The Use of Commercial Tobacco Among Minority Populations Centers for Disease Control and Prevention Office on Smoking and Health Sydney Lee

Office on Smoking and Health Mentors: Michelle Johns and Leah Johnson Mentors: Michelle Johns and Leah Johnson Epidemiology Branch Epidemiology Branch Program Services Branch Program Services Branch Health Communication Branch Health Communication Branch

Epidemiology Branch Advances science of tobacco control Advances science of tobacco control Coordinates research and surveillance Coordinates research and surveillance Evaluates products, tobacco use, health effects, economic impacts, and interventions Evaluates products, tobacco use, health effects, economic impacts, and interventions

Program Services Branch Provides training and technical assistance to 50 states, D.C., 7 US Territories, 6 National Networks, and 7 Tribal Support Centers Provides training and technical assistance to 50 states, D.C., 7 US Territories, 6 National Networks, and 7 Tribal Support Centers Provides leadership for implementation of comprehensive interventions Provides leadership for implementation of comprehensive interventions Directs and manages National Tobacco Control Program Directs and manages National Tobacco Control Program

Health Communication Branch Develops and disseminates information to the public, policy makers, health professionals, and partners Develops and disseminates information to the public, policy makers, health professionals, and partners Tracks media coverage of tobacco Tracks media coverage of tobacco Provides technical assistance for tobacco counter-marketing media use Provides technical assistance for tobacco counter-marketing media use Promotes positive change in health behaviors, policies, and practices Promotes positive change in health behaviors, policies, and practices

Goals of OSH Prevent initiation of tobacco use among youth Prevent initiation of tobacco use among youth Promote tobacco use cessation among adults and youth Promote tobacco use cessation among adults and youth Eliminate exposure to secondhand smoke Eliminate exposure to secondhand smoke Identify and eliminate tobacco-related disparities Identify and eliminate tobacco-related disparities

Commercial Tobacco Use The leading cause of preventable death in the US The leading cause of preventable death in the US Causes coronary heart disease – the leading cause of death in US Causes coronary heart disease – the leading cause of death in US 8.6 million have serious illness caused by smoking 8.6 million have serious illness caused by smoking

Health Effects of Commercial Tobacco Adversely affects almost every organ in the body Adversely affects almost every organ in the body Causes cancer and coronary heart disease Causes cancer and coronary heart disease Doubles the chance for having a stroke Doubles the chance for having a stroke Drastically increases the chance for dying of lung disease Drastically increases the chance for dying of lung disease Increases risk for infertility, preterm delivery, stillbirth, low birth weight, and Sudden Infant Death Syndrome Increases risk for infertility, preterm delivery, stillbirth, low birth weight, and Sudden Infant Death Syndrome

Cigarette Smoking Prevalence CDC MMWR 2004 Percentage of adult cigarette use during the past month

Youth Prevalence Rates Percentage of youth age who smoked cigarettes in the past month CDC MMWR 2006

Youth Susceptibility Youth age who had never smoked but were susceptible to start smoking cigarettes CDC MMWR 2004

The Youth Stall 1.2 Million Percent of High School Students Who Reported Current Cigarette Use, National Risk Youth Behavior Surveys,

OSH Expert Panel Panel of tobacco and media experts Panel of tobacco and media experts Addressing the “Youth Stall” Addressing the “Youth Stall” Experts discuss the issues about reaching the youth, understand where teens are getting messages Experts discuss the issues about reaching the youth, understand where teens are getting messages Reactive vs. Proactive Reactive vs. Proactive OSH uses the suggestions of the panel to develop ideas for future projects OSH uses the suggestions of the panel to develop ideas for future projects

Culturally Appropriate Website Adding the definition of tobacco to the CDC’s tobacco website Adding the definition of tobacco to the CDC’s tobacco website Tobacco refers to “the use of manufactured, commercial tobacco products including, but not limited to, cigarettes, smokeless tobacco, and cigars” Tobacco refers to “the use of manufactured, commercial tobacco products including, but not limited to, cigarettes, smokeless tobacco, and cigars”

Secondhand Smoke Information guide for African Americans, American Indians and Alaska Natives Information guide for African Americans, American Indians and Alaska Natives African American guide is in process of development using focus groups for suggestions and approval African American guide is in process of development using focus groups for suggestions and approval American Indian and Alaska Native guide will be developed in the future American Indian and Alaska Native guide will be developed in the future

Sabemos Community outreach against secondhand smoke in the Hispanic/Latino population Community outreach against secondhand smoke in the Hispanic/Latino population Targeting families with children under 14 Targeting families with children under 14 Promotoras will go to homes in the Colonia to teach them about secondhand smoke and how to protect their children Promotoras will go to homes in the Colonia to teach them about secondhand smoke and how to protect their children Sabemos will be launched at a health fair and then surveys will evaluate effectiveness Sabemos will be launched at a health fair and then surveys will evaluate effectiveness

Don’t smoke in your home or car Don’t smoke in your home or car Talk to your kids about the dangers Talk to your kids about the dangers Keep your home and car smoke-free Keep your home and car smoke-free Teach your kids how to avoid secondhand smoke Teach your kids how to avoid secondhand smoke Support restaurants and businesses that are smoke- free Support restaurants and businesses that are smoke- free We Know – Out of respect, there is no smoking here

Community Case Study Native youth have highest prevalence rates Native youth have highest prevalence rates Have youngest average initiation age Have youngest average initiation age Research on Native American youth tobacco programs Research on Native American youth tobacco programs Research is needed to develop promising practices Research is needed to develop promising practices

Methods for Community Case Study In-depth interviews In-depth interviews Programs developed or adapted for a native audience Programs developed or adapted for a native audience Tribal Support Centers and Non-TSCs Tribal Support Centers and Non-TSCs Different regions including Oklahoma, Aberdeen area, California, Michigan Different regions including Oklahoma, Aberdeen area, California, Michigan Forming a committee with interviewees to help guide research Forming a committee with interviewees to help guide research

Preliminary Results Programs reach native audience in many ways Programs reach native audience in many ways Group youth into clans Group youth into clans Learn about history Learn about history Native imagery Native imagery Traditional games Traditional games Youth make decisions about strategies, write PSAs and material to teach peers Youth make decisions about strategies, write PSAs and material to teach peers

Final Thoughts OSH vs. Tobacco industry OSH vs. Tobacco industry Understand the audience Understand the audience Cultural competency Cultural competency Collaboration Collaboration

Interview Questions Target audience – age, gender, location Target audience – age, gender, location Program Program Length Length Development Development Activities Activities Evaluation Evaluation Informal – feedback about program Informal – feedback about program Formal – baseline data, outcome evaluation Formal – baseline data, outcome evaluation Dissemination Dissemination

Acknowledgements National Indian Health Board National Indian Health Board Morehouse School of Medicine Morehouse School of Medicine Ms. Rasheed Ms. Rasheed Ms. Graves Ms. Graves Leah Johnson Leah Johnson Michelle Johns Michelle Johns