Indiana University Bloomington

Indiana Prevention Resource Center (IPRC)

Tobacco Use Awareness Month

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As communities work together in fighting substance use and abuse, we wish to reach out to smokers and encourage smoking cessation. During the month of November, we would like to acknowledge and inform consumers on different issues that focus on tobacco awareness.
Additionally, we strive to emphasize the importance of smoking cessation overall, and offer available public health opportunities that will support tobacco prevention.

Tobacco usage

Percentage of U.S. adults aged 18 years or older who were current cigarette smokers in 2013 (CDC, 2015c):
17.8% of all adults (42.1 million people): 20.5% of males, 15.3% of females

    • Nearly 27 of every 100 non-Hispanic multiple race individuals (26.8%)
    • About 26 of every 100 non-Hispanic American Indians/Alaska Natives (26.1%)
    • More than 19 of every 100 non-Hispanic Whites (19.4%)
    • About 18 of every 100 non-Hispanic Blacks (18.3%)
    • About 12 of every 100 Hispanics (12.1%)
    • More than 9 of every 100 non-Hispanic Asians (9.6%)(CDC, 2015c)

Current cigarette smokers are defined as persons who reported smoking at least 100 cigarettes during their lifetime and who, at the time they participated in a survey about this topic, reported smoking every day or some days (CDC, 2015c).

Indiana Statistics:

Tobacco use in Grades 6-8

In 2015, 1.5% of 6th-grade students reported past month use of cigarettes. Students in 7th and 8th grades also were asked about smokeless tobacco, cigars, pipe, and electronic vapor products. For both grades, electronic vapor products were the most prevalent substance used in the past month, followed by cigarettes, then pipe smoking, smokeless tobacco, and finally cigars, in that order.

Tobacco use in Grades 9 to 12
For students in Grades 9 to 12, the most frequently used tobacco products were electronic vaping products followed by cigarettes. Depending on grade level, prevalence rates for pipe smoking, smokeless tobacco, and cigars varied in order of prevalence, though this order was not assessed for statistical significance. An example of prevalence rates for the five types of tobacco products appearing on the Indiana Youth Survey is included in Figure 2.

Types of tobacco

Tobacco product use by Indiana 9th – 12th graders, 2015(2015 INYS)

According to Behavioral Health Trends in the United States (2015), an estimated 12 million American youth aged 12 or older in 2014 were current cigar smokers, 2.2 million smoked pipe tobacco in the past month, and 8.7 million were current smokeless tobacco users. In Indiana, an estimated 9,700 persons age 25 and over have died from smoking related diseases. Indiana ranks 43 for smoking-attributable deaths among the states (IPRC, 2015). Tobacco use harms the physical health of our population, resulting in loss of productivity and premature deaths, up to 20-25 years earlier than non-smokers (IPRC, 2015).
Additionally, there is an increase in the use of Electronic Cigarettes (E-Cigarettes). According to the 2015 Indiana Youth Survey, conducted by the Indiana Prevention Resource Center, 32.5 percent of 12th-graders in Bartholomew Consolidated School Corp. had used an electronic cigarette within the past 30 days at the time the survey was administered, compared with 24.8 percent across the state and 17.1 percent across the nation.
According to Stephanie Womack of the Columbus Republic (2015), “E-cigarettes are being promoted as a less dangerous alternative to cigarettes or smoking cessation aids, however e-cigarettes have not been approved as safe by the Food and Drug Administration. The FDA has warned the public that e-cigarettes contain various toxic and carcinogenic (cancer causing) chemicals. E-cigarettes emit an aerosol through a process similar to passive tobacco smoking called passive vaping. The health effects of exposure to aerosol from e-cigarettes are currently unknown; however, research shows that the aerosol releases measurable amounts of carcinogens and other toxins into the air, including nicotine, formaldehyde and acetaldehyde.”
Stephanie continues saying “because they contain nicotine, electronic nicotine delivery systems might be addictive and have lasting consequences for adolescent brain development. Also, the e-liquid solutions are very concentrated. A 30 milliliter (about 1 ounce) bottle of e-cigarettes solution can easily contain 500 milligrams or more of nicotine. This creates a risk of overdosing or poisoning, because the lethal dose of nicotine for children is just 10 milligrams, and for adults it is 30 to 60 milligrams if swallowed.”


