Prevention Matters

The Centers for Disease Control and Prevention (CDC) issued updated Sexually Transmitted Diseases Treatment Guidelines—2010. The guidelines appear in the December 17, 2010 issue of Morbidity and Mortality Weekly Report (MMWR) Recommendations and Reports.

The Guidelines, which were previously issued in 2006, are based on newly available evidence and serve as a source of clinical guidance and advise health care providers on the most effective treatment regimens, screening procedures, and prevention and vaccination strategies for STDs. The new guidelines include expanded STD prevention recommendations, including HPV vaccination; revised guidance on the diagnostic evaluation and management of syphilis; revised gonorrhea treatment regimens; and other topics.

Over 19 million cases of STDs occur in the United States each year, with a disproportionate share among young people and racial and ethnic minority populations. The estimated annual direct medical costs of treating STDs and their sequelae are $16.4 billion. Left untreated, STDs can cause serious health problems ranging from infertility to increased risk of HIV infection. Partnership for Prevention is working through the National Chlamydia Coalition (NCC) to address the continued high burden of chlamydia infection, especially among women age 25 and under. For more information on the NCC, visit www.prevent.org/ncc.

The Guidelines are available at www.cdc.gov/std/treatment/2010/. For more information, contact 800-CDC-INFO (800-232-4636) or e-mail cdcinfo@cdc.gov.


Susan K. Maloney, MHS
Managing Senior Fellow and Senior Program Officer

Partnership for Prevention is pleased to announce 2011 funds for the current ActionToQuit state grantees. Colorado, Florida, Nevada, New England, New York and Virginia will receive $15,000 for the continuation of efforts made in 2010 to increase access to tobacco cessation treatments through policy and system change. Funds are to be used primarily for the implementation of the state strategic plans developed during the first year of the program.

Next month, Partnership will also award a second round of ActionToQuit grants to three new states. With generous funding from Pfizer Inc. and the Pfizer Foundation, Partnership for Prevention is working to dramatically increase access to and use of proven tobacco cessation treatments through this grant program. This will be accomplished through strengthening of state level alliances for tobacco cessation. These alliances will chart a course for increasing coverage for these services in States, strengthen quitlines, work with health systems/employers/insurers, and promote the importance of tobacco cessation. As a result, utilization of these treatments will increase and tobacco use will decline.

To learn more about the ActionToQuit state grant program and the 2010 projects, please visit http://actiontoquit.org/stateprojects/.


Brandi Robinson
Tobacco Control Program Associate

"Best and Worst News for Prevention” is based on a purposive sample consisting of expert staff members who each week choose to share their opinions on the best and worst news for prevention.

BEST

N.J. National Guard could serve as a national model for mental health care

During a visit to Trenton in August, the nation's top military officer turned to his hosts in the New Jersey Army National Guard, noting the group's success in monitoring and treating the mental well-being of the state's citizen-soldiers. Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, then asked for more information. It wasn't an idle inquiry. At a time when suicides in the military have soared to record levels, New Jersey is one of just six states in which no Guard members have taken their own lives since 2002. While the Department of Defense mandates some mental health programs, New Jersey has gone further, marshaling state resources and assembling a network of private practitioners to treat distressed Guard members or their family members. The state's primary tool is a 24-hour helpline that's both confidential and independent of the military. Operated by the University of Medicine and Dentistry of New Jersey and funded by the state, the helpline is staffed by veterans and therapists. They counsel soldiers and their relatives, make referrals for treatment and, in the most critical cases, summon help. They also make callers aware of resources available to them, including Department of Veterans Affairs programs, family assistance centers and individuals who can help process claims with the VA.

The New Jersey Guard has deployed more than 11,000 soldiers since 2002, with the biggest mobilization -- just over 2,800 soldiers -- spanning 2008 and 2009. Shortly after that contingent returned, calls to the helpline jumped 20 percent, said Cherie Castellano, the line's director. More recently, she said, therapists fielded two consecutive calls from suicidal veterans.


WORST

Prescriptions for Stimulants, Painkillers Soaring Among Youth


The number of prescriptions for controlled medications such as opioids and stimulants has nearly doubled in adolescents and young adults since 1994. The trend, reported in the December issue of Pediatrics, mirrors a similar increase in misuse of these drugs, with adolescents and young adults' illicit use of prescription drugs now outstripping all other illicit drug use except marijuana. The researchers couldn't attribute the increased misuse directly to more prescriptions, but did urge both physicians and patients to be vigilant when considering the use of drugs such as Oxycontin or Ritalin.


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

National Chlamydia Coalition (NCC) member, Dr. Alwyn Cohall has been named today’s Huffington Post’s Greatest Person of the Day. Dr. Cohall is a pediatrician who has dedicated his career to improving the health and lives of the children in Harlem. He is a Professor of Clinical Public Health and Pediatrics at Columbia University's Mailman School of Public Health and New York Presbyterian Hospital.

Dr. Cohall represents the American Academy of Pediatrics on the NCC and is an active participant in the public awareness committee. Through the Harlem Health Promotion Center and Project STAY, Dr. Cohall is tackling many of the major health problems faced by his community's youth. His work and dedication is truly an inspiration to us all. Congratulations on this well-deserved recognition, Dr. Cohall!

Mara Leff
NCC Intern
Partnership for Prevention

The National Chlamydia Coalition (NCC) recently launched its new Facebook page. The page features the coalition’s mission and goals and links to NCC resources. It will be updated with news and interesting information on chlamydia, preventive services, other STDs, adolescent health, and related topics.  Check out the latest post on a creative chlamydia screening and surveillance initiative in the United Kingdom. To support the NCC on Facebook simply visit our page and click the “like” button. Don’t forget to share it with your friends and colleagues.

Partnership for Prevention was an invited guest at the December 2 launch of Healthy People 2020, with both Jonathan E. Fielding, MD, MPH, MBA, Chair, Partnership for Prevention, who also serves as Chair of the Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020 and Catherine M. Baase, MD, Global Medical Director, Dow Chemical and Secretary of the Board of Directors, making remarks.

Healthy People 2020, the ambitious agenda for improving the nation’s health, are the result of a multiyear process that reflects input from a diverse group of individuals and organizations. Healthy People provides science-based, 10-year national objectives for improving the health of all Americans. For decades, Healthy People has established benchmarks and monitored progress over time in order to:

• Encourage collaborations across sectors. 
• Guide individuals toward making informed health decisions. 
• Measure the impact of prevention activities. 

Healthy People 2020 strives to:

• Identify nationwide health improvement priorities. 
• Increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress. 
• Provide measurable objectives and goals that are applicable at the national, State, and local levels. 
• Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge. 
• Identify critical research, evaluation, and data collection needs. 

For further information, please visit http://healthypeople.gov/2020/ where users can tailor information to their needs and explore evidence-based resources for implementation.

