CDCs Best Practices for Comprehensive Tobacco Control Programs

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CDCs Best Practices for Comprehensive Tobacco
Control Programs

• Jerelyn Jordan
• Centers for Disease Control and Prevention
• Office on Smoking and Health

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Environment -- U.S.A.

• Master Settlement Agreement, November 23,
  1998
• Settled state lawsuits against tobacco industry
• Extends to 46 states (4 settled individually)
• Provides 206 billion over 25 years to states
• Limited public health provisions
• No funds specifically earmarked for tobacco
  control

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Basis for Lawsuits

• Recoup costs states paid to treat ill smokers
• Companies violated antitrust laws
• Violated consumer protection laws
• Conspired to withhold information about adverse
  health effects of tobacco
• Manipulated nicotine levels to keep smokers
  addicted

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Post-MSA Spendingper Federal Trade Commission
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Major Issues for States

• Funding competition between tobacco control and
  other state priorities
• Restrictions in state legislation (e.g.,
  earmarking funds for youth activities only)
• Need for future renewal of legislation
• Shortened start up timeline for increased funding
  and activity
• Increased scrutiny of programs

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Best Practices for Comprehensive Tobacco Control
Programs

• U.S. tobacco control resources are expanding
• CDC/Office on Smoking and Health has received
  increased requests for guidance on effective
  programs
• Response Best Practices for Comprehensive
  Tobacco Control Programs

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Whats in Best Practices?

• Program recommendations
• Funding recommendations
• References for more information
• State comparison information
• State specific information, by program area

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Origin of Best Practices

• Recommendations are evidence based
• Analysis of excise tax funded programs in
  California and Massachusetts
• CDCs involvement in planning programs
• Activities in 4 states that individually settled
  with the tobacco industry

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Best Practices

• Tobacco control program key attributes
• Comprehensive
• Sustainable
• Accountable

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Comprehensive Tobacco Control Programs Work

• Dose response relationship between levels of
  spending and program effect
• Increase in spending per capita associated with
  larger tobacco control program effect
• Increased efficiency from lessons learned

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Best Practices

• Programmatic elements
• Community programs to reduce tobacco use and
  denormalize smoking
• School programs
• Enforcement of existing regulations and laws
• Statewide programs
• Cessation programs

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Best Practices

• Programmatic elements (continued)
• Countermarketing programs,
  including paid broadcast and print media, media
  advocacy, public relations, public education, and
  health promotion activities
• Surveillance and evaluation
• Administration and management

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Best Practices

• Goals of community programs
• To reduce exposure to environmental tobacco smoke
• To prevent initiation in youth
• To promote cessation in adults and youth
• To identify and eliminate health disparities
  among populations

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The potential for combined effects underscores
the need for comprehensive approaches.

• Reducing Tobacco Use
• A Report of the Surgeon General
• August, 2000

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Young people will perceive contradictory or
inconsistent messages in our prevention efforts
if programs do not address the smoking behavior
of parents and other adult role models and the
public health risks of environmental tobacco
smoke.

• Reducing Tobacco Use, 2000

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Investment in Tobacco ControlState Highlights
2001

• State information
• Adult smoking rates
• Youth tobacco use
• Health impact and cost
• Tobacco control legislation/tobacco taxes
• Tobacco economy (sales, agriculture,
  manufacturing)
• Sources of funding for tobacco control

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Simply stated, our recent lack of progress in
tobacco control is attributable more to the
failure to implement proven strategies than it is
to a lack of knowledge about what to do.

• Reducing Tobacco Use, 2000

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CDC WebsiteHttp//www.cdc.gov/tobacco

• Best Practices for Comprehensive Tobacco Control
  Programs
• Investment in Tobacco Control State
  Highlights 2001
• Reducing Tobacco Use A Report of the Surgeon
  General, 2001