Centers for Disease Control and Prevention (2015)

Second hand tobacco exposure
Non-smokers suffer from adverse effects of second-hand smoke (SHS). In adults, SHS has been linked to an increased risk for lung cancer and coronary heart disease, along with nasal sinus cancer and eye, nose, and throat irritation (Center of Health Policy, 2009). In children, SHS exposure from a parent have been found to increase the risk of sudden infant death syndrome (SIDS), lower birth weight, and lead to higher rates of respiratory illness, asthma, poorer lung function, and other breathing problems, middle ear infections. Center of Health Policy, 2009).

Options for Intervention
According to the CDC (2015a), defining risk behaviors associated with smoking and formulating interventions thereby enables smoking cessation. Proven interventions that promote cessation are important for reducing smoking-related morbidity and mortality and include mass media campaigns, telephone-based tobacco cessation services (quitlines), higher prices for tobacco products, comprehensive smoke-free laws, better health insurance coverage of effective cessation treatments, and health systems changes to integrate tobacco dependence treatment into routine clinical care (CDC, 2015a).

 

Community Funding Resource: Indiana State Department of Health—Tobacco Prevention and Cessation Commission (TPC)
The Tobacco Prevention and Cessation Commission (TPC) is sponsored by the Indiana State Department of Health. It exists to prevent and reduce the use of all tobacco products in Indiana and to protect citizens from exposure to tobacco smoke. The 2015 Indiana Tobacco Control Strategic Plan has four priority areas:

  • Increase proportion of Hoosiers not exposed to secondhand smoke.
  • Decrease Indiana adult smoking rates.
  • Maintain state and local infrastructure necessary to lower tobacco use rates and thus make
  • Indiana competitive on economic fronts (ISDH-TPC, 2015)

For more information, including funding opportunities for your agency, please visit: http://www.in.gov/isdh/tpc/files/TPC_StatewidePartnerships_Application_2015-2017.pdf

Other Statewide Funding Resources
American Lung Association in Indiana
115 West Washington Street, Suite 1180-South
Indianapolis, Indiana 46204
(317) 819-1187
Monique Hill-French monique.french@lung.org
This grant supports the TPC Priority Areas: Decrease Exposure to Secondhand Smoke, and Maintain State and Local Infrastructure for Tobacco Control.
They will be working with TPC partnerships to increase the number of smoke free policies in multi-unit housing with public and private market housing. ALA will also support coalition development and increase capacity and communications for TPC partnerships.

Purdue University College of Pharmacy
Fifth Third Bank Faculty Office Building, 3rd Floor
640 Eskenazi Avenue
Indianapolis, IN 46202
Debi Hudson dhudson@iupui.edu
http://bringinginalong.org/
This grant supports the TPC Priority Area: Decrease Adult Smoking Rates, with an emphasis on behavioral health professionals and consumers.
Bringing Indiana Along (BIA) provides technical assistance and training for community mental health centers, addiction treatment centers, and substance abuse treatment programs. The educational components promote recommendations set forth in the Clinical Practice Guideline for Treating Tobacco Use and Dependence through (a) integration of evidence-based treatment approaches into mental health, addiction treatment, and substance abuse treatment programs, and (b) implementation and enforcement of tobacco-free campus policies. This project includes customized technical assistance and training related to the Indiana Tobacco Quitline (1-800-QUIT NOW)

Indiana Rural Health Association
2901 Ohio Blvd., Suite 240
Terre Haute, IN 47803
(812) 478-3919, ext. 222
Tina Elliott telliott@indianarha.org
This grant supports the TPC Priority Area: Decrease Adult Smoking Rates, with an emphasis on the rural communities in Indiana.
Indiana Rural Health Association (IRHA) provides outreach to a prioritized list by county of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) and other healthcare facilities to: enroll health care providers in the Indiana Tobacco Quitline Preferred Provider Network if they have not already enrolled; follow up with those who have enrolled to see if any other assistance is necessary; increase the number of fax referrals to the Indiana Tobacco Quitline; provide resources to rural health care providers on tobacco treatment; enroll RHCs and CAHs and other healthcare facilities in the Indiana Tobacco Quitline Preferred Employer Network; and promote the Indiana Tobacco Quitline to rural communities throughout Indiana.
IRHA provides the outreach to the unfunded counties in the state of Indiana for cessation systems change. IRHA?s contract responsibilities include enrolling healthcare providers and employers in rural areas in the TPC Preferred Networks and providing tobacco use treatment resources to the RHCs, CAHs, and other healthcare facilities. IRHA is an established organization with existing working relationships with the RHCs and CAHs, which provides an ideal situation to share resources on cessation systems change.