"Best and Worst News for Prevention” is based on a purposive sample consisting of expert staff members who each week choose to share their opinions on the best and worst news for prevention.

BEST

Study Finds Big Strides Made in Treating Leukemia, Lymphoma in Past Decade

Clinicians have made remarkable advances in treating blood cancers with bone marrow and blood stem cell transplants in recent years, significantly reducing the risk of treatment-related complications and death, a new study shows.


Between the early 1990s and 2007, there was a 41 percent drop in the overall risk of death in an analysis of more than 2,500 patients treated at Fred Hutchinson Cancer Center in Seattle, a leader in the field of blood cancers and other malignancies.


WORST

Diabetes Epidemic Will Hit Half of U.S. by 2020


More than half of all Americans may develop diabetes or prediabetes by 2020, unless prevention strategies aimed at weight loss and increased physical activity are widely implemented, according to a new analysis.


These efforts could in theory also save about $250 billion in health care costs in the next 10 years, suggests the analysis published by UnitedHealth Center for Health Reform & Modernization, a specialized center within UnitedHealth that focuses on health care reform issues.


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

...antibiotics and STD screening.

This week CDC released its annual sexually transmitted diseases surveillance report, which showed that chlamydia and syphilis rates in the U.S. continued to rise in 2009. However, gonorrhea reached its lowest level in almost 70 years. All three STDs can be easily treated with antibiotics but can have serious consequences, including infertility and organ damage, if left untreated.

According to the report, chlamydia rates increased by 3% last year, with 409 cases per 100,000 people—representing an all-time high for reported chlamydia infections. The rate increased by almost 20% since 2006. On a positive note, CDC believes that the increase is likely attributed to expanded screening, and not an increase in the disease.

Unfortunately, large disparities still exist among racial and ethnic minority groups, with young African Americans baring a large burden of the disease.

STD screening can help detect disease early and, combined with treatment, is an effective way to protect a person’s health and reduce transmission to partners. One of the continuing problems is that less than half of the people who should be screened for STDs, do so. To help improve screening, as well as prevention and treatment of chlamydia, Partnership for Prevention convenes and leads the National Chlamydia Coalition, whose mission is to reduce the rates of Chlamydia and its harmful effects among sexually active adolescent and young adults.

"Best and Worst News for Prevention” is based on a purposive sample consisting of expert staff members who each week choose to share their opinions on the best and worst news for prevention.

BEST

Smokers Urged to Join Thursday's Great American Smokeout

Get ready, get set, quit! Thursday marks the annual Great American Smokeout, sponsored by the American Cancer Society, which urges all smokers to lay off the habit for at least 24 hours. There have been dramatic changes in attitudes about smoking and a large decrease in smoking rates since the Smokeout was first held in 1977. The annual event includes local and nationwide events meant to encourage smokers to quit for at least one day in the hope that they may decide to permanently kick the habit. The Smokeout has helped focus attention on the dangers of tobacco use and contributed to a "cultural revolution" in tobacco control, says the American Cancer Society. Between 1978 and 2009, the percentage of adults who smoke in the United States fell from 34 percent to 21 percent, according to the U.S. Centers for Disease Control and Prevention (CDC).


WORST

Number of Uninsured Rises, Report Says


The number of uninsured adults in the United States continues to rise, with one in four adults under 65 reporting they were without health insurance at some point in the last year, according to a recent report from the federal Centers for Disease Control and Prevention.  About 50 million adults said they were uninsured for at least some time. The report is based on a survey conducted between January and March.


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

Worksite wellness programs can be successful if implemented and executed correctly, a new study suggests. The study identifies six pillars that create a successful, strategically integrated wellness program regardless of an organizations size that include topics like multilevel leadership, alignment, and communication. The study examined 10 organizations across a variety of industries whose wellness programs have systemically achieved measurable results.

Worksite wellness programs have a history of being effective at increasing employee health while decreasing health care cost. Since 1995, Johnson & Johnson’s employee wellness program has cumulatively saved the company $250 million on health care, and from 2002-2008 the return was $2.71 for every dollar the company spent. Other organizations have had similar results with their worksite wellness programs. MD Anderson Cancer Center within the last 6 years was able to decrease lost works days by 80%, and the software firm SAS Institute was able to lower voluntary attrition to just 4% with their worksite wellness program.

Partnership for Prevention also recognizes the importance of worksite wellness programs with our Leading by Example initiative. The initiative includes publications designed to increase CEOs and CFOs understanding of the importance of worksite wellness programs by highlighting companies with exemplary comprehensive worksite wellness programs. Two new publications each featuring 16 companies will be released in the upcoming months.

For more information on the study please click here.


Katherine Ruffatto
Worksite Health Program Associate

"Best and Worst News for Prevention” is based on a purposive sample consisting of expert staff members who each week choose to share their opinions on the best and worst news for prevention.

BEST

FDA Proposes Graphic Warnings on Cigarette Packs

A series of gruesome pictures depicting emaciated lung cancer patients, a dead body in a morgue, a baby confined to a respirator (presumably the result of secondhand smoke) and other consequences of smoking that will appear on the outside of cigarette packages will hopefully shock people into quitting the habit or not starting in the first place, U.S. officials announced Wednesday, November 10.


WORST

Florida researcher looks for answers to alarming suicide rate among soldiers


American soldiers are killing themselves at the highest rate since the U.S. Military started keeping records and the trend is getting worse.

Military leaders say they are desperate to take action on the problem so the federal government is awarding a $17 million grant to Florida State and the Denver Veterans Affairs Medical Center for a suicide prevention program.

FSU's Professor Thomas Joiner is an internationally renowned expert on suicide who will help lead the military's effort to prevent suicides.

Joiner says there's a new trend of suicide in the military. The suicide rate among soldiers used to be lower than the general population. Joiner says now it's higher at an average of 12.5 suicides per 100,000 soldiers.


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

Wow….New graphic cigarette health warnings … FDA wants to know what you think.

At a press conference this morning (November 10, 2010) Health and Human Services Secretary Kathleen Sebelius helped unveil a “comprehensive tobacco control strategy that includes proposed new bolder health warnings on cigarettes and advertisements. In 2009 President Obama signed into law the “Family Smoking Prevention and Tobacco Control Act” (Public Law 111-31) which required that the Food and Drug Administration add “nine new larger and more noticeable textual warning statements and color graphic images depicting the negative health consequences of smoking.” The Notice of Proposed Rule Making includes 36 proposed images that are a remarkable and long overdue improvements over the warnings Congress required on cigarette packages and advertising ,back in 1984. The FDA is also conducting an extensive 18,000 person consumer test of the proposed graphic images to help identify the nine that will most effectively help current smokers quit and discourage potential new smokers from starting. The results of the FDA’s consumer research will also be released shortly and public comment will be solicited.

