1. Public Health – Seattle & King County
Scott Neal, MBA
Tobacco Prevention Program Manager
Good morning, my name is Scott Neal and I manage the Tobacco/Vapor Product Prevention Program for Public Health Seattle & King County. Thank you for the opportunity to speak with you today. I’m here today to help share the local county experience over the past several years without a comprehensively funded tobacco control program.

2. The comprehensive benefit
Youth Smoking cut in half
Significant declines in adult smoking rates
Savings of $5 for every $1 spent
You just heard from the state about the core elements of what makes up a scientifically proven tobacco control program. But I want to help illustrate this in a little more detail. When the program was funded, it meant that not only was there statewide programs like the a robust Quitline and mass media being implemented across the State, but it also meant that every single county was also funded to address tobacco prevention within their own communities and that these interventions were coordinated and aligned with CDC best practices. Additionally there was a focus on addressing tobacco use disparities by funding organizations that worked on tobacco prevention in the most vulnerable communities. This was a winning formula and Washington was a national leader in our success in cutting both youth and adult smoking rates.

3. Impact to King County Loss of more than $1,000,000/year
Forced a reliance on seeking federal funds
Extremely competitive
Unsustainable, never guaranteed
Don’t always address what is locally important
Many smaller counties ended their programs
As you know, this program was ended several years ago now and the impact for King County was significant. It meant a loss of more than $1M/year (about 80+% our total tobacco prevention funds) . This loss forced us to look elsewhere for resources to support this foundational public health work.
Tobacco prevention is somewhat unique to public health services in that we can’t afford to take the foot off the gas pedal because when we do, there is a very sophisticated industry that is constantly working to lure new smokers each and every day. Without the CDC recommended best practices being implemented; there is really only one result that can be expected…more youth will use tobacco products.
While I’m happy to share that King County was successful in obtaining some federal grants over the past several years, these are extremely competitive, never guaranteed, and do not always to address what is most important locally. Our current federal grant ends in September 2017 and we face the very real likelihood of having to cut our program in half again, bringing our program down to only 2 FTEs for a population of over 2 million people and almost 2,000 tobacco retailers.
The sad part is we are the lucky ones. When state funding ended, many of our state’s smaller counties essentially had to close their entire program down and even today have little to no tobacco prevention work being done.

4. Specific services lost in King County
Local grants for community based agencies
Cessation training and support to social service providers
Ability to earn Medicaid matching funds (Avg. $200k/yr)
Community education on tobacco and new emerging issues such as hookah and e-cigarette/vapor product use
Policy support and technical assistance for helping housing providers and colleges implementing to smoke-free policies
Reduction of local enforcement efforts for both youth access and smoking in public places
This slides shows you the services we’ve had to cut or severely reduce since the program was ended.
Lost all grant funding for local community agencies working within priority populations
Lost Training and support to social service providers that work with the most vulnerable populations
Lost ability to earn Medicaid matching funds (Avg. $200k/yr) that were used to support cessation through providing nicotine patches to social service provider agencies.
Lost ability for community education/prevention messaging about the harms around tobacco and new emerging issues such as hookah and e-cigarette/vapor product use
Lost T/A and support for helping multi-unit housing providers and local colleges/universities interested in implementing to smoke-free policies
Reduction of local enforcement efforts…youth access and smoking in public places

5. Youth tobacco use is high
Unfortunately the loss of these services has resulted in an overall increase in youth tobacco use. In the latest data from the 2014 HYS, nearly 1 in 5 (19%) of King County students report using a tobacco product in the past 30 days. Just two years ago, that figure was only 15%. As you may know, the largest increase in product use is with e-cigarettes and vapor products. In fact in just a two year window the use of these innovative products increased nearly 4 times for youth in King County.
Healthy Youth Survey (2012 & 2014)

6. Continued or widening disparities
But youth use isn’t the only troubling trend. We also still have significant disparities among a variety of populations that continue to face an unequal burden of tobacco use. In some cases the disparities have even widened over time. You will hear from a couple of speakers shortly that will highlight these issues in more detail.
These are very troubling trends, but the good news is that we know what to do to reverse it. As you’ve seen there is a mountain of evidence and best practices for reducing youth tobacco use. And we know it works in Washington, because we’ve seen the success before.
Thank you for the opportunity to share this information with you today and I’m happy to answer any questions you might have.