Tobacco use in the United states: A fatal and expensive public health dilemma

Tobacco use in the United states: A fatal and expensive public health dilemmaJacqueline BrownJacksonville UniversityNursing 512

Tobacco use

Cigarette smoking is the leading cause of death in the United States (NIH, 2015)

Dowst-Mayo (2015) Tobacco use remains the single largest preventable cause ofdeath in the United States. Even with the increased cost oftobacco products, increase in anti-tobacco media campaigns andsmoke-free laws for workplaces and public places, almost 20%of Americans still continue to use tobacco(p.58).

Agaka et al.,(2014) found there is a significant decline in cigarette smoking among adults in the United States over the past five decades. In recently years progress has slow down and the use of tobacco products such as cigars and smokeless tobacco remains the same. (p.542).

Tobacco useIn 2009, an estimated 20.6% of all American adults age 18 and older46.6 million peoplesmoked.

Every day another 850 young people age 12 to 17 began smoking on a daily basis.

Result: Widespread tobacco use, results in approximately 443,000 Americans die from tobacco-related illnesses each year.

Tobacco Related Illnesses: cancer and heart disease.

An estimated 49,000 of these deaths are the result of secondhand smoke exposure.

For every person who dies from tobacco use, another 20 suffers from at least one serious tobacco-related illness.

Tobacco use: Financial Burden on U.S. Economy and Medical Care System

AnnuallyCigarette smoking costs more than $193 billion in medical care cost.Second hand smoking cost an additional $10 million

Tobacco use

Tobacco use is one of the leading cause of the increase mortality and morbidity in the United States.

The Tobacco Use Reduction and Initiation is part of the Healthy People 2020 Initiative.

Goals of the Programs:

Tobacco Use Prevalence: Implementing policies to reduce tobacco use and initiation among youth and adults.

Health System Changes: Adopting policies and strategies to increase access, affordability, and use of smoking cessation services and treatments.

Social and Environmental Changes: Establishing policies to reduce exposure to secondhand smoke, increase the cost of tobacco, restrict tobacco advertising, and reduce illegal sales to minors.

Health consequences of tobacco use

Smoking Tobacco:

The use of tobacco in any form even intermittent smoking results in serious disease and health problems including:Several forms of cancer, including cancers of the lung, bladder, kidney, pancreas, mouth, and throatHeart disease and strokeLung diseases, including emphysema, bronchitis, and chronic obstructive pulmonary disease (COPD)Pregnancy complications, including preterm birth, low birth weight, and birth defectsGum diseaseVision problems

Health consequences of tobacco useSecond Hand Smoking from Cigarette and Cigar:

Adults: Heart disease and lung cancerInfant and Children: Asthma, Respiratory infectionsEar infections, Sudden infant death syndrome (SIDS)Smokeless Tobacco Causes: Serious oral health problems- mouth cancer, gums, periodontal disease, and tooth loss.

Monitoring program outcomes

Outcome data is monitored based on specific programs [Cessation and Initiation]

Frequency for data collection: Periodic

Methodology for Data Collection:

The Tobacco Use Supplement to the Current Population Survey (TUS-CPS)National Adult Tobacco SurveyNational Sample Size

Desired change

Healthy People 2020 provides a framework for action to reduce tobacco use to the point that it is no longer a public health problem for the nation.

Reduce Tobacco Use Strategies:Fully funding tobacco control programs.Increasing the price of tobacco products.Enacting comprehensive smoke-free policies.Controlling access to tobacco products.Reducing tobacco advertising and promotion.Implementing anti-tobacco media campaigns.Encouraging and assisting tobacco users to quit.

Desired ChangeFrom 2009-2010, major advances were made in the campaign to end the tobacco use epidemic, including: The U.S. Food and Drug Administration (FDA) was granted the authority to regulate the sales, advertising, and ingredient content of all tobacco products marketed in the United States.15The Federal Government increased the Federal tobacco excise tax by $0.61 to $1.01 per pack.25 states and the District of Columbia (DC) had comprehensive smoke-free laws eliminating smoking in workplaces, restaurants, and bars, and 14 States and DC had cigarette excise tax rates of at least $2 per pack.

Sustainability

Heathy People 2020 is a multi-year cross-disciplinary public health initiative led by the federal government in close collaboration with a diverse group of individuals and organizations from partnering public and private entities.Healthy People initiative began 30 years ago and continues its commitment to improving the quality of our Nation's health.The science-based initiative is centered around a framework for public health prevention priorities and actions. Most recently, Healthy People launched Healthy People 2020, outlining new 10-year goals and objectives for health promotion and disease prevention.

(U.S. Department of Health & Human Services, 2015)

Accountability and program evaluationFunding and Accountability:Annual audit report

Make website visit to review financial records and to ensure that everything documented can be verified.

The use of funds with special permission from the granting agency. Revising Program Interventions:

Data is collected and reviewed

Analysis performed

The goals, targeted measures, interventions updated (revised or added) applicable to accomplishing the programs goals(Milstead, 2016)

Accountability in program Evaluation

Providing Information:Information is updated periodically to reflect the Departments strategies, actions, and progress toward goals.(HHS, 2015)Unintended Effects:Evaluations of programs to identify unintended effects.No intended effects were identified for this programAccreditation:The goal of the national accreditation program is to improve and protect the health of the public by advancing the quality and performance of public health departments. State, tribal, local and territorial health departments are eligible to apply (CDC, 2015)

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Reference

Agaku, I. T., King, B. A., Husten, C. G., Bunnell, R., Ambrose, B. K., Hu, S. e., & ... Day, H. R. (2014). Tobacco product use among adults - United States, 2012-2013. MMWR: Morbidity & Mortality Weekly Report, 63(25), 542-547.Center for Disease Control and Prevention (2015). Program Performance and Accountability. Retrieved on August 2, 2015 from http://www.cdc.gov/program/performance/index.htm.Dowst-Mayo, L. (2015). Puff, Not the Magic Dragon... The Cost of America's Tobacco Use. Rdh, 35(1), 57-65. National Institute of Health(2015). Cancer Trend Progress Report: Adult Tobacco Use. Retrieved on July 31, 2015 from: http://progressreport.cancer.gov/prevention/adult_smokingMilstead, J. (2016). Health policy and politics: a nurse's guide (5th ed.). Burlington, MA: Jones & Bartlett Learning.U.S. Department of Health and Human Services (2015). Healthy People 2020: Tobacco Use. Retrieved on July 30, 2015 from :http://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use