The current deadline for public comment on the proposed 36 images is January 9, 2011. The wording of the nine warnings was specified by the Congress when it enacted Public Law 111-31. These warnings include:

‘‘WARNING: Cigarettes are addictive."
‘‘WARNING: Tobacco smoke can harm your children."
‘‘WARNING: Cigarettes cause fatal lung disease."
‘‘WARNING: Cigarettes cause cancer."
‘‘WARNING: Cigarettes cause strokes and heart disease."
‘‘WARNING: Smoking during pregnancy can harm your baby."
‘‘WARNING: Smoking can kill you."
‘‘WARNING: Tobacco smoke causes fatal lung disease in nonsmokers."
‘‘WARNING: Quitting smoking now greatly reduces serious risks to your health."

The challenge for the FDA is to identify graphic images that best amplify the statutorily mandated wording of the cigarette warnings. Federal law also requires that the warnings and graphic images make up the top 50 percent of the front and back of cigarette packages.

FDA Commissioner Margaret Hamburg said it best: “When the rule takes effect, the health consequences of smoking will be obvious every time someone picks up a pack of cigarettes. This is a concrete example of how FDA’s new responsibilities for tobacco product regulation can benefit the public’s health.

So….take a few minutes to check out the FDA’s proposed new labels.

If you have family and friends who smoke…show them the new labels… get their advice and then tell the FDA.

The FDA has given us all an opportunity to play an important role, individually and collectively, in fighting the nation’s leading cause of premature death and preventable illness. Stronger health warnings, especially if they are accompanied by the 1 800 QUIT NOW cessation number, can help more smokers get access to effective cessation medications and discourage thousands of young people from striking the first match of what can become a lifelong, life threatening addiction.

Lets get to work. Tell the FDA what you think.


E Ripley Forbes
Director, Government Affairs

"Best and Worst News for Prevention” is based on a purposive sample consisting of expert staff members who each week choose to share their opinions on the best and worst news for prevention.

BEST

Drinking Beet Juice Increases Blood Flow to Brain and May Fight Dementia

Drinking beet juice increases blood flow to the brain in older people, a finding that suggests the dark red vegetable may fight the progression of dementia, a new study shows.

Beet roots contain high concentrations of nitrates, which are converted into nitrites by bacteria in the mouth. And nitrites help open blood vessels in the body, increasing blood flow and oxygen to places lacking in oxygen.


WORST

Many Higher-Income Parents Forgoing Kids' Vaccinations: Report


Vaccination rates for children insured by commercial plans dropped almost four percentage points between 2008 and 2009, even though the rate of children on Medicaid getting vaccinated is rising.

"Rates had been gradually improving in the commercial plans. This was the first time we'd seen a drop -- and it was a pretty big drop," said Sarah Thomas, vice president of public policy and communication for the National Committee for Quality Assurance, which recently released its annual State of Health Care Quality report.


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

The Nevada ActionToQuit state summit was held in Reno on October 21, 2010. Led by the American Lung Association in Nevada, the summit brought together a diverse group of stakeholders to develop a state plan to reduce tobacco prevalence in Nevada by improving access to cessation treatments.

The summit opened with the State Health Officer as the keynote speaker to set the tone for the event. As noted by the keynote and other presenters, Nevada has a smoking prevalence rate of 21.5%. And of those smokers surveyed, 75% of them wish to quit. For every dollar Nevada spends on providing tobacco cessation treatments, it has an average potential return on investment of $1.31.

Panelists at the summit were all asked the following questions to help facilitate the formation of priority topics and inform the group strategic planning: 1) Please describe how your company or organization provides tobacco cessation services; 2) What impact has tobacco cessation had on your company, organization, or community?; 3) What are the barriers to people accessing tobacco cessation services?; 4) What other actions need to be taken to increase cessation in Nevada?; and 5) What do you think should be our priorities as we develop a statewide cessation plan for Nevada?

Following the presentations, participants at the summit prioritized areas and voted for the following workgroup topics: youth access, closing gaps in access, economic impact, educating officials, and expanding awareness of cessation. The 66 attendees choose which workgroup they wanted to participate in for the remainder of the afternoon and began to develop recommendations for the statewide plan, which will be available early in the new year.

The Nevada summit was a great first step to engage stakeholders in leading the way in increasing access to tobacco cessation treatment and ultimately decreasing tobacco use across the state.

Earlier this week leaders from six of the nation’s most respected public health organizations expressed concerns about a recommendation to “move the majority of all tobacco related research at the NIH into a proposed addiction institute…” In a letter to NIH Director Dr. Francis Collins, the American Cancer Society, American Heart Association, American Lung Association, Campaign for Tobacco-Free Kids, LEGACY and Partnership for Prevention stressed that the proposed move “poses considerable risks to the ongoing efforts by the Department of Health and Human Services to reduce tobacco use.”

The November 2nd letter was sent in response to recommendations of the NIH’s Scientific Management Review Board which recommended the merger of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA). Historically, leadership on tobacco research has been championed by the National Cancer Institute and the National Heart, Lung and Blood Institute. Additionally, neither NIAAA nor NIDA have a significant tobacco research portfolio. The proposed merger of NIAAA and NIDA did not specifically assess the scientific value of transferring the tobacco research portfolios that have driven much of the our nation’s successful policy work and cessation advances over the past thirty years. The letter notes that transfer of tobacco research from NCI and NHLBI to a new entity generally unfamiliar with tobacco science will “create uncertainly about future funding for tobacco-related research…(i)t would also convey the impression … that the NIH considers the tobacco problem solved or that it is now less important to NIH.”

These leaders make a thoughtful and compelling case that removal of tobacco research from the protection and guidance of NCI and NHLBI is premature. In the absence of carefully study, such a move potentially endangers the nation’s continued progress to reduce tobacco use and help the Food and Drug Administration develop and execute a research agenda that will support its life saving regulatory mandates. This issue could have a profoundly negative impact on the quality and relevance of the excellent tobacco work currently underway in NIH’s flagship institutes.

The letter urges Dr. Collins to “postpone any action to include tobacco-related research in the proposed new institute” and to “initiate a review of (NIH’s) current tobacco research portfolio and determine what additional research is necessary to fully support the Administration’s efforts to reduce tobacco use. Such a review would also help inform your decision about whether a reorganization of tobacco research is appropriate.”

There is an old wisdom ... “if it ain’t broke…don’t fix it.” Tobacco continues to represent the nation’s leading cause of premature death and preventable illness. We have made remarkable progress in the decades since Surgeon General Luther Terry alerted the nation to the adverse health effects of smoking. Now is not the time to endanger continued progress in the vital public health work that NCI and NHLBI led tobacco research has supported over the decades. Requesting a thorough study of this issue seems a reasonable course of action for Dr. Collins to endorse.

