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.
|
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 |
|
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 |
|
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 |
|
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 |
| 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 |
|
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 |
|
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 |