Tobacco Control: How is Michigan Doing?

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Tobacco Control How is
Michigan Doing?
Tobacco-Free Michigan Membership Meeting July 25,
2003 / East Lansing, Michigan

• Ron Davis, M.D.
• Center for Health Promotion Disease Prevention
• Henry Ford Health System

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Henry Ford, 1916How Employers Feel Toward
Cigarette SmokersHere is an Automobile Companys
Attitude
Cigarette smoking is acquiring a hold on a great
many boys in our community. Since it is such a
bad practice and is taking such a hold upon so
many people, we think it is a disgrace for a
grown man to smoke cigarettes, because it is not
only injurious to his health, but it is such a
bad example to the boys.
Source Henry Ford, The Case Against the Little
White Slaver, 1916. (reprinted by the Historical
Society of Michigan, 1992)
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Henry Ford, 1916 (continued)
Boys who smoke cigarettes we do not care to keep
in our employ. In the future we will not hire
anyone whom we know to be addicted to this habit.
It is our desire to weed it entirely out of the
factory just as soon as practicable. We have
two objects in interesting ourselves in this
matter First, to help men and boys second, we
believe that men who do not smoke cigarettes or
frequent the saloon can make better automobiles
than those who do.
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Michigan versus U.S.
Michigan All States
Adult smoking (2000) 24.2 23.3



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Michigan versus U.S.
Michigan All States
Adult smoking (2000) 24.2 23.3
Youth smoking (grades 6-8) 9.3 11.0


National YTS (2000) Michigan YTS (2001)
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Michigan versus U.S.
Michigan All States
Adult smoking (2000) 24.2 23.3
Youth smoking (grades 6-8) 9.3 11.0
Youth smoking (grades 9-12) 27.6 28.0

National YTS (2000) Michigan YTS (2001)
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Michigan versus U.S.
Michigan All States
Adult smoking (2000) 24.2 23.3
Youth smoking (grades 6-8) 9.3 11.0
Youth smoking (grades 9-12) 27.6 28.0
Smoking-attributable death rate, 1999 (per 100,000) 299.0 295.5
National YTS (2000) Michigan YTS (2001)
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Guide to Community Preventive Services Tobacco
Use Prevention and Control

• Strategies to Reduce Tobacco Use Initiation
• Increase the unit price for tobacco products
  strongly recommended
• Mass media campaigns strongly
  recommended (when
  combined with other interventions)

Source Amer J Prev Med 2001 20 (2S) 1-88
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Guide to Community Preventive Services Tobacco
Use Prevention and Control

• Strategies to Increase Tobacco Use Cessation
• Increase the unit price for tobacco products
  strongly recommended
• Mass media campaigns strongly
  recommended (when
  combined with other interventions)

Source Amer J Prev Med 2001 20 (2S) 1-88
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Guide to Community Preventive Services Tobacco
Use Prevention and Control

• Strategies to Increase Tobacco Use Cessation
• Multicomponent patient telephone support
  strongly recommended
• Provider reminder system and a provider education
  program, with or without patient education
  strongly recommended

Source Amer J Prev Med 2001 20 (2S) 1-88
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Guide to Community Preventive Services Tobacco
Use Prevention and Control

• Strategies to Reduce Exposure to ETS
• Smoking bans and restrictions strongly
  recommended
• Community education
  insufficient evidence

Source Amer J Prev Med 2001 20 (2S) 1-88
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Michigans Investment in Tobacco
Control

• CDCs Best Practices recommends
• 55-155 million / year
• In FY 2002, Michigan spent
• 3.9 million from state sources
• 2.4 million from federal/national sources
• 6.3 million total (63 per capita)

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State Cigarette Excise Taxes, 2002

• 1.51 Massachusetts
• 1.51 Connecticut
• 1.50 New York
• 1.50 New Jersey
• 1.50 Rhode Island

• 1.425 Washington
• 1.30 Hawaii
• 1.28 Oregon
• 1.25 Michigan

State average 70.5
Very little earmarked to health in MI
http//tobaccofreekids.org/research/factsheets/pdf
/0099.pdf
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Cigarette Taxes and Prices in Selected Developed
Countries, 2002
Percentages represent proportion of retail price
devoted to taxes
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States with Comprehensive Smoke-free Workplace
Laws

• California 1994, 1998 (bars)
• Delaware 2002
• Florida
• 2002 ballot initiative (71 support)
• 2003 law
• Connecticut 2003
• New York 2003

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Municipalities with 100 Smoke-Free Ordinances
Source American Nonsmokers Rights Foundation
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Michigan Clean Indoor Air Policies

• Weak Michigan Clean Indoor Air Act
• Does not apply to most private worksites
• Allows designated smoking areas in public places
  (no requirement to be physically separated and
  separately ventilated)
• Weak state restaurant smoking law
• gt 50 nonsmoking seating (gt 50 seats)
• gt 25 nonsmoking seating (lt 50 seats)
• (no special requirements for ventilation)

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Michigan Clean Indoor Air Policies(continued)

• State preemption of local restaurant smoking
  ordinances
• State school smoking ban applies only to public
  schools, and allows smoking on school grounds
  after school hours
• Few local jurisdictions have adopted
  comprehensive smoke-free ordinances (Ingham and
  Washtenaw Counties, City of Marquette)

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Secondhand Smoke
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Australia Aorta
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Australia Stroke
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Australia Eye
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Michigans Scorecard

• Adult smoking C-
• Youth smoking C
• Smoking deaths C-
• Investment in tobacco control D
• Tobacco taxes B-
• Clean indoor air D-

• Mass media D-
• Cessation support (healthcare/quitline) C
• Organizational commitments B
• Human capital A

Overall Score
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Omar Paulk Grade 8 In the neighborhood, the
phrase to smoke means to kill someone. He got
smoked means he got killed. When smokers finish
a cigarette, they say they are killing the
cigarette. My drawing asks the question, Whos
Smoking Who? It means the cigarette is killing
the smoker.
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James Robinson Grade 11 Cass Technical High School
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Damardre Williams Grade 11 Detroit High School
for the Arts
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Edwin Andrews Grade 12 Renaissance High School
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