2004  but  has  not  raTfied  

Tobacco  Control  Who’s  Who  Research  &  Dissemina.on  

Advocacy  

Federal  Regula.on  &  Tobacco  Control    

NC  Tobacco  Control  

And  us!  

US  Adult  Smoking:  19.3%  

   

1.  Centers  for  Disease  Control  and  PrevenTon.  Vital  Signs:  Current  CigareAe  Smoking  Among  Adults  Aged  ≥  18  Years—United  States,  2005–2010.  Morbidity  and  Mortality  Weekly  Report  2011;60(33):1207–12  [accessed  2012  Jan  24].  

2.  h:p://www.cdc.gov/VitalSigns/AdultSmoking/index.html#StateInfo  

Where  do  smokers  live?    

19.8%    

h:p://www.cdc.gov/VitalSigns/AdultSmoking/index.html#StateInfo  

Major  Events  in  U.S.  Tobacco  Control  •  1998  Master  Se:lement  Agreement  –  Billions  to  states  in  yearly  investments  –  Limited  adverTsing  to  youth  and  eliminated  outdoor,  billboard  &  public  transit  ads  

–  Industry  documents  made  public  •  2009  Family  Smoking  PrevenTon  and  Tobacco  Control  Act  –  Youth  markeTng  and  sales  restricTons    –  FDA  regulaTon  –  “appropriate  for  protecTon                                          \  of  public  health”  

–  Bans  reduced  harm  claims  (e.g.  “light”)  – New  warnings    

Tobacco  Control  Funding  in  the  States  

Tobacco  Control  in  NC  

•  EffecTve  mulT-­‐component  youth  prevenTon  iniTaTve  2001-­‐2010  

•  Gu:ed  by  NC  Legislature,            now  minimal  funding  for            NC  Quitline  and            county  health            departments    

CDC  Tips  From  Former  Smokers  

h:p://www.youtube.com/watch?v=52rXcTVyPzI&feature=player_embedded  

Tobacco  Control  Act  &  FDA  Center  for  Tobacco  Products  

Cigare:e  Warning  Labels  •  Held  up  in  the  courts  

Menthol    •  Not  included  in  ban  on  flavored  cigare:es  •  Study  report:  removing  menthol  cigare:es  from  market  would  

benefit  public  health,  but  no  recommendaTon  for  ban  •  Industry  suit  in  process    Cigars  •  Flavor  bans  &  new  warning  labels  do  not  apply    •  RegulaTons  of  cigars  is  opTonal  •  LegislaTve  efforts  underway  to  exempt  big  cigars  

NC  Tobacco  IniTaTves    

•  Master  Se:lement  funds  used  to  establish  Health  and  Wellness  Trust  Fund  (HWTF):  2001-­‐2011  

•  Four  primary  components:  –  Teen  IniTaTve:  2003  –  TRU  Media  Campaign:  2004  –  Quitline:  2005  –  Colleges  IniTaTves:  2006  

Teen  Tobacco  Use  PrevenTon  and  CessaTon  IniTaTve  

•  Funds  43  School  and  Community  Based  Grantees  –  Prevent  Youth  IniTaTon  of  Tobacco  Use  –  Promote  Tobacco  Use  CessaTon  Among  Youth  –  Eliminate  Youth  Exposure  to  Secondhand  Smoke  –  Reduce  Tobacco  Related  DispariTes  Among  Priority  PopulaTons  

Youth  Smoking  in  NC  

15.0%  

11.3%  9.3%  

5.8%  4.5%   4.3%   4.2%  

31.6%  

27.8%   27.3%  

20.3%  19.0%  

16.7%  15.5%  

0%  

5%  

10%  

15%  

20%  

25%  

30%  

35%  

1999   2001   2003   2005   2007   2009   2011  

NC  Middle  &  High  School  Smoking  Prevalence  1999-­‐2011  NC  YTS  

Middle  School   High  School  

•  Major  source  of  statewide  tobacco  prevenTon  and  cessaTon  resources  for  North  Carolina  youth  

•  Growth  in  policy  outcomes  –  100%  Tobacco  Free  Schools  –  Smoke  Free  Restaurants  and  bars  

•  Significant  reducTons  in  youth  tobacco  rates  –  53,000  fewer  teen  student  smokers  in  2009  than  in  2003  

 

Teen  Tobacco  IniTaTve  Accomplishments