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Measuring Progress in Tobacco Control

Measuring Progress in Tobacco Control. Patrick Remington Erich Mussak Ann Christiansen David Ahrens. Overview. Predicting expected rates of tobacco use using historical trends Setting goals based on predicted rates Evaluating progress using comparison states.

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Measuring Progress in Tobacco Control

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  1. Measuring Progress in Tobacco Control Patrick RemingtonErich MussakAnn ChristiansenDavid Ahrens

  2. Overview • Predicting expected rates of tobacco use using historical trends • Setting goals based on predicted rates • Evaluating progress using comparison states

  3. Background: Wisconsin Tobacco Control Board • Established in 2001 with funds from the Master Settlement Agreement • $24 million per year in first year/$15 million per year since then • Comprehensive program following the CDC guidelines

  4. Monitoring and Evaluation Program • Goal: Evaluate the effectiveness of Wisconsin’s $15 million/year tobacco control program • 3 components: • Monitor trends in tobacco use in Wisconsin • Evaluate statewide programs • Provide training and technical assistance for local program evaluation

  5. 1. Predicting Future Trends in Tobacco Use • First step: calculate the expected rates of tobacco use in 2005 • Use Wisconsin historical trends to predict future trends • Will use per capita sales estimates as an example • Can be applied to other measures of tobacco use

  6. Trends in Per Capita Cigarette Sales, Wisconsin, 1950-2000

  7. Trends in Per Capita Cigarette Sales, Wisconsin, 1950-2000

  8. Trends in Per Capita Cigarette Sales, Wisconsin, 1950-2000

  9. Predicting Trends in the Future What is expected by 2005?

  10. Predicted Trend Using Linear Regression

  11. Predicted Trend Using 2nd Order Polynomial

  12. Predicted Trend Using 3rd Order Polynomial

  13. Predicted Trend Using “Visual Extrapolation”

  14. Measure Percent Change from Year-to-Year Trends in Per Capita Cigarette Sales, Wisconsin, 1950-2000

  15. Year-to-Year Changes in Per Capita Sales

  16. Year-to-Year Changes in Per Capita Sales

  17. Expected Rate with a 5% Annual Decline

  18. Year-to-Year Changes in Per Capita Sales

  19. Expected Rate with a 3% Annual Decline

  20. Expected Rate with a 3% Annual Decline

  21. Summary Assumption Expected Rate Linear regression 79 Polynomial regression 59 (or 27) “Visual regression” 59 5% per year decrease 62 3% per year decrease 69* *Best estimate?

  22. 3. What Should the Goal be for 2005? Expected by 2005 Program begins

  23. 3. What Should the Goal be for 2005? Expected by 2005 20% reduction from expected

  24. 3. What Should the Goal be for 2005? Expected by 2005 Actual Board Goal (20% less than 2000)

  25. Summary • It is difficult to estimate the “expected” rates of tobacco use, using historical trends • Regardless, should calculate these expected rates PRIOR to setting goals! • Goals should be set based on a reduction for the expected rate, not from the current rate.

  26. 4. Evaluating Program Effects • The Board wants to know if the program is effective (the sooner, the better) • Strongest design is to use ‘comparison’ groups • Control for ‘inputs’ (e.g., annual tobacco control spending)

  27. Recent Example • Data from 2001 become available on per capita sales (77 packs per capita?) • These data showed a 3% decline from the value in 2000 • Is there any “early” evidence that the program is working?

  28. Annual Rates of Per Capita Cigarette Sales, if the State is to Meet its 2005 Goal Board Goal ‘Aggressive’ Goal

  29. Long-Term Trends in Per Capita Cigarette Sales, Wisconsin and US US WI

  30. Long-Term Trends in Per Capita Cigarette Sales, Wisconsin and US US WI

  31. Long-Term Trends in Difference Between U.S. and Wisconsin in Per Capita Cigarette Sales

  32. Difference Between U.S. and Wisconsin Per Capita Cigarette Sales

  33. Difference Between U.S. and Wisconsin Per Capita Cigarette Sales Effective Not Effective

  34. Adjustments • Stratify states prospectively, on the amount spend per capita for tobacco control • Compare Wisconsin to the low- medium- and high-spending states • Hypothesis: Wisconsin’s program will be effective if it achieves rates similar to states spending $3 per capita (and greater than states spending less)

  35. Trends in Per Capita Cigarette Sales, Wisconsin and Arkansas, 1950-2000 AK WI

  36. Trends in Per Capita Cigarette Sales, Wisconsin and California, 1950-2000 WI CA

  37. Trends in Per Capita Cigarette Sales, Wisconsin, 1950-2000 CA WI US AR

  38. Summary • States need to use historical data to predict future trends in tobacco use • Per capita sales • Current smoking (BRFSS) • Smoking in pregnancy (vital records) • Middle and high school (YTS/YRBS)

  39. Summary, cont. • Program effects can be assessed by comparing progress with other states, stratified by per capita program investments • Future research should consider long-term trends in tobacco use in states

  40. Acknowledgments • Monitoring and Evaluation Program • Ellen Taylor-Powell, Paul Moberg • David Ahrens, Ann Christiansen, Erich Mussak, Ann Olen, Barbara Hill, Matthew Renfro-Sargent, Amanda Riemer, Eden Schafer • Wisconsin Tobacco Control Board • David Gunderson, Earnestine Willis • Wisconsin Division of Public Health • Meg Taylor, Tom Conway, Nancy Chudy, Cathryn Brue, Jenny Commons

  41. Trailer slide • 41 slides * 1 set = 41 total slides • Monitoring and Evaluation (WTCB) • 265-9931 (Erich Mussak) • 1 of 3 sets of slides

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