E Ripley Forbes
Director, Government Affairs

In October, Partnership for Prevention sponsored Colorado’s ActionToQuit tobacco cessation summit in Denver. The event brought together organization, agencies, advocates, and leaders to discuss tobacco cessation policy strategies. The state-level summit was convened by the Colorado Tobacco Education and Prevention Alliance, which received a grant from Partnership for Prevention to develop a state action plan for tobacco cessation.

Colorado’s target audience is the 700,000 uninsured persons in the state, whose collective smoking rate is 32%, compared to 18% in the general population. At the summit, this new alliance of organizations learned about current tobacco cessation coverage gaps and shortly will create a comprehensive strategic plan for the state’s uninsured. Colorado has made great strides in smoke-free air, tobacco tax, and insurance coverage for privately insured and Medicaid populations – assisting the uninsured population is now the top priority to drive down smoking prevalence.

The uninsured in Colorado are similar to those nationwide – higher smoking rates, more in-home smoking, less access to treatment, and less success at quitting. Two thirds of the adult smokers in Colorado are in the lower socioeconomic strata. The touch points for the uninsured are emergency departments, federally qualified health clinics, and other safety net clinics, but cessation treatment is not likely to be offered through these channels, at present. Smoking related health costs for the state total $1.3 billion annually, including $300 million in Medicaid costs.

The Colorado team has held key informant interviews and roundtable meetings in addition to the state summit. The target groups involved are: 

• Medical providers/professionals serving the uninsured
• Mental health and substance abuse treatment providers and professionals
• Advocacy/policy organizations and funders serving the uninsured
• Cessation/addiction experts
• Media professionals with knowledge of reaching low income populations (focus on increasing utilization)
• Uninsured Coloradans
• Health plans
• Colorado health systems experts
• Workforce/employee/employer organizations serving/employing the uninsured

This ActionToQuit summit was an excellent first step toward the alliance’s goal of making Colorado the best state in the USA for tobacco cessation treatment.

"Best and Worst News for Prevention” is based on a purposive sample consisting of expert staff members who each week choose to share their opinions on the best and worst news for prevention.

BEST

Kids benefit from strength training a few times a week

While strength training was once doubted to benefit kids, a new research review confirms that children and teenagers can boost their muscle strength with regular workouts.

The findings, researchers say, support recent recommendations from the National Strength and Conditioning Association (NSCA) that kids strength-train two to three times a week -- though only under professional supervision. In years past, there were concerns that school-age children and teenagers might run a high risk of injuring themselves through strength training, which can be performed using free weights, exercise machines, elastic bands or the body's own resistance.


WORST

U.S. Preschoolers Getting Too Much Screen Time: Combined hours between home and day care often exceed recommended 2-hour daily limit


Two-thirds of preschoolers in the United States are exposed to more than the maximum two hours per day of screen time from television, computers, video games and DVDs recommended by the American Academy of Pediatrics, a new study has found.

Researchers from Seattle Children's Research Institute and the University of Washington looked at the daily screen time of nearly 9,000 preschool-age children included in the national Early Childhood Longitudinal Study-Birth Cohort, an observational study of more than 10,000 children born in 2001.


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

Partnership for Prevention’s ActionToQuit summit for the New England area was held on October 19 in Framingham, Massachusetts. The event brought together organizational representatives, leaders, and advocates from six states to learn about and discuss tobacco cessation policy strategies. The summit was convened by the American Lung Association, which received a grant from Partnership for Prevention to develop an action plan for tobacco cessation in New England.

David Zauche, Senior Program Officer at Partnership for Prevention, presented on the ActionToQuit Program and addressed the impact of health reform on tobacco cessation policies. He emphasized the need to strengthen cessation coverage for Medicaid beneficiaries. As of 2010, federal health reform mandates that all pregnant women insured under Medicaid be eligible for cessation treatment at no cost to them. While this is a step forward, Partnership for Prevention advocates that this benefit be extended to all Medicaid subscribers, providing barrier free access to comprehensive treatments for all tobacco users.

The focus of this summit was the Massachusetts Medicaid benefit, which the other five New England states will attempt to replicate. Lois Keithly, Massachusetts Tobacco Cessation and Prevention Program, and Ayesha Cammaerts, formerly of MassHealth’s Office of Clinical Affairs, presented information on the outstanding Massachusetts initiative, which shed light on several previously unanswered questions:

• If a tobacco cessation benefit is offered and promoted heavily, will a large number Medicaid subscribers use it?
• If they use the benefit, will a large number quit smoking? 
• If this occurs, can there be positive short term benefits as well as long term?  

The results were remarkable. Over a thirty month period 75,000 Medicaid subscribers in Massachusetts used the tobacco cessation benefit, and 33,000 quit smoking. The smoking rate for this population dropped from 38% to 28%, representing a 26% decrease. Additionally, significant decreases were seen in hospitalization rates for heart disease.

"Best and Worst News for Prevention” is based on a purposive sample consisting of expert staff members who each week choose to share their opinions on the best and worst news for prevention.

BEST

Big VA Study Shows Surgery Checklist Saves Lives

Answering such basic questions from surgery checklists — and involving everyone as a team, even patients — saved lives in Veterans Affairs hospitals, according to one of the most rigorous studies of patient safety in the operating room.

Surgery deaths dropped 18 percent on average over three years in the 74 VA hospitals that used the strategy during the study. Surgery team members all created checklists and discussed them in briefings before, during and after surgery. That's a somewhat novel concept in a setting where the surgeon has traditionally called all the shots.


WORST

Americans Still Reaching for the Salt Shaker


Despite constant pleas by public health experts to hold the salt, the sodium intake of the U.S. population hasn't decreased over the past 46 years, according to a new review.

Most of us eat a lot more sodium than is recommended, says researcher Adam Bernstein, MD, ScD, a research fellow in the department of nutrition at Harvard School of Public Health in Boston.


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

A new study printed in Current Medical Research and Opinion found that aspirin use for primary prevention of cardiovascular disease (CVD) could produce overall savings of $79.6 million dollars over 10 years for a base population of 1 million patients, while use for secondary prevention shows a savings of $32.2 million. Aspirin use for primary prevention was also shown to save $29 million in out of pocket costs, which is an immediate benefit for patients.

The study measured cost savings associated with aspirin use for the prevention of CVD. Savings are seen if this preventive service was increased to reflect current guidelines with the greatest savings for primary prevention (i.e. in those patients without CVD, but at risk). Current clinical guidelines recommend aspirin use for the primary prevention of heart disease in men and stroke in women.

In addition to producing millions of dollars in savings, the study reported that aspirin use for primary prevention of CVD would prevent 1273 heart attacks, 2184 angina events, and 565 ischemic strokes in a base population of 1 million patients. Aspirin use for the primary prevention of CVD is not just financially valuable – it saves lives.

