2. Presentation Objectives Describe an organizational collaboration to produce a joint research report. Characterize the desire to quit smoking among: –adult Minnesotans. –members of two publicly subsidized insurance programs. –high school students. Identify unique barriers for low-income groups. Suggest use of results to advocate for offering cessation resources.

3. Collaborators Minnesota Partnership for Action Against Tobacco (MPAAT) –Barbara Schillo, Ph.D. Minnesota Dept. of Health: Center for Health Statistics –Brian Zupan, Ph.D. –Pete Rode, Ph.D. –Ann Kinney, Ph.D. Blue Cross Blue Shield of Minnesota –Steven Foldes, Ph.D. –Nina L. Alesci, M.P.H.

4. Who Was Surveyed? Minnesota Adults (MPAAT) –6,000 adult state residents Blue Cross Blue Shield of Minnesota publicly subsidized adult members –Minnesota Care: 1,000 adult members –Prepaid Medical Assistance Program: 1,000 adult members (under age 65) Minnesota Youth: Minnesota Dept. of Health Youth Tobacco Survey – 12,000 6th-12th grade students

5. Adult Survey Methods One survey instrument developed by team –Blue Cross Blue Shield of Minnesota –Minnesota Partnership for Action Against Tobacco –MN Dept. of Health & Dept. of Human Services –U of Minnesota: Medicine and Epidemiology Randomly selected adult sample (age 18 +) –Minnesotans: Random Digit Dial method –Blue Cross: List sample of members –Not representative of minority populations Telephone interviews conducted in 1999

6. What’s the Story? Smoking Causes Death and Disease Many Adult Minnesotans Smoke Many Adult Smokers Try to Quit Quitting is Difficult Because Smoking is Addictive Many Smokers Quit Successfully, for Many Reasons There are Many Barriers to Quitting Smoking People Trying to Quit Smoking are Increasingly Seeking Assistance (Teen Story: 5 points) Quitting Assistance Now Widely Available to Minnesotans

7. Many Adult Minnesotans Smoke Statewide adult smoking rates

8. Many Adult Minnesotans Smoke Blue Plus MinnesotaCare adult smoking rates

9. Many Adult Minnesotans Smoke Blue Plus PMAP adult smoking rates

10. Many Adult Smokers Try to Quit Reduced smoking and quit attempts among current adult smokers

11. Quitting is Difficult Because Smoking is Addictive Of current smokers who tried to quit in the 12 months before the survey: –76% made multiple quit attempts –25% tried to quit six or more times –All these attempts failed How addicted are these smokers? –46% smoke their first cigarette within 30 minutes of waking –17% within 5 minutes –Mean cigarettes per day = 15

12. Quitting is Difficult Because Smoking is Addictive The more adults smoke, the less confidence they have in their ability to quit permanently.

13. There are Many Barriers to Quitting Current adult smokers identify many barriers to quitting. Percent reporting “yes”

14. There are Many Barriers to Quitting Smoking Variations in Barriers: –Risk of gaining weight Women = 48%Men = 17% –Loss of way to handle stress Women = 65%Men = 46% –Cost of medicines/products to help quit State = 30%, MNCare = 50%, PMAP = 51% Social Environment: –Spouse or close friend is a current smoker Never smoker = 30% Current smoker = 60%

15. People Trying to Quit are Increasingly Seeking Assistance Former adult smokers’ use of quit aids by time since quit. Former smokers who used a quit aid Length of time since quit

16. People Trying to Quit are Increasingly Seeking Assistance 36% of current smokers with at least one quit attempt in the prior 12 months used assistance in their most recent attempt. Interest in using assistance in future attempts “if cost were not an issue”: –60% of all Minnesota smokers –72% of Blue Plus MinnesotaCare smokers –71% of Blue Plus PMAP smokers

17. Types of aid preferred by current adult smokers’ who would use assistance “if cost were not an issue.” Percent reporting “yes” Type of aid

18. Minnesota Youth Tobacco Survey 2002 High school students (9 th to 12 th grades) only, n=7,625 About 1/3 rd current smokers, i.e. smoked cigarettes on 1 or more of past 30 days –17% frequent smokers –15% moderate smokers Many Teens in Minnesota Smoke

19. Over 60% have tried unsuccessfully to quit at least once in the past year Of those who have tried to quit, almost 3/4 ths attempted twice or more Likely underexposed to quit support. Only 10% report participating in quit program. Most Teen Smokers Want to and Have Tried to Quit

20. Quitting is Especially Difficult for Teen who are Frequent Smokers Frequent high school smokers encounter greater difficulty than moderate smokers when trying to quit. Frequent smoker Moderate smoker

21. Family: –61% of frequent teen smokers report living with another smoker compared to 27% of teens who have never smoked. Friends: –90% of frequent teen smokers have 2 or more close friends who smoke, compared to 13% of “never-smokers.” Family and Friends who Smoke Make it Harder for Teens to Quit

22. Teens with Failed Quit Attempts are Least Confident Frequent high school smokers, especially those with prior quit attempts, less often expressed confidence than moderate smokers in their ability to quit smoking. Percent confident in ability to quit in future Frequent smokerModerate smoker

23. Recommendations What we already know: –Provide effective medications and counseling. –Develop more resources for teens. To build support: –Develop clear, simple, data-driven statements and graphics. –Disseminate information widely. –Collaborate to provide a unified message.