1. Tobacco Health Effects and Best Practices in Tobacco Control

2. Tobacco Use: Scope of the Problem
Tobacco use is the leading preventable cause of disease and premature death in the U.S. and the world
1,400 deaths in Montana each year
430,000 deaths annually in U.S.
1,200 each day
5 million world wide
Get Visual from TFY

3. Scope of the Problem Cont.
There are approximately 1.25 billion smokers in the world, and 800 million of these live in the developing world.
By million people in the world will die of tobacco related illnesses

4. • At the beginning of the new century, Virginia Slims launched a new ad campaign targeting women of many ethnic backgrounds.
• Each ad depicts a strikingly beautiful woman, extols her beauty and includes the slogan “Find your voice,” implying that smoking is a woman’s right, despite the mores of her particular culture. The tagline “No single institution owns the copyright for beauty,” is vague and can easily be interpreted in a variety of ways.
Slide A21

5. Montana Youth Tobacco Use
Ever tried a cigarette
Ever smoked daily
*Chew/dip/snuff
*Cigars, cigarillos
*Any tobacco use
*past 30 days

6. Adults
In Montana 21.1% of all adults smoke cigarettes and 6% use spit tobacco

7. The Real Marlboro Man

8. Everyone Has To Die Sometime ...But Not Like This
Smoking related illness and death can occur at any age. The young man in this photo started smoking at age 13. He died at age 34 from lung cancer brought on by smoking.
Speaking Points:
Bryan Lee Curtis wanted the world to know what cigarettes did to him. His story (and this photo) was published in the St. Petersburg Times (Florida) shortly after he died in June He was only sick for a few weeks before he died. He left behind a wife and toddler son, and a lifetime of experiences for the sake of 20 years of cigarettes. In Bryan’s hands is a picture of himself holding his son just two months before he died.
You don’t have to be super old to die from smoking-induced lung cancer (or other disease).
Some smoking victims get lung cancer in their twenties or thirties.
Discussion Questions:
Does this slide change your perception of what it means to die from tobacco use?
Students in the class may wish to add their own personal stories to this one.
Before the next slide: What kind of effect do you think smoking, and nicotine, have on a person’s mood?
Source:St. Petersburg Times, [22831] Tuesday, June 15, 1999

9. Secondhand Cigarette Smoke
Each year, secondhand cigarette smoke is responsible for:
• 37,000 deaths from heart disease in adults
• 3,000 deaths from lung cancer in adults
• 13,000 deaths from other cancers in adults
• 300,000 cases of lung infections, such as pneumonia and bronchitis, in infants and young children
200 death per year in Montana
• Second-hand smoke is the name for smoke that is given off by a burning cigarette, cigar, or pipe. It is also called environmental tobacco smoke (ETS) is a human carcinogen for which there is no safe level of exposure.1
• Second-hand smoke: • causes approximately 3000 deaths from lung cancer.1 • causes increases in attacks for about 20% of asthmatic children.1 • causes 30 times as many lung cancer deaths as all regulated pollutants.1 • can produce six times the pollution as a busy highway in a crowded, smoking-allowed restaurant.1 • causes up to 300,000 lung infections (such as pneumonia and bronchitis) in infants and young children each year.1 • many of the same poisons found in the air around toxic waste dumps into the air.1 • is estimated to cause 37,000 heart disease deaths and 13,000 deaths from cancers other than lung cancer each year.2 • contains at least four known human carcinogens and 10 possible carcinogens
1 Cancer Facts & Figures — 2000, American Cancer Society.
2. American Heart Association, 1997.

10. Secondhand Smoke Effects

12. What can be done about this?
Best Practices for Comprehensive Tobacco Control Programs

13. Goal of comprehensive tobacco control programs is to reduce disease, disability, and death related to tobacco use by:
Preventing the initiation of tobacco use among young people
Promoting quitting among young people and among adults
Eliminating nonsmokers’ exposure to environmental tobacco smoke
Identifying and eliminating the disparities related to tobacco use and its effects among different population groups

14. Comprehensive,Sustainable and Accountable
CDC recommends a minimum of $9.3 million for prevention programs in MT
Currently, there is about $6.3 million each year allocated specifically for prevention
In order for a program to be successful, it must include essential components

15. Nine Components of Comprehensive Tobacco Control
Statewide Programs
Counter-Marketing
Cessation Programs
Surveillance and Evaluation
Administration and Management
Community Programs
Chronic Disease Programs
School Programs
Enforcement

16. 1. Community Programs to Reduce Tobacco Use
To achieve individual behavior change that supports the nonuse of tobacco, communities must change the way tobacco is promoted, sold and used while changing peoples knowledge, attitudes and practices.

17. Community Components Continued
Programs involve:
People in their homes
Work sites
Schools
Places of worship
Entertainment
Civic organizations etc.