Partnership for Prevention supports aspirin use for the primary prevention of heart disease and stroke. Partnership convenes the Aspirin Task Force (ATF), a multidisciplinary group of experts committed to promoting aspirin use for the primary prevention of cardiovascular disease. The ATF supports the USPSTF recommendations, and encourages men and women to speak to their health care provider to decide if aspirin use is right for them.

In addition to the aspirin initiative, Partnership’s National Commission on Prevention Priorities (NCPP) has identified aspirin use for primary prevention as one of the highest value clinical preventive services. In fact, the NCPP reports that if 90% of those who were recommendation to use aspirin did use aspirin, 45,000 lives per year would be saved.

This study, along with Partnership’s initiatives, shows the importance of aspirin use for the primary prevention of heart disease and stroke. In particular, the study reinforces the value of utilizing preventive services to benefit our healthcare system and society as a whole.

This week – October 17-23 – has been designated as National Teen Driver Safety Week. And, we have a good reason to celebrate – today’s edition of the Morbidity and Mortality Weekly Report states that in 2009 there were approximately 500 fewer teen deaths in motor vehicle crashes. During 2004-2008, the percentage of drivers aged 16-17 years involved in fatal crashes decreased by 36%.

However, we can’t be too joyful. In 2009, about 3,000 teens died in motor vehicle crashes – still the leading cause of death for teens.

The numbers do illustrate the value of teen driver safety programs, graduated driver licensing and more involved parents. Evaluations of the graduated driver license programs show a 20-40 percent reduction in crash risk for the youngest drivers.

The watch word – keep it up! The programs and policies in place are working. Communities need to continue to proactively enforce minimum drinking age laws, blood alcohol levels, and safety belt laws. Ongoing evaluation of value of anti-texting laws needs to occur as well to assess impact of distracting driving on teen motor vehicle crashes.


Diane Canova
VP, Policy & Programs
Partnership for Prevention

Think about how often you use your mobile phone and how many “apps” you’ve downloaded. Folks promoting health and wellness believe this could be a good way to engage people and to encourage healthy living. But, what do mobile phone users think? Not too much, judging by a recent survey conducted by the Pew Internet and American Life Project. Only 9 percent of mobile phone users indicated that they use phone apps to help track or manage their health.

Despite low usage now, public health officials remain optimistic that mobile technology is a good way to reach young people, as well as African Americans and Latinos. Like pedometers, scales and journals, mobile apps can assist in tracking food intake, exercise or smoking cessation. They can also provide reminders for medication usage and doctor’s visits. As more mobile applications become available, it will be interesting to see how these tools can assist health decision-making.

http://www.npr.org/blogs/health/2010/10/20/130703545/for-many-of-us-health-apps-are-just-not-part-of-our-routine


Diane Canova
VP, Policy & Programs
Partnership for Prevention

Partnership for Prevention’s fourth ActionToQuit state summit was held on October 14 in Orlando, Florida. Led by the American Lung Association in Florida, the event brought together 65 organizational representatives, leaders, and advocates committed to saving lives and improving health through tobacco cessation at the one of the newest facilities in Orlando, the Sanford-Burnham Medical Research Center at Lake Nona. The Orlando event was unique in that about 190 participants from 27 remote locations across Florida tuned into the summit virtually and participated in workgroups of their own to begin to develop a strategic plan for the state to increase access to tobacco cessation treatments.

The summit continued to take advantage of technology and social media throughout the day, encouraging participants to “tweet” updates from the summit with their Smartphone and to send in questions for presenters by email and text messages. On-site participants were polled on a variety of issues after each presenter using electronic polling keypads which allowed for the results to be displayed for the audience in seconds. These additional features of the Florida summit were definitely value-added and made for increased dialogue and participation.

As noted in the presentation given by Dr. Thomas Brandon, Director of the Tobacco Research & Intervention Program at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, 17.5 percent of adults in Florida are current cigarette smokers. While over a span of 10 years at least 2-3 people die from shark attacks, 10 die from alligator attacks, and 10,000 people are murdered, tobacco use will kill 300,000 individuals.

Jennifer Singleterry, Manger of Cessation Policy at the American Lung Association, pointed out that smoking not only costs Florida thousands of lives each year, but there are also significant economic costs incurred. Each year Florida suffers $4.4 billion in workplace productivity losses; $7.9 billion in costs of premature death; and $7.3 billion in direct healthcare expenditures. These outrages losses, coupled with the prevalence of morbidity and mortality due to tobacco use, continue to make the case for providing a comprehensive cessation benefit in the state of Florida. For every $1.00 spent on providing cessation treatments, Florida has the potential to see an average return of $1.24.

Diane Canova, Vice President of Policy & Programs at Partnership for Prevention provided the presentation on health reform and what it means for tobacco addiction treatment. She stressed that tobacco cessation offers the highest value of all preventive services, receiving the top rating by the National Commission for Prevention Priorities for health impact and cost effectiveness. She also noted the recent expansion of Medicare coverage for cessation counseling to all tobacco users and other key provisions in the Affordable Care Act. The take-away message was that implementation of expanded coverage is key and we must keep tobacco a prominent priority in community prevention to truly drive down the number of tobacco users.

After the morning presenters, summit participants were divided into workgroups to begin making recommendations for the following audiences to ensure that they receive or provide comprehensive tobacco cessation coverage in the state of Florida: 1) healthcare industry; 2) government employees; 3) Medicaid recipients; and 4) businesses. The larger group reconvened at the end of the day to report out on the recommendations and everyone was pleased by the thought and work that had been put into them in such a short amount of time.

The American Lung Association in Florida and its partners will take the next step in the development of the statewide plan by gathering all the information received at the summit and choosing the recommendations that will hopefully lead to all employees in the state having comprehensive coverage. We look forward to seeing Florida’s plan sometime in December and helping them to implement their plan in the upcoming year.


Brandi Robinson
Tobacco Control Program Associate

Partnership for Prevention’s second ActionToQuit state summit was held on September 28 in Buffalo, New York. The event brought together organizational representatives, leaders, and advocates committed to saving lives and improving health through tobacco cessation. The summit was led by the New York State (NYS) Smokers Quitline, which received a grant from Partnership for Prevention to develop a state plan for tobacco cessation.

David Zauche, Senior Program Officer at Partnership for Prevention, provided the keynote address at the Buffalo summit. He stressed that tobacco cessation offers the highest value of all preventive services, receiving the top rating by the National Commission for Prevention Priorities for health impact and cost effectiveness. He noted the Centers for Disease Control and Prevention’s recommendation that tobacco cessation services be covered benefits for all employees, and he explained how federal health reform will positively impact cessation in the nation.

Currently there are 2.7 million smokers in New York State. Leaders from the state quitline and other agencies and organizations set an ambitious goal of reducing that number by one million by the year 2014. This would entail reducing the adult smoking prevalence from 18% to 12%. Fortunately, most cessation indicators are moving in the right direction in New York.

