1. Kendre Israel, MSW Coalition Coordinator Tobacco Free Missouri

2. Overview Burden of Tobacco What Works What’s Being Done Implications & Next Steps

4. Missouri by the Numbers 23.1 percentage of adult smokers (nat’l average 20.6%) 18.9 percentage of high school students (nat’l average 19.5%) 9,500 deaths of adult smokers each year 1,180 deaths of non-smokers exposed to SHS 8,600 kids who become smokers each year 14.8M cigarette packs bought or smoked by kids per year $2.13B annual health care costs caused by smoking

5. Burden on citizens, communities, and state State of Tobacco Control in MO

6. Adult Smoking Prevalence: 2007 Source: Center for Tobacco Policy Research, 2007 County Level Study

7. Secondhand Smoke Exposure: Workplace, 2007 Source: Center for Tobacco Policy Research, 2007 County Level Study

8. Top 5 Smoking Prevalences: 2007 Source: Center for Tobacco Policy Research, 2007 County Level Study

9. However, youth other tobacco products use increased during same time period Decrease in Youth Cigarette Smoking Source: Missouri Youth Tobacco Survey 2003-2009, Missouri DHSS, May 2010

11. What the CDC Recommends CDC recommends $73.2 million for Missouri When you have less than CDC recommended funding: Be aware of the resources available Know your priorities Trust the evidence-base Plan with reach in mind

12. What is Reach? Reach is a program’s ability to provide outreach to the population targeted by the Best Practice components. With limited resources, priorities need to be placed on activities which: Achieve greater efficiency in reaching the targeted populations. Place emphasis on interventions that influence social norms, systems, and networks.

13. TFM’s Focus Work statewide to reduce tobacco use and eliminate secondhand smoke for all Missourians through education and policy change. Policy Goals: Sustained funding for a comprehensive tobacco control program Comprehensive statewide smokefree workplace law

14. Youth Engagement: What works Policy Advocacy: letters to legislators, attending school board meetings to promote campus policies, engaging social networks, etc. Media advocacy: advertising in school publications, designing counter- marking campaigns, attracting news coverage at events, etc. Community engagement: promoting tobacco-free community events, recruiting advocates, coordinating efforts with local organizations, etc. Fighting pro-tobacco influences: monitoring industry tactics, exposing industry efforts (e.g., Cancer No. 9), etc.

15. We don’t smoke that s***. We just sell it. We reserve the right to smoke for the young, the poor, the black and stupid. - R.J. Reynolds Tobacco Company Executive

16. Resource User Guide: Youth Engagement Focuses on role youth play in advancing policy and best practices to use as adults and youth work together in partnership.

19. Missouri’s Funding Gap: FY 2010

20. Current Funding FY 11 – funding for cessation but youth prevention zeroed out $3.2 million for evidenced-based services for MO Medicaid clients Leverages $5.3 million in federal funds Won’t see much change in fiscal year 2012

21. Our Funding Options Master Settlement Agreement Zero dollars MSA allocated Increase the tobacco tax Lowest tax in the nation Single most effective intervention

22. High Cigarette Tax Leads to Low Adult Smoking Prevalence Source: Campaign for Tobacco Free Kids and BRFSS

23. Funding Needs Tobacco Tax? Opportunities Economic climate, budget deficit projections Increased interest in tax MO now lowest in nation Challenges Tax increase too low if done legislatively Hancock amendment No public health benefit Viability

24. TFM Position on Tobacco Tax Support ballot measure to go before voters that: Substantially raises tobacco tax Allocates a portion of the generated revenue to tobacco control and prevention.

26. MO Smokefree Map: 2004

27. MO Smokefree Map: 2006

28. MO Smokefree Map: 2008

29. MO Smokefree Map: Today

30. O’Fallon: Comprehensive ordinance passed (73% supportive). Springfield: Strengthened current ordinance (53% supportive). Cape Girardeau: Failed by about 300 votes. Webb City: Yes vote on non-binding poll encouraging Council to enact ordinance. 2011 Election Recap

31. What percentage of Missouri citizens are now protected by comprehensive smokefree laws? O’Fallon advocates Trivia Timeout

32. Missouri Is Not Last – YAY! 2 nd in number of new local smokefree laws passed in 2010 Maryville advocates

33. Smokefree Legislation: State-level 2 nd year in a row that a comprehensive smokefree workplaces bill introduced HB 438 (Schupp, D-82) Other smokefree bills: Smokefree prisons: SB 289 (Lembke, R-1) & HB 445 (Molendorp, R-123) Tobacco-free schools: HB 314 (Wells R-147)

34. On average, takes 3-5 years to pass strong law after first bill introduced What’s the Smokefree Timeline?

36. Opportunities, but also challenges ahead Education curve for legislators Reality of time Need stronger grassroots network Opposition tactics! Implications

37. Next Steps Continue to support passage of local policies Expand, ramp up grassroots network Continue to educate legislators, cultivate potential champions Ensure any new legislation introduced is (and stays) comprehensive

38. Be apart of local and statewide policy efforts Educate, educate, educate One voice, one message Focus on what works! Policy & media advocacy, community engagement, fighting pro-tobacco What You Can Do?

39. “ Too much money can make you lazy. It takes the focus off of the partnerships and networks. People are the key.” Terry F. Pechacek, PhD Associate Director for Science CDC Office on Smoking and Health

40. www.tobaccofreemo.org Email Us: info@tobaccofreemissouri.org

41. Kendre Israel, MSW Coalition Coordinator Tobacco Free Missouri – Statewide Coalition Phone: 314.935.3746 info@tobaccofreemissouri.org Thank you & Questions