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Indiana Prevention Resource Center (IPRC)

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  • 6.6a Alcohol Spending
  • 6.6b Alcohol Consequences
  • 6.7a Tobacco Spending
  • 6.7b Tobacco Consequences
  • 6.8a Alcohol (SAC) Non-Compliance Rates
  • 6.8b SAC: Intensity of Inspection
  • 6.9 Intensity of Inspection (TRIP/FDA)
  • 6.11 Hoosier Lottery Sales
  • 6.12 Crime Indices
  • 6.13 FBI Uniform Crime Report (All Arrests and Juvenile Arrest)
  • 6.14 Alcohol Related Crash
  • 6.14b INSPECT Data for Rx Drugs
  • 6.14c HIV, HCV, STD, and Opioid Profiles
  • Home > Prev-Stat > County Profiles Data > Introduction

    Community Risk Factors: Laws and Norms

    6.7b Tobacco Consequences
    Tobacco causes more deaths in the United States than do all other illicit drugs combined. In Indiana an estimated 9,700 people ages 35 and over die annually, putting Indiana in 43rd place for smoking-attributable deaths among the states (CDC, 2011; TCSH 2010). 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. Tobacco use damages our economic well-being. Smoking causes more than $193billion each year in health-related costs, including the cost of lost productivity caused by deaths from smoking (Cancer.org, 2011). Overall cost of healthcare and premature loss of life attributed to secondhand smoke for Indiana residents in 2007 = $390.3 million dollars. (IN.gov, 2009) Indiana is especially burdened by the consequences of tobacco use, since the prevalence of tobacco use here is among the highest in the nation, “Indiana ranks 50th among the states” (CDC, 2011).

    According to Healthy People 2020, the leading health indicators for tobacco are adults who are current cigarette smokers and adolescents who smoked cigarettes in the past 30 days. Smoking rates among Indiana’s adult population according to the CDC’s Tobacco Control State Highlights 2010 include the following. Whereas the national rate (median) for adult smoking is 18.4%, Indiana’s rate was 26%. By age group rates were 41.1% for those 18-24, 27.3% for ages 25-44, 26% for 45-64, and 11.7% for 65+. By education the rate was highest for those with less than a high school diploma at 51.5%, 21.2% for with only a high school diploma, and lowest for those with more education, at 18.5%. By gender rates for males were 28.3% and females were 23.9%. By race/ethnicity the highest rate was for American Indians/Alaskan Natives at 53.6%, followed by Hispanics at 31.2%, African Americans at 28.2%, Whites at 24.3%, and lowest for Asians at 10%. For youth ages 12-17, Indiana ranked 35th among the states at 11.8%, with the range being from 6.5% to 15.9% across the nation (CDC, 2011).

    The indicators of the consequences of tobacco use are reflected in the goals and objectives of the Health 2020 plan for the nation, which calls for strategic actions targeting tobacco use, health system changes, and social and environmental change. Here is the complete list of indicators from Healthy People 2020.