• There have been steady increases in the past decade in the percentage of smokers receiving assistance from their health care provider
• Similar increases have been seen in the percentage of smokers making a quit attempt
• The NYS Smokers Quitline is heavily promoted, providing free telephone and online cessation services and free medications to thousands of people each year
• Paid media campaigns reinforce the need to quit and cessation centers exist to provide additional help

In a strongly worded letter to President Obama and Members of the US House and Senate, Partnership for Prevention joined key national and state public health leaders in supporting the Environmental Protection Agency’s (EPA) effort to reduce emissions that contribute to climate change. The September 28 correspondence advised US political leaders to “fully support the EPA in fulfilling its responsibilities” and oppose “any efforts to weaken, delay or block the EPA from protecting the public’s health from these risks.”

The letter acknowledges “the threat to public health posed by climate change” and urged support for “measures that will reduce these risks and strengthen the ability of our local, state and federal public health agencies to prepare for and respond to the impacts of climate change.”

In addition to Partnership for Prevention, national organizations signing the letter included American Academy of Pediatrics, American College of Preventive Medicine, American Lung Association, American Medical Association, APHA, ASTHO, NACCHO, NALBH, Trust for America’s Health and over 100 public health organizations representing 37 states.


E. Ripley Forbes
Director, Government Affairs

September 26, 2010 marked the 10th anniversary of World Heart Day. Organized by the World Heart Federation, including the American Heart Association and the American College of Cardiology, World Heart Day calls attention to the death and disability caused by heart disease and stroke. Most people now understand that cardiovascular disease is the world’s leading cause of death and most people can identify at least some of the contributing risk factors – high cholesterol, high blood pressure, tobacco use. While we can name the threats, we are slower to recognize and embrace the policies and actions to prevent heart disease and stroke. Controlling diabetes, stopping tobacco use, eating more nutritiously and being more physically active are all important ways to help your heart stay healthy.

This year’s World Heart Day focus was workplace wellness. Most working adults spend the majority of their day at work and what we do at work affects our heart health. One of Partnership’s signature programs, Leading by Example (LBE) promotes workplace health through CEO to CEO engagement. Our LBE publications highlight the efforts of leading companies to build and support a healthy workforce.

Make your heart a 365 day project. Incorporate healthier practices while at work and home. Those working virtually or at home aren’t off the hook. Take a walk, put down the candy bar or cigarette and think about other ways to protect your heart during your work day.

For more information on Leading by Example click here, and for worksite health click here.


Diane Canova
VP, Policy and Programs
Partnership for Prevention

The bill introduced in California to require schools to provide free drinking water in eating areas was named the “Best News for Prevention” while the new report showing the high price of obesity was named the “Worst News for Prevention.”

BEST

Bill seeks to add free water to school menus

In many California school cafeterias, there's no free water to drink. Surprised?

"Everyone I talked to says, 'You're kidding,' " said state Sen. Mark Leno (D- San Francisco).

Leno has introduced legislation to change that. His bill requiring schools to offer drinking water at no charge to students has passed the Senate and Assembly and awaits the governor's signature — a fairly sure thing because the governor sponsored the bill.

"As we all know, young people are constantly bombarded by advertisements and pressure from their peers to consume junk beverages that are high in calories and sugar. Yet many students do not have access to free, fresh drinking water at lunchtime," Leno said in material promoting his bill.


WORST

Obesity hurts your wallet and your health


Obesity puts a drag on the wallet as well as health, especially for women.

Doctors have long known that medical bills are higher for the obese, but that's only a portion of the real-life costs.

George Washington University researchers added in things like employee sick days, lost productivity, even the need for extra gasoline — and found the annual cost of being obese is $4,879 for a woman and $2,646 for a man.

That's far more than the cost of being merely overweight — $524 for women and $432 for men, concluded the report being released last Tuesday, which analyzed previously published studies to come up with a total.


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

Partnership for Prevention’s first ActionToQuit state summit was held on September 21 in Richmond, Virginia. The event brought together some sixty organizational representatives, leaders, and advocates committed to saving lives and improving health through tobacco cessation.

Over one million Virginians are current smokers, and 60% of them attempted to quit in the past year. This decade the smoking rate in the state declined steadily, while the quit attempt rate increased. The tobacco control community has given first priority to tax increases and smoke free public places, and many successes have been realized. But policy and system changes to advance tobacco cessation have not kept pace. Because of this, many people who want to quit have not had access to treatments that have been proven to work.

This summit was an outstanding example of state leaders coming together to solve a problem, in this case a deadly problem. If advocates are serious about significantly decreasing the smoking rate and its corresponding mortality, then change must occur. That’s why discussions centered on: 

• expanding Medicaid coverage in Virginia for tobacco cessation
• working with hospitals and health centers to routinely identify and treat tobacco users 
• urging all employers and private health plans to offer coverage 
• securing additional funding for the Virginia telephone quitline  
• convincing thought leaders and elected officials that cessation treatments are high value, saving lives and money  

The defeat of the Johanns Amendment was named the “Best News for Prevention” while the report showing that Americans are not eating enough fruits and veggies was named the “Worst News for Prevention.”

BEST

Senate Defeats Effort to Eliminate Prevention and Public Health Investment Fund

On a procedural vote of 46 to 52, the Senate today defeated an effort to eliminate the Prevention and Public Health investment fund; one of the signature initiatives Partnership and other prevention advocates worked to include in the recently passed health reform legislation.

“We are grateful the Senate has affirmed the value of investing in evidence-based programs to help individuals and families live healthier lives. The passage of health reform represented an important compact with the American people to transform our current sick care system into a health care system that places value on keeping people healthy,” said Robert J. Gould, President and CEO of Partnership for Prevention.

The Johanns (R-NE) Amendment was offered to HR 5297, the “Small Business Jobs and Credit Act.” The amendment proposed to offset the costs of eliminating a tax code reporting requirement by eliminating funding Congress reserved to support community-based programs to reduce chronic disease rates, address health disparities and strengthen the “evidence-base for effective prevention programming.” Had the amendment passed, over $10 billion in prevention funding would have been cut from vital public health and prevention programs.


WORST

Americans still skipping fruits, veggies


Most Americans still don't eat vegetables often enough, and fruit consumption is actually dropping a little, according to a new government report released Thursday.

The Centers for Disease Control and Prevention found that last year about one-third of U.S. adults consumed fruit or fruit juice at least twice a day. That's down slightly from more than 34 percent in 2000.

Only about 26 percent ate vegetables three or more times a day, the same as in 2000. The statistics come from a national telephone survey of hundreds of thousands of Americans..


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

The American Lung Association released the results of a nation-wide study Tuesday showing that investing in smoking cessation services saves lives and money. Researchers at Penn State University studied the costs and benefits of behavioral and pharmacologic programs to determine if the costs of making smoking cessation programs available on the state-level could be justified by the benefits. The study specifically took into account the costs that smoking cessation would have on each state, such as lost tax and retail revenue, as well as the benefits each program would have. Researchers focused on the state-level, since it is ultimately the state that is responsible for insurance regulation and coverage decisions.