18. Examples of Programs
Engaging young people to plan and conduct events and campaigns
Educational Programs for medical personnel, schools, daycares, & city officials
Secondhand smoke campaigns

22. Examples continued
Smoking cessation programs by drug and alcohol prevention agencies in addition to medical facilities
Include Native American Community and educate about tobacco use and media literacy

23. Role of Health Communication

24. 2. Chronic Disease Programs to Reduce the Burden of Tobacco-Related Diseases
Even if current tobacco use stopped, the residual burden of disease among past users would cause disease for decades to come
Communities can focus attention directly on tobacco related disease to prevent them and detect them early and addressing additional risk factors

25. Examples of Chronic Disease programs
Community interventions that link tobacco control interventions with cardiovascular disease prevention
Develop counter-marketing to increase awareness of ETS as a trigger for asthma
Train dental providers to counsel their patients on the role of tobacco use in the development of oral cancer
Expand cancer registries to monitor tobacco related cancers

26. Role of Health Communications

27. 3. School Programs
School program activities include implementing CDC’s Guidelines for School Health Programs
This includes: tobacco-free policies, evidence-based curricula, teacher training, parental involvement, cessation services and linking efforts with local community coalitions and statewide media and educational campaigns

28. Example of School based programs
Best Practices curriculum such as Implementations of Life Skills Training or Towards No Tobacco Use
Linking school-based efforts with local coalitions and counter advertising programs.
Media Literacy Training
Tobacco Free Schools Policy

29. Role of Health Communications

30. 4. Enforcement
There are two primary policy areas: restrictions on minors’ access to tobacco and on smoking in public place

31. Example of Enforcement Policy
No one under 18 allowed to purchase tobacco
No one under 18 allowed in any bar or casino where smoking is allowed
No smoking allowed in any restaurants (some bars and casinos are exempt)
No tobacco products allowed on any public school ground or at public school event

32. Role of Health Communications

33. 5. Statewide Programs
Statewide programs increase the capacity of local programs by providing assistance on evaluating programs, promoting media advocacy, implementing smoke-free policies, and reducing minors access to tobacco

34. MTUPP’s role Statewide meetings for Contractors
Regional quarterly meetings
Advocacy calls on a bi-monthly basis
Daily s that provide up to date information on tobacco issues from around the world
Contracts with Strategicom, M&R Strategic Services, Quitline,etc

35. 6. Counter-Marketing
Marketing strategies to counter pro-tobacco influences and increase pro-health messages and influences throughout a state, region, or local community. Counter marketing consists of a wide range of efforts, including: paid television, radio, billboard, and print

36. Examples of Counter Marketing
Television spots
CDC clips
Print ads

37. Local Examples of Counter Marketing

38. More Examples

43. 7. Cessation Programs
Strategies to help people quit smoking can yield significant health and economic benefits. Effective strategies include: brief advice by medical providers, counseling, and pharmacotherapy.

44. Local Cessation Efforts
Quitline
Information and materials to medical professionals
Hospital-based programs at Deaconess Billings Clinic and the VA

45. 8. Surveillance and Evaluation
A surveillance and evaluation system monitors programs for accountability for state policymakers and other responsibilities for fiscal oversight. State evaluation efforts should be coordinated with federal tobacco surveillance programs such as SAMHSA’s National Household Survey on Drug Abuse.

46. Montana Evaluation Statewide Monitoring and Evaluation Group
TFY Action Plan
State Deliverables
TFY Quarterly Report
Standardized Data Sources

47. 9. Administration and Management
An effective tobacco control program requires a strong management structure to facilitate coordination of all of these program components.
In Montana, it is the Montana Tobacco Use Prevention Program that provides the fiscal and program management.

48. Media Literacy:
The ability to “read” or “decode” messages in a variety of print and electronic media.

49. Why Teach Media Literacy?
Media is a force that determines culture and peoples’ behavior

50. Why Teach Media Literacy?
Media has a powerful influence on our lives, and especially in the development of our children. It can shape young people’s beliefs and their sense of self and understanding of the world around them…By empowering our young people with a better understanding of the media, we can help them control their relationship with the vast array of media messages they receive in their everyday environment.
Hillary Clinton, 1996 Conference on Media in Education

51. Kids watch between 3 and 4 hours of television each day.

53. Direct instruction is the best way to counteract the influence of media

54. Peter DeBenedittis, Ph.D.
I want to take kids’ natural tendency to rebel, and have them apply it - do some critical thinking - so they’ll make choices to rebel against the people that are selling them addictive lifestyles.
Peter DeBenedittis, Ph.D.

55. Research Four studies in New Mexico indicate:
Statistical analysis of survey results showed that media literacy presentations helped students question the reality of what they saw in the media.
Students were less likely to believe the hyperbole presented in alcohol and tobacco advertising, and they were less likely to identify favorably with the people they saw on TV

56. Deconstruction Who paid for the media? Who is being targeted?
What messages and values are expressed?
What kind of lifestyle is presented? Is it glamorized? How?
Image available at:

57. Who paid for the media? Why?
Who is being targeted?
What text, images or sounds lead you to this conclusion?
What is the text (literal meaning) of the message?
What is the subtext?
What kind of lifestyle is presented? Is it glamorized? How?
What values are expressed?
What tools or techniques of persuasion are used?
What story is not being told?
In what ways is this a healthy and/or unhealthy media message?

58. Student Created Ads

59. Student Created Ads

60. Websites
Coordinated School Health Program:
Preventing Drug Abuse for Parents and Teachers:
California Based Guide to Healthy Schools and Children
New Mexico Media Literacy Project:

61. Websites Center for Media Literacy: http://www.medialit.org/
Teen Health and the Media:

62. Jackie Lloyd and Ernie Randolfi

63. For More Information: Jackie Lloyd, MSU-B, 657-2927
Katie Mayer, YCCHD,