Cuyahoga County Partnership for Tobacco Reduction: Results from the Adult Tobacco Surveillance Survey E. Borawski 1, S. Zelenskiy 1, E. Trapl 1, N. Shine 2, M. Peak 2, N. Colabianchi 1 1 Center for Health Promotion Research, Dept of Epidemiology and Biostatistics, CASE 2 Division of Community Health Services, Cuyahoga County Board of Health As part of the Cuyahoga County Partnership for Tobacco Reduction initiative, an annual surveillance of adult (age 18+) tobacco use, cessation and tobacco-related health is conducted via a telephone survey, using random digit dialing phone methodology. An enhanced version of the Ohio Behavioral Risk Factor Surveillance Survey (BRFSS), the survey includes questions on tobacco product (cigarettes, cigars, pipe, chew, little cigars) use, cessation efforts, rules about smoking at home and work, knowledge about secondhand smoke, opinions about smoke-free policies, and tobacco-related health issues. This poster highlights the trends in the results collected annually from , involving 3,788 Cuyahoga County residents. In nearly all of the tobacco-related questions, a positive trend is observed across the three years of data. Examples of these trends include a reduction in reported cigarette use from 26.7% in 2003 to 24.0% in Reported cessation attempts increased from 45.5% to 55.6% among smokers. The percentage of residents who reported that smoking is prohibited in their home increased from 57% to 69% over the 3 year period. With regard to smoke-free policies, support for a ban in restaurants and bars increased from 45% to 54%. In addition to more examples of trend changes, geographic distributions of tobacco product use for six regions of the county will be displayed: Cleveland (east); Cleveland (west); Inner Ring (east); Inner Ring (west); Outer Ring (east); Outer Ring (west). These results provide valuable information regarding tobacco use among county residents to be used for the development of targeted interventions. It also provides some evidence of success for the county-wide prevention and reduction efforts provided by the Partnership and its many participating community organizations and agencies. ABSTRACT SURVEY METHODOLOGY TRENDS IN TOBACCO USE AND OPINIONS ON TOBACCO-RELATED ISSUES AMONG CUYAHOGA COUNTY ADULTS RESIDENTS ( ) Tobacco Use Across Cuyahoga County Each year, Cuyahoga County adult residents are randomly telephoned on behalf of the Partnership and asked a broad range of questions regarding tobacco use and cessation, attitudes and awareness and tobacco-related health correlates and outcomes. The survey is an adaptation of the Behavioral Risk Factor Surveillance Survey, which is a comprehensive health behavior survey developed by the Centers for Disease Control and Prevention (CDC) and administered annually in every state in the US. For the past three summers (2003, 2004, 2005), ORC Macro has conducted the Cuyahoga County BRFSS on behalf of the Partnership. The annual data is then weighted to the county population estimates and results are extrapolated to represent all adults (aged 18+) living in Cuyahoga County, based on 2000 Census data. SIX GEOGRAPHIC REGIONS IN CUYAHOGA COUNTY  Cleveland – east side (C-E)  Cleveland – west side (C-W)  Inner Ring – east side (IR-E) Euclid, East Cleveland, Cleveland Heights, South Euclid, Lyndhurst, University Heights, Shaker Heights, Warrensville Township, Warrensville Heights, North Randall, Maple Heights, Garfield Heights, Cuyahoga Heights, Newburgh Heights  Inner Ring – west side (IR-W) Lakewood, Fairview Park, Linndale, Brooklyn, Parma Heights, Parma, Brooklyn Heights,  Outer Ring – east side (OR-E) Richmond Heights, Highland Heights, Mayfield Village, Mayfield Heights, Gates Mills, Beachwood, Pepper Pike, Hunting Valley, Woodmere Township  Outer Ring - west side (OR-W)** Bay Village, Rocky River, Westlake, North Olmsted, Olmsted Township, Olmsted Falls, Berea, Brookpark,, Middleburgh Heights, Strongsville, North Royalton, Broadview Heights, Seven Hills, Independence, Brecksville, Valley View ** Inner-ring suburbs are considered outer ring if they share a school district with an outer ring suburb. SUMMARY NO SMOKING IN THIS HOME Since the launching of the Partnership, our local surveillance of tobacco product use reveals a small, but consistent decline in cigarette and cigar use, the two most common tobacco products used by adults in Cuyahoga County. In 2003, the local prevalence rate of cigarette use was higher than the state average (26.7% vs. 25.4%). In 2004, the state average remained nearly the same (25.8%), while the rate in Cuyahoga County dropped to 25.0%. The trend continues in 2005, where the local prevalence rate was 24.0% (the state BRFSS data is not yet available). While these trends are extremely promising, the fact remains that a quarter of adults in the county smoke and engage in a risk behavior that is highly associated with debilitating disease and death. Of particular concern are the multiple product users. The data also reveal that public opinion regarding tobacco use in the home and in public is changing in Cuyahoga County. There was a significant increase in the number of households that ban tobacco altogether, increasing from 57% to 69% during the 3 year period. Similarly, an increasing number of residents support tobacco bans, even those including restaurants and bars. In 2005, the percentage of supporters for such a ban reached a majority (54%). The Cuyahoga County Behavioral Risk Factor Surveillance System is supported with funds from the Ohio Tobacco Use Prevention and Control Foundation and the Community Vision Council Health and Caring for All Community Vision Council All Products Local, State and National Comparisons % of current cigarette smokers Cuyahoga County State of Ohio NA 2 Nationwide NA 2 1 Adults (18-98) who report smoking cigarettes every day or some days BRFSS data for Ohio and nation not yet available. 3 The BRFSS is a state- based system and therefore does not provide a national estimate. However, as suggested by the CDC, the median prevalence across the 50 state can be used. Little Cigar Facts 71% of little cigar smokers are male 61% are African-American 79% of those who smoke little cigars also smoke cigarettes or regular cigars -- smoking, on average, a half pack of cigarettes, and one regular cigar a day.