Researchers conducted a cost-benefit analysis on smoking cessation treatments, which included nicotine replacement therapy (NRT), bupropion, and varenicline, both with or without smoking cessation counseling. Benefits included in the analysis were a reduction in direct and indirect medical expenses, as well as increased workplace productivity and a reduction in premature deaths. Costs included in the analysis were the direct costs of the smoking cessation programs, lost tax revenue and lost revenues to retailers and distributors.

Results from this study showed that the annual direct costs to the economy due to smoking were greater than $298 billion. Among these direct costs were workplace productivity losses of an estimated $67.5 billion, premature death losses of $117 billion, and medical expenditures of $116 billion. While a pack of cigarettes on average costs $5.51, taking into account these medical costs and productivity losses, a pack would cost approximately $18.05.

While the Centers for Disease Control and Prevention and the Department of Health and Human Services have issued recommendations on smoking cessation, access to these treatments is not guaranteed and many payers do not provide coverage for smoking cessation. The health benefits of smoking cessation have been known for some time, but there is now economic justification as well. Now it’s time to urge states to take action. If states offer coverage for smoking cessation they will realize health and financial benefits. Researchers have estimated that with every dollar states spend on smoking cessation, they will save on average $1.26. Partnership for Prevention urges all states to join Indiana, Massachusetts, Minnesota, Nevada, Oregon and Pennsylvania in expanding comprehensive coverage to Medicaid recipients to save lives and money.


Katie Burggraf
Tobacco Control Team
Partnership for Prevention

The new baby carrot campaign to get people excited about eating their vegetables was named the “Best News for Prevention” while the report showing that five million eligible children in the U.S. are not enrolled in Medicaid or CHIP was named the “Worst News for Prevention.”

BEST

Oh snap! New baby carrot campaign mimics junk food

Baby carrot farmers are launching a campaign that pitches the little, orange, crunchy snacks as daring, fun and naughty — just like junk food.

A group of 50 producers hopes the 'Eat 'Em Like Junk Food' effort starting next week will double the $1 billion market in two or three years.

The goal is to get people to think of baby carrots as a brand they can get excited about — not just a plain, old vegetable. A website, www.babycarrots.com, features metal music and deep male voices chanting "Baby. Carrots. Extreme." On social networking site Twitter, the campaign's account suggests people eat them "like there's no tomorrow (maybe there won't be...)"

WORST

Medical programs missing millions of kids: report


An estimated five million uninsured children in the United States were eligible for Medicaid or the Children's Health Insurance Program (CHIP) but were not enrolled in either plan, according to a new report.

The study published last Friday in the journal "Health Affairs" recommended policy reforms and broader efforts to get uninsured children into government medical programs, including the use of income tax data for automatic enrollment.

An estimated 7.3 million children were uninsured on an average day in 2008 and 65 percent of them were eligible for Medicaid of CHIP coverage, the report said.


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.

President Barack Obama issued a Proclamation from the White House earlier this month declaring September “National Childhood Obesity Awareness Month.” He said childhood obesity was a national crisis “with nearly one in every three of America's children being overweight or obese” and noted that obesity affects children in every state, that “particular racial and ethnic groups are more severely impacted” and that “obesity can be influenced by a number of environmental and behavioral factors, including unhealthy eating patterns and too little physical activity at home and at school.”

The President acknowledged that more must be done “to halt and reverse this epidemic, as obesity can lead to severe and chronic health problems during childhood, adolescence and adulthood, including heart disease, diabetes, cancer, and asthma.” Nearly $150 billion is spent annually on obesity-related medical conditions. “This is not the future” he added “to which we want to consign our children, and it is a burden our health care system cannot bear.

Partnership believes the Proclamation is a timely and important opportunity to remind Americans of the goals and accomplishments of the First Lady’s "Let's Move!" initiative to combat childhood obesity. “Let’s Move” is an historic public health campaign guided by the recommendations of a Task Force on Childhood Obesity which was charged with review of all programs and policies relating to child nutrition and physical activity and development of a national action plan to maximize federal resources and set concrete benchmarks that can end childhood obesity in a generation. The Task Force has produced a report containing a comprehensive set of recommendations and “strategies to address childhood obesity, including providing healthier food in schools, ensuring access to healthy affordable food, increasing opportunities for physical activity, empowering parents and caregivers with better information about making healthy choices, and giving children a healthy start in life.”

Reducing the incidence of childhood obesity will not be easy or quick. While this crisis has been building for three decades growing awareness and resolve across all sectors of our country provide hope that the President’s goal of reducing childhood obesity to 5% by the year 2030 is achievable.

“Our history shows that when we are united in our convictions, we can safeguard the health and safety of America's children for generations to come. When waves of American children were stricken with polio and disabled for life, we developed a nationwide immunization program that eradicated this crippling disease from our shores within a matter of decades. When we discovered that children were going to school hungry because their families could not afford nutritious meals, we created the National School Lunch Program. Today, this program feeds more than 30 million American children, often at little or no charge. When we work together, we can overcome any obstacle and protect our Nation's most precious resource -- our children. As we take steps to turn around the epidemic of childhood obesity, I am confident that we will solve this problem together, and that we will solve it in a generation.

Partnership for Prevention, the Congressional Prevention Caucus and the Preventive Cardiovascular Nurses Association are sponsoring two Capitol Hill briefings on September 21 to broaden the awareness of legislators and congressional staff about the threat childhood obesity poses to our nation. The briefings, “Eliminating Childhood Obesity: Developing National Consensus on a Prescription for Change” will include presentations by some of the nation’s most distinguished medical leaders including:

Ursula Bauer, PhD, Director, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention

Joe Thompson, MD, MPH, Surgeon General for the State of Arkansas and Director of the Robert Wood Johnson Foundation Center to Prevent Childhood Obesity

Laura Hayman, PhD, RN, Associate Dean for Research and Professor of Nursing in the College of Nursing and Health Sciences, University of Massachusetts, Boston

These briefings are open to the public. Anyone interested in attending can send their contact information and indicate whether they will attend the House or Senate briefing to meetings@prevent.org

This week’s Morbidity and Mortality Weekly Report (MMWR) was dedicated to new and disappointing findings in tobacco control. In addition to the article on secondhand smoke exposure, referenced in a Partnership blog posted yesterday, the Centers for Disease Control and Prevention also published, “Vital Signs: Current Cigarette Smoking Among Adults Aged ≥ 18 Years – United States, 2009.” Researchers at the CDC used data from the 2009 National Health Interview Survey and the 2009 Behavioral Risk Factor Surveillance System to determine adult smoking prevalence rates on both the national and state level.

