1. Crisis as Opportunity NAQC NCTOH, June 9 th, 2009 Phoenix, AZ Jeannette Noltenius PhD, National Coordinator

2. Crisis as Opportunity

3.  Future clientele  New Products  National Legislation  What can be done? Parity, Inclusion and Renewed Advocacy

4. Projections by Race and Hispanic 200020102020203020402050 Total282,125308,936335,805363,584391,946419,854 White alone228,548244,995260,629275,731289,690302,626 Black alone35,81840,45445,36550,44255,87661,361 Asian alone10,68414,24117,98822,58027,99233,430 All Other Races 7,0759,24611,82214,83118,38822,437 Hispanic (of any race) 35,62247,75659,75673,05587,585102,560 White alone not Hispanic 195,729201,112205,936209,176210,331210,283 (In Thousands. As of July 1 Resident Population) US Census Bureau

5. Minority Populations’ Combined Percentage of Total US Population

6. The Elderly Population (persons age 65 and over) YearNumber Numeric Change from Previous Decade % of U.S. Population 197020,065,5023,858,2659.9 198025,549,4275,483,92511.3 199031,241,8315,692,40412.6 200035,061,2473,819,41612.4 201040,243,7135,182,46613.0 202054,631,89114,388,17816.3 203071,453,47116,821,58019.7 204080,049,6348,596,16320.4 205086,705,6376,656,00320.7

7. Cigarette Smoking* Trends: Adults, 1983-2002 *Smoking on 1 or more of the previous 30 days. Source: National Health Interview Surveys, 1983-2002, selected years, aggregate data American Indian/Alaska Native African American Hispanic/Latino Asian/Pacific Islander White HP 2010 Goal (12%)

8. Smoking Prevalence Ranges for Asian American Men Rod Lew, APPEAL, CDC Disparities Call Presentation

9. What are the implications?  70% of Hispanic/Latinos are low and intermittent smokers  80-90% of African Americans Menthol  Youth Groups, pods, work settings, communities  + Low SES, Mental Health Issues + unemployment, lower educational attainment

10. Other Implications  Safety Net Community Health Clinics, they reach low SES & minorities= 7,000 points of service  Institutionalization at the CHC level  Build relationships to assure fax referral success and quits  Share resources=get results

11. 33% of the total Adult Market and 40-50% of Adolescent Market www.trinketsandtrash.org

12. New Products Source: www.trinketsandtrash.orgwww.trinketsandtrash.org

13. e cigarrettes “Finally you can quit smoking cigarettes by smoking”! www.ecigarrettes.com

14. Disolvable Strips and Orbs http://tobaccoproducts.org/index.php/Cam el_Sticks,_Camel_Orbs_and_Camel_Strip s

15. Federal Legislators burn the midnight oil!

16. Recent Federal Legislation  CHIPRA and its impact $ 1.00 hike  Stimulus Package = lost opportunity  Federal Budget = No $ for Cessation  HIT, Health Information Technology (Is the tobacco Question prominent, is fax referral included in HIT, EMR?  Parity for Mental Health (cessation treatment covered or discussed?)

18. Congress is negotiating various proposals

19. “Family Smoking Prevention and Tobacco Control Act” o FDA authority to Regulate content, flavors packaging; o Restrict tobacco marketing and sales to kids; o Require changes in tobacco products to make them less toxic and less addictive; o Stop tobacco companies from misleading the public about the health consequences of using their products; o What about Harm reduction and its impact on this field? Are you involved?

20. Change in the Number of Uninsured, By Income 2009-2019 (in millions) 20092019 Baseline Best Case Intermediat e Case Worst Case <200% FPL31.134.736.537.6 200-399% FPL 12.514.816.818.2 >400% FPL5.57.58.99.9 All Incomes49.157.062.265.7 20 John Holahan, Bowen Garrett, Irene Headen, and Aaron Lucas Heath Care Reform the Cost of Failure Urban Institute 2009 www.rwjf.org/healthreform/products www.rwjf.org/healthreform/products

21. Health Care Reform Legislation  Many Players: check your state delegation!!!!!  Many Options (Single payer, multiple payers,  Will Cessation be covered?  What is being planned?  Will Community Health Centers Expand? HRSA work with them?  Are you one of the players?

22. Increased taxes at the State Level Budget Cuts  What are the implications?  Who will support the Quitlines?  Have you built allies who will advocate for you and the tobacco programs?  Physician Associations AMA, etc.?  What are your links to community groups and minorities?

23. 4- Prongs Policy Change Model 1.Need to advocate within every community where tobacco is not a high priority 2.Within the mainstream tobacco control movement where minorities are not a high priority (Parity Kit ) 3.With policymakers where neither tobacco nor emerging communities is a priority 4.Against the tobacco industry where priority populations are one of the highest priorities

24. Community Stages of Readiness Model

25. Why Parity? Parity: “being equal in the process, as well as the outcomes attained in tobacco control.” Concept based on inequities in history of tobacco control and institutional inequities Parity requires systems changes within each institution Rod Lew, APPEAL, www:appealforcommunities.org

26. Train Advocacy Skills = Not lobbying  Train at state level with all communities to build Advocates  Minority/Priority Communities  Faith Communities  Youth Advocates  Business groups  Local officials who have seen the benefits  Present a benefit/cost analysis  Put the HUMAN FACE on the EX Smoker!

27. Thank you, Muchas Gracias  Jeannette Noltenius, National Coordinator  National Latino Tobacco Control Network  www.latinotobaccocontrol.org www.latinotobaccocontrol.org  www.tobaccopreventionnetworks.org