1. TRU Programs: Framing SHS and Tobacco Price for the Media Ann Houston Staples, CHES Tobacco Prevention & Control Branch

2. What is Framing? ( Is this little guy demonstrating tobacco cessation?) How to talk about an issue to achieve a specific result What is most important? What do you leave out? What do you include?

3. What is Framing? (Or litter prevention?) How to talk about an issue to achieve a specific result What is most important? What do you leave out? What do you include?

4. What are the important questions to keep in mind when framing an issue? Who am I trying to reach? What do they know, think or do now? What do I want them to know, think or do? What is likely to move them towards my objective?

5. Framing Example: Same Question/Different Answer Why do teens use tobacco? If you are working on Tobacco Free Schools? Because they see examples of tobacco use at school If you are working on price/tax increase? Because tobacco is cheap and easy for teens to get If you are working on SHS policy? Because they see examples of tobacco use all around them, at their jobs, and other places they go

6. Another Example: SF Worksite Law Overall Message All workers in our state deserve to be protected from secondhand smoke – not just government workers and restaurant and bar workers. For Lawmakers Smoke-free worksite laws are popular with voters and save public dollars through reduced health care costs. For Business Owners Smoke-free worksite laws reduce health care costs for workers, reduce cleaning costs and increase worker morale.

7. For Today Secondhand Smoke Tobacco Pricing Strategies

8. Secondhand Smoke How to make SHS a Teen Tobacco issue: Teens suffer the health consequences of SHS SHS Laws help teens by reducing their exposure to a known health threat and reducing their tobacco

9. Teens suffer the health consequences of SHS SHS causes those with asthma to suffer more frequent and severe attacks. (SGR, 2006) 1 Long-term exposure to SHS increases the risk of heart disease & lung cancer. (SGR, 2006) 2 There is evidence that SHS causes heart attacks. (IOM, 2009) 3

10. Teens suffer the health consequences of SHS SHS increases teens risk of developing metabolic syndrome* by nearly five-fold. (Circulation, 2005) 4 *Defined as excess body fat, high blood sugar, high lipids and high blood pressure SHS predisposes adolescents to become tobacco users themselves. (CMAJ, 2005) 5 SHS causes learning deficits in reading, math and reasoning. (Journal of Adolescent Health, 2007) 6

11. SHS Laws Help Teens Smoke-free laws reduce exposure to SHS. (The Guide to Community Preventive Services, 2010) 7 Teens in towns with strong SF restaurant laws have lower rates of progression to smoking than teens in towns with weaker or no laws. (Tobacco Control, 2005) 8 SF Workplaces and homes are associated with lower teen smoking. (JAMA, 2000) 9 Restrictions on smoking at school, home & Public Places may reduce teen smoking. (British Medical Journal, 2000) 10

12. References (SHS) 1, 2 The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, US DHHS, 2006 3 Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Institute of Medicine. October, 2009 4 Weitzman, M.R. et al. Tobacco smoke exposure is associated with the metabilic syndrome in adolescents. Circulation. August 1, 2005. 5 Becklake, M.R., et al Childhood predictors of smoking in adolescence: a follow-up study of Montreat school children, CMAJ, August 16, 2005 6 Collins, Bradley N, et al Adolescent Environmental Tobacco Smoke Exposure Predicts Academic Achievement Test Failure Journal of Adolescent Health, 41 (2007) 7 www.thecommunityguide.orgwww.thecommunityguide.org 8 Siegel, M. et al. Effect of local restaurant smoking regulations on progression to established smoking among youths Tobacco Control. October 2005 9 Farkas, A. et al. Association between Household and Workplace Smoking Restrictions and Adolescent Smoking JAMA, August 9, 2000 10 Wakefield, M. et al. Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional study. British Medical Journal. August 5, 2000.

13. Into the Frame: Teens & SHS Secondhand smoke can hurt teens now, and, even worse, can take away their future. Smoke-free law can reduce teen exposure to secondhand smoke and even help teens not to become tobacco-users. Smoke-free laws create healthy futures for todays teens.

14. Tobacco Pricing Strategies Economic research confirms that tobacco tax increases reduce teen tobacco use Numerous studies in peer-reviewed journals document that cigarette price increases reduce teen smoking. Summary: Every 10 percent increase in price reduces young adult smokers by 3.5% and teen smokers by 6-7%. (Campaign for Tobacco Free Kids, 2009) 1

15. Tobacco Pricing Strategies Higher Taxes on smokeless tobacco reduce its use, particularly among young males; and increasing cigar prices through tax increase reduces young cigar smoking. (AJPH, 2005) 2

16. Tobacco Pricing Strategies: Expert Recommendations Raising cigarette taxes and indexing them to inflation would reduce use (Institute of Medicine, 2007) Increasing cigarette taxes would prevent initiation among potential users (Presidents Cancer Panel, 2007) Raising tobacco taxes is one of the most effective tobacco prevention and control strategies (SGR, 2000)

17. Average State Cigarette Tax: $1.38 per pack North Carolinas Current Tobacco Tax: Cigs: 45 cents per pack Smokeless: 28% of wholesale price North Carolinas Cigarette Tax Ranking: 44 th Highest Among 50 States Campaign for Tobacco-Free Kids, April 2010 3

18. References: Pricing 1 http://www.tobaccofreekids.org/research/ factsheets/pdf/0146.pdf http://www.tobaccofreekids.org/research/ factsheets/pdf/0146.pdf 2 Chaloupka, R. et al. Public Policy and Youth Smokeless Tobacco Use Southern Economic Journal October, 1997. 3 http://www.tobaccofreekids.org/research/ factsheets/pdf/0097.pdf http://www.tobaccofreekids.org/research/ factsheets/pdf/0097.pdf

19. Into the Frame: Tobacco Pricing Strategies Tobacco products in North Carolina are too cheap and too easy for teens to purchase and use. Studies prove that using tobacco taxes to increase the prices of tobacco products will discourage many teens from using or becoming addicted to tobacco. A tobacco tax can protect teens from a lifetime of addiction, health problems, and early death.