Tobacco & Other Risk Factors

Tobacco and Other Risk Factors

The fact that most lung cancers are preventable is a widely accepted fact. The tragic statistic that support it comes from the American Lung Association—87% of all lung cancers are caused by smoking. In Delaware, we have implemented programs to help everyone understand the immense toll smoking can take on the health of individuals who smoke or are exposed to smoke. We have initiated cessation programs. We’ve worked to pass landmark legislation—the Clean Indoor Air Act. We’ve worked directly with schools and community organizations to encourage adults and kids to never start smoking. We’ve asked doctors to urge their patients to stop using tobacco. We also offer medications—such as nicotine patches and gum—to individuals to help them quit.

The results are encouraging:

  • 21% of public high school students say they smoked cigarettes during the past month—down from 35% in 1997.
  • 55.5% of smokers tried to quit smoking for at least a day or more during the past year.
  • 70.2% of adult smokers reported that their doctor or health care provider advised them to quit smoking in the past year.
  • Only one in every five Delawareans smokes.

But there is still more to do:

  • Our tobacco excise tax must be increased so that it is at least comparable to that of neighboring states.
  • Employers must be encouraged to fund programs to help people stop using tobacco and to become partners in existing programs that have been successful.
  • Educating adults about the damaging effects of secondhand smoke on those least able to control their environment—children under the age of 18—could make a significant impact.
  • Other factors that affect cancer such as obesity—shown in a recent report* to cause 14% of the deaths from cancer in men and 20% of deaths in women, particularly in cancers of the colon, breast (postmenopausal), endometrium (the lining of the uterus), kidney, esophagus, gallbladder, ovaries and pancreas—must become another priority in both education and program implementation.

Smoking in Delaware has reached the lowest prevalence since data collection was begun.

Data from the 2005 Delaware BRFSS show about one of every five Delaware adults (20.7%)now smokes cigarettes—down from a fourth of the population during most of the past decade.
Source: Behavioral Risk Factor Surveillance Survey, Delaware Division of Public Health, 2005

Youth smoking prevalence is at the lowest level13.8% lower than it was five years ago.

Smoking among Delaware youth continues to decline. In fact, only about 21% of Delaware public high school students say they smoked cigarettes during the past month, down dramatically from 35%in 1997.
Source: Youth Risk Behavior Survey, Delaware Department of Education, 2005

Lung cancer mortality rates ’99–’03 ’00–’04
Males, both races 81.1 79.0
Females, both races 47.0 46.8
African American males 103.3 92.1
African American females 47.7 47.0
Caucasian males 79.1 76.9
Caucasian females 47.1 46.6

Click each goal to read about the objectives, tasks and timeframes.

Goal 1:

Initiate and support policies to reduce tobacco use and exposure to secondhand smoke.

Year 1
$0
Year 2
$0
Year 3
$0
Year 4
$0
Objective 1A: Increase excise tax on tobacco products to be comparable to bordering states.
Task/Action Responsible Party Timeframe
Educate and inform legislators and decision makers on the health and economic benefits of increasing the state excise tax on tobacco. Voluntary health organizations, IMPACT, DCC Ongoing
Educate and inform the general public on the many health and economic benefits of increasing the state excise tax on tobacco products. Voluntary health organizations, IMPACT, DCC Ongoing
Objective 1B: Strengthen, expand and enforce Delaware’s Clean Indoor Air Act (CIAA).
Task/Action Responsible Party Timeframe
Monitor draft legislation for any potential changes to CIAA. Voluntary health organizations, IMPACT, DCC, DHSS Ongoing
Objective 1C: Increase insurance coverage for cessation.
Task/Action Responsible Party Timeframe
Work with private insurance, unions and employers to cover cessation counseling and products. Voluntary health organizations, IMPACT, DCC, DHSS Ongoing
Work with government insurance plans (such as Medicaid) to cover cessation counseling and products. Voluntary health organizations, IMPACT, DCC, DHSS Ongoing
Objective 1D: Support national policy initiatives.
Task/Action Responsible Party Timeframe
Encourage legislators to support FDA regulation of tobacco products. Voluntary health organizations,IMPACT, DCC Ongoing—until adopted

Goal 2:

Maintain Delaware’s leadership in comprehensive tobacco prevention.

Year 1
$0
Year 2
$45,000
Year 3
$45,000
Year 4
$45,000
Objective 2A: Fund tobacco prevention programs above CDC minimum-recommended levels.
Task/Action Responsible Party Timeframe
Continue to recommend funding from Delaware Health Fund for tobacco prevention activities. DCC, IMPACT Annually
Identify potential funding opportunities to support tobacco prevention efforts from private and federal sources. DCC, IMPACT Ongoing
Objective 2B: Endorse and utilize the objectives in the “Plan for a Tobacco-free Delaware.”
Task/Action Responsible Party Timeframe
Evaluate programs utilizing plan objectives. DHSS, IMPACT, DCC Ongoing
Provide tobacco plan to agencies and organizations and partner with them to achieve objectives. DHSS, IMPACT, DCC Ongoing
Review and update tobacco plan. DHSS, IMPACT Year

Goal 3:

Prevent youth initiation to tobacco products and subsequent use of tobacco.