    Tobacco Use
    1. Reduce tobacco use by adults
    2. Reduce tobacco use by adolescents
    3. Reduce the initiation of tobacco use among children, adolescents, and young adults
    4. Increase smoking cessation attempts by adult smokers
    5 .Increase recent smoking cessation success by adult smokers
    6 .Increase smoking cessation during pregnancy
    7. Increase smoking cessation attempts by adolescent smokers
    Health System Changes
    8. Increase comprehensive Medicaid insurance coverage of evidence-based treatment for nicotine dependency in States and the District of Columbia Increase comprehensive Medicaid insurance coverage of evidence-based treatment for nicotine dependency in States and the District of Columbia
    9. Increase tobacco screening in health care settings
    10. Increase tobacco cessation counseling in health care settings
    Social and Environmental Changes
    11. Reduce the proportion of nonsmokers exposed to secondhand smoke
    12. Increase the proportion of persons covered by indoor worksite policies that prohibit smoking
    13. Establish laws in States, District of Columbia, Territories, and Tribes on smoke-free indoor air that prohibit smoking in public places and worksites
    14. Increase the proportion of smoke-free homes
    15. Increase tobacco-free environments in schools including all school facilities, property, vehicles, and school events
    16. Eliminate State laws that preempt stronger local tobacco control laws
    17. Increase the Federal and State tax on tobacco products
    18. Reduce the proportion of adolescents and young adults grades 6 through 12 who are exposed to tobacco advertising and promotion
    19. Reduce the illegal sales rate to minors through enforcement of laws prohibiting the sale of tobacco products to minors
    20. (Developmental) Increase the number of States and the District of Columbia, Territories, and Tribes with sustainable and comprehensive evidence-based tobacco control programs.
    The CDC Best Practices for Comprehensive  Tobacco Control Programs calls for three major components plus surveillance, evaluation, and administration.   The three major components are state and community interventions, health communication interventions, and cessation interventions  (CDC, 2007).   http://www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2007/BestPractices_Complete.pdf

    To stem the effects of tobacco use, Indiana’s 2015 Tobacco Control Strategic Plan follows the CDC recommendations for universal population and community-based prevention, including environmental strategies  and evidence-based education and outreach programs to address tobacco use and to improve the social determinants of health.  (ITPC, 2009:14)

    For additional information on tobacco consequences, see the following state and national resources

    State Resources

    American Lung Association of Indiana: www.lungIN.org
    Indiana Alcohol and Tobacco Commission: www.in.gov/atc
    Indiana Latino Institute: www.indianalatino.com
    Indiana State Department of Health: www.in.gov/isdh/
    Indiana Tobacco Quitline: www.indianatobaccoquitline.net
    IN Shape Indiana: www.inshape.in.gov
    Live. Without Tobacco.: www.whitelies.tv

    National Resources

    American Academy of Family Physicians: www.aafp.org
    American Cancer Society: www.cancer.org
    American Legacy Foundation: www.americanlegacy.org
    American Lung Association www.lungusa.org
    Association for the Treatment of Tobacco Use and Dependence: www.attud.org
    Campaign for Tobacco-Free Kids: www.tobaccofreekids.org
    National Guideline Clearinghouse: www.guideline.gov
    North American Quitline Consortium (NAQC): www.Naquitline.org
    Office of the Surgeon General Tobacco Use & Dependence www.surgeongeneral.gov/tobacco/
    Office on Smoking and Health at the Centers for Disease Control and Prevention: www.cdc.gov/tobacco
    Robert Wood Johnson Foundation: www.rwjf.org
    Tobacco Free Nurses: www.tobaccofreenurses.org
    Tobacco Technical Assistance Consortium: www.ttac.org
    World Health Organization: www.who.int

    Select Bibliography

    CDC. Best Practices for Comprehensive Tobacco Control Programs, 2007.  Accessed 5-17-2012 at http://www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2007/BestPractices_Complete.pdf
    CDC. Tobacco Control State Highlights 2010, 2011.  Accessed 5-17-2012 at http://www.cdc.gov/tobacco/data_statistics/state_data/state_highlights/2010/states/indiana/index.htm  ]
    Indiana State Tobacco Control Program.  http://www.in.gov/isdh/tpc/index.htm
    Indiana Tobacco Prevention & Cessation.  Indiana 2015 Tobacco Control Strategic Plan. 2009.  Accessed 5-17-2012 at http://www.in.gov/isdh/tpc/files/IN_2015_Tobacco_Control_Strategic_Plan.pdf
    Tobacco and the National Economy http://www.cancer.org/Cancer/CancerCauses/TobaccoCancer/QuestionsaboutSmokingTobaccoandHealth/questions-about-smoking-tobacco-and-health-tob-and-economy
    Tobacco and the Indiana Economy  http://www.in.gov/isdh/tpc/files/IUCtrforHealthPolicySmokeFreeReport.pdf