Effective Strategies to Reduce Tobacco Use

1. Effective Strategies to Reduce Tobacco Use

2. Background on ASH Action on Smoking & Health (ASH) is Western Canada’s leading health agency devoted to tobacco reduction Founded in 1979, ASH is one of Canada’s longest serving tobacco control organizations ASH has provided local, regional, provincial and national leadership

3. ASH’s strategies include: Public awareness and education Healthy public policy Media advocacy and promotion Community mobilization

4. Alberta’s Tobacco Epidemic Tobacco use is the leading avoidable killer in Alberta - an estimated 3,458 deaths resulted from smoking in 1997 Twenty percent of all deaths in Alberta (one in five) result from tobacco use Tobacco kills more Albertans than alcohol, traffic accidents, suicide, illicit drug use, and AIDS combined Source: Alberta Tobacco Control Centre

5. Alberta’s Tobacco Epidemic Unique characteristics of tobacco: no safe level of consumption nicotine is highly addictive the vast majority of users are addicted tobacco is the only legal product known to be lethal when used exactly as intended by its manufacturers

6. Alberta’s Tobacco Epidemic Smoking rate in Canada, 1996: 27% Smoking rate in Alberta, 1996: 28% Smoking rate in Northern Lights Health Region, 1996: 39% Source: 1995/96 National Population Health Survey

7. Alberta’s Tobacco Epidemic Smoking rate in Canada, 1999: 25% Smoking rate in Alberta, 1999: 26% Smoking rate in B.C., 1999: 20% Source: Canadian Tobacco Use Monitoring Survey, Health Canada

8. Alberta’s Tobacco Epidemic Smoking rate in Canada, 1999: 25% Smoking rate in Alberta, 1999: 26% Smoking rate in B.C., 1999: 20% Source: Canadian Tobacco Use Monitoring Survey, Health Canada

9. Alberta’s Tobacco Epidemic More than 35,000 potential years of life were sacrificed to tobacco use in Alberta in 1992 An estimated 300,000 hospital days are attributed to tobacco use annually Of course, the human costs of this epidemic are intangible Source: Canadian Centre for Substance Abuse, 1996

10. Alberta’s Tobacco Epidemic Tobacco use cost the Alberta economy $728 million in 1992 alone These costs include: Direct health care costs $215 million Productivity losses $508 million Other* $ 5 million *Other includes prevention investment of less than $1 million Source: Canadian Centre on Substance Abuse

11. Alberta’s Tobacco Epidemic Cost of Smoking in the Workplace per Smoking Employee - Canada, 1995 Decreased productivity $ 2,175 Increased absenteeism 230 Increased life insurance 75 Smoking area costs 85 TOTAL = $ 2,565 Source: Conference Board of Canada, 1995

12. Effective Strategies to Reduce Tobacco Use Recent Best-Practice Reports: U.S. Task Force on Community Preventive Services, 2001 U.S. Surgeon General, 2000 U.S. Public Health Service, 2000 U.S. National Association of City and County Health Officials, 2000 U.S. Centres for Disease Control, 1999

13. Effective Strategies to Reduce Tobacco Use The most effective strategies include: 1. Tobacco tax increases 2. Smoking bans and restrictions 3. Mass media education

14. Effective Strategies to Reduce Tobacco Use Effective cessation strategies include: Provider reminder systems Provider reminder + provider education Treatment subsidy programs Telephone quitlines

15. Effective Strategies to Reduce Tobacco Use Insufficient evidence Smoke-free home campaigns Smoking cessation media series Smoking cessation contests Standalone provider education Provider feedback system

16. Effective Strategies to Reduce Tobacco Use Success stories California, Massachusetts, Oregon, and Florida have been achieving record-setting declines in tobacco use Strategies include tax/price increases, smoking bans, mass media education, and comprehensive, well-funded evidence-based program

17. Effective Strategies to Reduce Tobacco Use Results: Tobacco consumption is down by over 50% in California since 1988 Smoking prevalence has dropped from 23% to 18% since 1988 Lung cancer and heart disease have declined by 14%-15%

18. Effective Strategies to Reduce Tobacco Use No Canadian jurisdiction has adopted a comprehensive evidence-based strategy that reflects available best-practice guidelines $5/capita to $10/capita is required for a comprehensive, evidence-based strategy Bill S-15 would provide the required funding through a 19 cent/carton levy applied to tobacco manufacturers

19. Effective Strategies to Reduce Tobacco Use AADAC is leading the development of an intergovernmental strategy that will be announced this spring The need for more tobacco reduction initiatives was addresses in the Throne Speech and the PC Election Platform Health Minister Gary Mar is committed

20. Effective Strategies to Reduce Tobacco Use Program and Funding Guidelines for Comprehensive Local Tobacco Control Programs - U.S. National Association of City and County Health Officials (NACCHO) - Based on CDC Best Practice Guidelines

21. Effective Strategies to Reduce Tobacco Use Components of NACCHO Guidelines 1. Community programs 2. School Programs 3. Counter-Marketing 4. Cessation

22. Effective Strategies to Reduce Tobacco Use Components of NACCHO Guidelines 5. Enforcement 6. Administration and Management 7. Surveillance and Evaluation

23. Effective Strategies to Reduce Tobacco Use Examples of local programs Community education of the health effects of secondhand smoke School-based prevention programs Community mobilization for a local tobacco licensing bylaw Subsidized cessation treatment

24. Effective Strategies to Reduce Tobacco Use More examples: Pre/post natal education program Merchant enforcement program Regional telephone quitline Youth-driven counter-marketing effort Provider education initiative

25. Effective Strategies to Reduce Tobacco Use The Costs (urban/rural region) 1. Community education $ .94 2. School programs .88 3. Counter-marketing .68 4. Cessation 1.44 5. Enforcement .40 6. Surveillance and evaluation .44 7. Administration and management __.22 TOTAL = $5.00/capita

26. Effective Strategies to Reduce Tobacco Use Rationale: Northern Lights Region has the highest smoking prevalence in Alberta Smoking rates among Aboriginals and 20-24 year-old blue collar/pink collar workers is particularly high A major first step has already been taken with the passage of the smoke-free bylaw Northern Lights could be a national model for other health regions