Year 1
$0
Year 2
$70,000
Year 3
$70,000
Year 4
$70,000
Objective 3: Fund youth and young adult prevention programs.
Task/Action Responsible Party Timeframe
Conduct programs in communities and schools throughout the state. DHSS tobacco program staff, IMPACT members, DOE staff Year 2 & ongoing
Conduct programs in colleges and workplaces that target young adults. DHSS tobacco program staff, IMPACT members Year 2 & ongoing
Enforce Delaware Tobacco Regulation 877 in schools DDOE, IMPACT members Ongoing

Goal 4:

Increase the number of Delawareans who stop using tobacco products.

Year 1
$850,000
Year 2
$1,250,000
Year 3
$1,250,000
Year 4
$1,250,000
Objective 4A: Enhance available resources to help people quit use of tobacco products.
Task/Action Responsible Party Timeframe
Provide qualified counseling services (Quitline, face-to-face). DHSS tobacco program staff Years 1 & 2 & ongoing
Provide online information and resources. DHSS tobacco program staff Ongoing
Provide approved cessation products to program participants. DHSS tobacco program staff Year 2 & ongoing
Objective 4B: Reduce the use of tobacco products by youth.
Task/Action Responsible Party Timeframe
Provide cessation programs specific to youth and young adults. DHSS tobacco program staff, DOE Year 2 & ongoing
Expand current programs to include youth. DHSS tobacco program staff, DOE Year 2 & ongoing

Goal 5:

Reduce routine exposure to secondhand smoke.

Objective 5A: Reduce exposure in places not currently covered by the CIAA.
Task/Action Responsible Party Timeframe
Encourage individuals to develop personal policies not to allow smoking in their homes or cars. Voluntary health organizations, IMPACT, DCC, DHSS Ongoing
Encourage organizations exempt from the CIAA to develop policies not to allow smoking. Voluntary health organizations, IMPACT, DCC, DHSS Ongoing
Support development of policies by agencies who are responsible for individuals under their jurisdiction Voluntary health organizations, IMPACT, DCC, DHSS Ongoing
Objective 5B: Reduce exposure to secondhand smoke in outdoor areas.
Task/Action Responsible Party Timeframe
Support development of polices to not allow smoking near entrances or exits to buildings Voluntary health organizations, IMPACT, DCC, DHSS Ongoing
Support health care facilities, workplaces and agencies to develop smoke-free grounds policies Voluntary health organizations, IMPACT, DCC, DHSS, state & local government Ongoing

Goal 6:

Decrease the social acceptability of tobacco use.

Year 1
$1,200,000
Year 2
$1,200,000
Year 3
$1,200,000
Year 4
$1,200,000
Objective 6: Develop comprehensive social marketing campaigns to support all the goals and objectives.
Task/Action Responsible Party Timeframe
Increase awareness of available cessation programs and resources. DHSS tobacco program staff, IMPACT members, DCC Year 1 & ongoing
Increase awareness of problems associated with secondhand smoke. DHSS tobacco program staff, IMPACT members, DCC Ongoing
Utilize “countermarketing” to decrease the effectiveness of tobacco industry promotions and to increase knowledge on harmful effects of tobacco use. DHSS tobacco program staff, IMPACT members, DCC Ongoing
Provide information on policies and emerging issues to key stakeholders and community leaders. Voluntary health organizations, IMPACT, DCC Ongoing

Goal 7:

Encourage healthy lifestyles and reduce risk factors.

Year 1
$0
Year 2
$1,150,000
Year 3
$3,150,000
Year 4
$3,150,000
Objective 7A: Implement and sustain a comprehensive physical activity and nutrition program in DPH similar to the tobacco prevention model.
Task/Action Responsible Party Timeframe
Make funding recommendations from the DCC. DCC Ongoing
Identify potential funding opportunities to support physical activity and nutrition efforts from private and federal sources. DHSS, voluntary organizations, physical activity coalitions, Nemours Year 2 & ongoing for infrastructure and program development Year 3 & ongoing for program implementation
Objective 7B: Increase regular and sustained physical activity for people of all ages.
Task/Action Responsible Party Timeframe
Support policies and plans to include physical activity when designing and refurbishing communities. Voluntary health organizations, DCC Ongoing
Support school policies to promote regular physical activity and healthy nutrition. DOE, voluntary health organizations, DCC Ongoing
Develop a social marketing campaign to promote physical activity. Voluntary health organizations, DHSS Year 2 & ongoing
Objective 7C: Promote healthy eating habits and proper nutrition.
Task/Action Responsible Party Timeframe
Develop a social marketing campaign to promote proper nutrition. Voluntary health organizations, DHSS Year 2 & ongoing
Encourage restaurants to make nutrition information on their foods available to the public. Voluntary health organizations, DHSS, DCC Ongoing