1. Tobacco Use Reduction as a National and Regional Priority Tobacco-free College Campuses: Promoting a Culture of Health Patrick O’Carroll, MD, MPH Assistant Surgeon General and Regional Health Administrator Region X, U.S. Department of Health & Human Services Tacoma, Washington, Dec 7, 2012

2. Public Health Approach ProblemResponse Surveillance: What is the problem? Risk Factor Identification: What is the cause? Implementation: How do you do it? Intervention Evaluation: What works? Impact Evaluation

3. What is the problem? Tobacco is the leading cause of preventable death in the United States Tobacco kills ~443,000 Americans each year— about 1 of every five deaths Lung cancer is the leading cause of cancer death among both men and women in U.S. Late 1800’s: Lung cancer was rare Cigarette smoking causes $96B in medical costs and $97B in lost productivity each year

4. What is the problem? Each day, over 3,800 young people under 18 years of age smoke their first cigarette, and over 1,000 youth become daily smokers. The vast majority of Americans who begin daily smoking during adolescence are addicted to nicotine by young adulthood. Despite progress, nearly one in four U.S. high school seniors and one in three young adults under age 26 smoke.

5. What is the problem? Nearly all tobacco use begins in childhood and adolescence 88% of adult cigarette smokers who smoke daily started smoking by the age of 18 99% of first use by 26 years of age!

6. Public Health Approach ProblemResponse Surveillance: What is the problem? Risk Factor Identification: What is the cause? Implementation: How do you do it? Intervention Evaluation: What works? Impact Evaluation

7. Public Health Approach ProblemResponse Surveillance: What is the problem? Risk Factor Identification: What is the cause? Implementation: How do you do it? Intervention Evaluation: What works? Impact Evaluation

8. What works? Four foundational documents: Best Practices for Comprehensive Tobacco Control Programs (2007) Guide to Community Preventive Services Treating Tobacco Use and Dependence: 2008 Update Report on the Global Tobacco Epidemic, 2008: The MPOWER Package Tobacco control programs must be comprehensive sustained, and accountable

9. Public Health Approach ProblemResponse Surveillance: What is the problem? Risk Factor Identification: What is the cause? Implementation: How do you do it? Intervention Evaluation: What works? Impact Evaluation

10. How do you do it? The Family Smoking Prevention and Tobacco Control Act, giving the FDA authority to regulate the manufacturing, marketing and sale of tobacco products (2009) Ending the Tobacco Epidemic: A Tobacco Control Strategic Action Plan for the US Department of Health and Human Services (2010) Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General (2012)

11. Public Health Approach ProblemResponse Surveillance: What is the problem? Risk Factor Identification: What is the cause? Implementation: How do you do it? Intervention Evaluation: What works? Impact Evaluation

12. YOUTH and TOBACCO Town Hall Meeting Region X, U.S. Department of Health & Human Services (Alaska, Idaho, Oregon, and Washington) University of Washington Seattle, Washington, June 14, 2012

13. A Challenge for Region X: Tobacco-free College Campuses across the Entire Pacific Northwest

14. Tobacco Use Reduction as a National and Regional Priority Tobacco-free College Campuses: Promoting a Culture of Health Patrick O’Carroll, MD, MPH Assistant Surgeon General and Regional Health Administrator Region X, U.S. Department of Health & Human Services Tacoma, Washington, Dec 7, 2012