Researchers found that in 2009, 20.6% of adults in the U.S. were current smokers. For the purposes of this study, cigarette smokers were defined as “adults aged ≥ 18 years who reported having smoked ≥ 100 cigarettes in their lifetime and now smoke every day or some days.” Among these smokers, 78.1% reported smoking every day and 21.9% reported smoking on some days. Results also showed that smoking prevalence varied greatly among different subgroups of the population. Men (23.5%) had a higher smoking prevalence than women (17.9%); non-Hispanic whites (22.1%) and non-Hispanic-blacks (21.3%) had a higher smoking prevalence than Hispanics (14.5%) and Asians (12.0%); and smoking prevalence was higher in the Midwest (23.1%) and South (21.8%) and lowest in the West (16.4%). In addition, there were great variations in smoking prevalence rates among individuals with different education levels. Overall smoking prevalence was found to generally decline with increasing education. Nearly half of all adults who obtained a General Education Development certificate were current smokers, while (49.1%) compared to 5.6 %of people with a graduate degree (5.6%). Researchers also found smoking prevalence to be higher among those living below the federal poverty line (31.1%) than among those at or above the poverty level (19.4%).

The 2009 smoking prevalence rate of 20.6% means that we will not be able to meet our Healthy People 2010 goal of reducing adult smoking prevalence to less than 12%. Results from this study also show that having any decline in smoking prevalence among adults is unlikely since data analyzed in this study show that declines have stalled during the past five years, with no significant difference between smoking prevalence rates in 2005 (20.9%) and 2009 (20.6%).

Partnership for Prevention believes this report provides significant evidence to support the notion that more efforts are needed to help reduce the prevalence of this leading cause of morbidity and mortality in the U.S. A closer look at various subgroups reveals that we have many disparities we need to focus our tobacco control efforts on, such as education and income level, in order to drive smoking prevalence down. Partnership for Prevention advocates for price increases, comprehensive smoke-free policies, and anti-tobacco media campaigns in addition to ensuring that all smokers have access to tobacco cessation treatment they need to quit.


Katie Burggraf
Tobacco Control Intern
Partnership for Prevention

A person’s decision to light up can have serious consequences for their health, but also for the health of those around them. Secondhand smoke is known to cause heart disease and lung cancer in nonsmoking adults but also to cause sudden infant death syndrome, acute respiratory infections, middle ear disease, exacerbated asthma, respiratory symptoms, and decreased lung function in children. Given these health hazards, how effective are our nation’s safeguards at preventing this secondhand exposure?

This week’s Morbidity and Mortality Weekly Report (MMWR), “Vital Signs: Nonsmokers’ Exposure to Secondhand Smoke – United States, 1999-2008,” provides the answer to this question by determining the proportion of the nonsmoking population who are exposed to secondhand smoke and by analyzing past trends in secondhand smoke exposure as determined by the 1999 to 2008 National Health and Nutrition Examination Surveys. Study results showed that the prevalence of secondhand smoke exposure among nonsmokers declined from 52.5% during the 1999-2000 survey to 40.1% during the 2007-2008 survey.

Despite this significant decrease in secondhand smoke exposure, this decline was only present for nonsmokers who did not live with a smoker in their home and also was not significant for non-Hispanic whites. This decline has also been shown to fluctuate from year to year and to be quite inconsistent. Furthermore, disparities among secondhand exposure still exists and study results have shown that exposure during every survey cycle is greater among men than among women; among non-Hispanic blacks than among non-Hispanic whites and Mexican-Americans; among children and youth than among adults; and among those below the federal poverty line than among those at or above the federal poverty line. What is most impressive, however, is that despite this decline in secondhand smoke exposure, 88 million nonsmokers who are above the age of three were still exposed to secondhand smoke during 2007-2008 and among these 88 million, 32 million were America’s children and youth (ages 3-19 years).

The results reported in this MMWR have major implications for public health practice and policies. Partnership for Prevention advocates for increases in state, local, and voluntary smoke-free policies in order to make this decline in secondhand exposure consistent and to eliminate existing disparities, especially among youth and children. Currently only twenty-four states and the District of Columbia have comprehensive smoke-free laws covering workplaces, restaurants, and bars. Complete state-wide bans are needed in order to reduce secondhand smoke exposure and protect the American public.

Homes were also shown to be a major source of secondhand smoke exposure, especially for children. Following the American Academy of Pediatrics and the U.S. Public Health Service’s recommendation, Partnership for Prevention supports efforts to increase clinician interventions for those parents who smoke. It is recommended that these parents not only get help in quitting smoking, but are also educated about the harms of secondhand smoke.

The Healthy People 2010 goal of reducing secondhand smoke exposure among the nonsmoking population to less than 56% has been accomplished. However, there are still a vast number of Americans who are exposed to the potential dangers of secondhand smoke. With more smoke-free policies and a greater emphasis on preventing at-home exposure, we can do a better job of safeguarding America’s nonsmokers.


Katie Burggraf
Tobacco Control Team
Partnership for Prevention

The new Medicare benefit that provides coverage for tobacco cessation counseling to all smokers was named the “Best News for Prevention” while the stalling of youth smoking rates in recent years was named the “Worst News for Prevention.”

BEST

Expanding Coverage: Medicare Offers New Tobacco Cessation Counseling Benefit

On August 25th, the U.S. Department of Health and Human Services announced an expansion of Medicare coverage that is supported by many tobacco control advocates around the nation. This new expansion offers coverage of evidence-based tobacco cessation counseling, allowing many more smokers to get the treatment that they need.

Despite the fact that Medicare provides coverage for over 43 million beneficiaries, tobacco counseling was previously only offered to those individuals who were diagnosed with or showed symptoms of a tobacco-related disease. This new benefit provides coverage for tobacco cessation counseling to all smokers. As Secretary Kathleen Sebelius explains, “For too long, many tobacco users with Medicare coverage were denied access to evidence-based tobacco cessation counseling. Most Medicare beneficiaries want to quit their tobacco use. Now, older adults and other Medicare beneficiaries can get the help they need to successfully overcome tobacco dependence."

WORST

Youth Smoking Rates Now Stalled


Although teen smoking rates dropped in the past decade, they have stalled in recent years, which means increased tobacco prevention efforts are needed, a new U.S. government study shows.

Between 2000 and 2009, cigarette smoking rates declined from 28 percent to 17.2 percent among high school students, and from 11 percent to 5.2 percent among middle school students, said researchers from the Centers for Disease Control and Prevention.

However, they noted that the declines between 2006 and 2009 were not statistically significant -- from 19.8 percent to 17.2 percent among high school students and from 6.3 percent to 5.2 percent among middle school students.


The “Best and Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. "Best and Worst News for Prevention” is based on a purposive sample of expert staff members who each week choose to share their opinions on the best and worst news for prevention. More information is available at http://www.prevent.org/.