Vincennes University-Indiana Teen Institute
5190 North High School Road
Indianapolis, Indiana 46254
(317) 299-7831
Mark R. Kaser mrkaser@aol.com
Indiana Teen Institute works with teams of young advocates from throughout the state to expand and enhance the Voice movement. Supporting the concept of Youth Development, ITI facilitates the development of youth leaders who experience meaningful engagement in the state's tobacco control program

Additional resources for tobacco prevention
Quit Now Indiana
Phone: 1-800-QUIT-NOW
Email: http://www.quitnowindiana.com/Quitting.html
Email: http://www.in.gov/quitline/

Aspire Tobacco Free program
Address: 8111 S. Emerson Avenue Indianapolis, IN 46237
Phone: 317-528-7848 (QUIT)
Fax 317-528-1318
Email: http://www.franciscanalliance.org/hospitals/indianapolis/services/cancer/cancer-screening-prevention/pages/aspire-tobacco-free-program.aspx

  • Local community health centers (Contingent upon Your Area)
  • School health centers – if sources are provided

Intangible methods to reduce tobacco usage

  • Gum
  • Stress ball methods
  • Patches
  • Lozenge
  • Nasal spray
  • Inhaler
  • Prescription medication
  • Individual and Group counseling

The IPRC Home Library offers links to these and hundreds of other online e-resources related to Tobacco use and related topics; the Home Library is available from the IPRC homepage from the Library tab. The IPRC Hispanic/ Latino Portal of online e-resources contains abundant resource in English and Spanish on tobacco use and health-related topics for this population and their service providers.
Here at the Indiana Prevention Resource Center, We wish to acknowledge our Veterans who have served or are currently serving in the Armed Forces, and wish everyone a Happy Thanksgiving.


References

Indiana Department of Health (2015). Tobacco Prevention and Cessation Commission—request for application for statewide partnershipshttp://www.in.gov/isdh/tpc/files/TPC_StatewidePartnerships_Application_2015-2017.pdf Accessed: October 16, 2015.

Centers for Disease Control and Prevention (2015a). Trends in Quits Attempts Among Adult Cigarette Smokers—United States, 2011-2013. Morbidity and Mortality Weekly Report (MMWR), http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6440a1.htm?s_cid=mm6440a1_w Accessed October 21, 2015.

Centers for Disease Control and Prevention (2015b). Fact Sheet: Current Cigarette Smoking Among Adults in the United States.http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/ Accessed October 9, 2015.

Centers for Disease Control and Prevention (2015c). Current Cigarette Smoking Among Adults—United States, 2005–2013. Morbidity and Mortality Weekly Report 2014;63(47):1108–12 Accessed October 26, 2015

Cesar Fax (2015). A Weekly Fast from the Center for Substance Abuse Research. University of Maryland, 24(7), http://www.cesar.umd.edu/cesar/cesarfax/vol24/24-07.pdf . Accessed October 9, 2015.

Indiana Center for Health Policy (2009). The Economic Impact of Smoke-Free Policies on Business and Health, Indiana Research for a Healthier Indiana, http://www.in.gov/isdh/tpc/files/IUCtrforHealthPolicySmokeFreeReport.pdf, Accessed October 16, 2015.

Indiana Prevention Resource Center (2015). Indiana Youth Survey, http://www.drugs.indiana.edu/publications/survey/indianaSurvey_2015.pdf , Accessed October 16, 2015.

MdWise (2015). Smoke-free options. http://www.mdwise.org/smoke-free/?referer=/for-members/hoosier-healthwise/health-and-wellness/smoke-free/ Accessed, October 16, 2015.

Saint Mary’s County Health Department (2015). E-Cigarette Use Surpasses Other Tobacco Products Among Youth, http://www.smchd.org/2015/05/e-cigarette-use-surpasses-other-tobacco-products-among-youth/ Accessed October 16, 2015.

Substance and Mental Health Association (2015). Behavioral Health Rends in the United States: Results from the 2014 National Survey on Drug Use and Health, http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf , Accessed October 16, 2015.

Womack, S. (2015) Electronic nicotine devices pose serious concerns, Columbus Republic, http://www.therepublic.com/view/local_story/Column-Electronic-nicotine-dev_1445720280 Accessed October 26, 2015.



By Julius Lee 11/12/2015