New CDC Report Offers Guidance to States on How to Implement Comprehensive Tobacco Control Programs

A new CDC report released today provides a guide to each of the 50 states and the District of Columbia for planning and implementing a comprehensive tobacco control program.  The CDC’s Best Practices for Comprehensive Tobacco Control Programs - 2014 describes an integrated programmatic structure for implementing interventions proven to be effective and provides levels of state investment to prevent and reduce tobacco use in each state.

The Best Practices guide provides specific recommendations for what each state should spend per year on a comprehensive tobacco control program that includes state and community, mass-reach health communication, and cessation interventions, as well as surveillance and evaluation activities, and infrastructure, administration, and management efforts.  

The Surgeon General’s Report released just two weeks ago revealed that comprehensive tobacco control efforts have averted at least 8 million early deaths since 1965, but that these evidence-based tobacco control interventions continue to be underutilized. 

This is the first update to the Best Practices guide since 2007.  It reflects new scientific literature, shifts in state populations and smoking rates, and changes to the tobacco control landscape since 2007. The guide also includes enhanced information on activities to eliminate tobacco-related disparities.  

“We have the resources to greatly reduce the death and disease caused by tobacco use,” said Tim McAfee, MD MPH, Director of the Office on Smoking and Health.  “This updated Best Practices guide gives states a great road map for the design and implementation of an effective tobacco control program.  It explains the components and budget recommendations that are necessary to achieve a comprehensive tobacco control program, and also provides references and resources to assist with maintaining and sustaining such programs. ”  

A comprehensive statewide tobacco control program is a coordinated effort to establish comprehensive smoke-free policies and social norms, promote and help tobacco users to quit, and prevent non-users from starting.  Evidence-based, statewide tobacco control programs that are comprehensive, sustained, and accountable have been shown to reduce smoking rates and tobacco-related deaths and diseases.  

To access the Best Practices guide, visit www.cdc.gov/tobacco, and for additional state-specific tobacco-related data, visit CDC's State Tobacco Activities Tracking and Evaluation System athttp://www.cdc.gov/tobacco/statesystem.

NIDA Releases New Resources to Help Treat Teens Struggling with Drug Abuse

Resources to help parents, health care providers, and substance abuse treatment specialists treat teens struggling with drug abuse, as well as identify and interact with those who might be at risk, were released this week by the National Institute on Drug Abuse (NIDA). The release came before the start of National Drug Facts Week, an annual observance to educate teens about drug abuse. NIDA is part of the National Institutes of Health.

Adolescents’ drug use, as well as their treatment needs, differ from those of adults. Teens abuse different substances, experience different consequences, and are less likely to seek treatment on their own because they may not want or think they need help. Parents can work with health care professionals to find appropriate treatment, but they may be unaware that the teen is using drugs and needs help. According to the 2012 National Survey on Drug Use and Health, only 10 percent of 12- to 17-year-olds needing substance abuse treatments receive any services. 

“Because critical brain circuits are still developing during the teen years, this age group is particularly susceptible to drug abuse and addiction,” said NIDA Director Dr. Nora D. Volkow. “These new resources are based on recent research that has greatly advanced our understanding of the unique treatment needs of the adolescent.”

A new online publication, Principles of Adolescent Substance Use Disorder Treatment: A Research Based Guide, describes the treatment approaches.  

Highlights include:

• Thirteen principles to consider in treating adolescent substance use disorders
• Frequently asked questions about adolescent drug use
• Settings in which adolescent drug abuse treatment most often occurs
• Evidence-based approaches to treating adolescent substance use disorders
• The role of the family and medical professionals in identifying teen substance use and supporting treatment and recovery.

To increase early screening of adolescent substance abuse, The Substance Use Disorder in Adolescents: Screening and Engagement in Primary Care Settings educational module was created. The online curriculum resource for medical students and resident physicians provides videos demonstrating skills to use in screening adolescents at risk for or already struggling with substance use disorders.  Both the patient and physician perspectives are highlighted.  Although created as a training tool, the resource is also free to anyone in the public seeking information on how to interact with teens at risk for addiction. The resource was developed by the NIDA Centers of Excellence for Physician Information, in collaboration with Drexel University College of Medicine and the University of Pennsylvania School of Medicine, both in Philadelphia.

NIDA has many other resources that will be promoted during National Drug Facts Week, Jan. 27-Feb. 2, 2014.  For more information on this observance, go to: http://drugfactsweek.drugabuse.gov/. 

Drug Tests Don’t Deter Teens From Using Drugs, Study Finds

School drug tests don't deter teens from smoking marijuana, but creating a positive school environment might be effective, a new study suggests. The study was reported in WebMD.

About 20 percent of U.S. high schools have drug testing, but this approach is controversial because there's little evidence that it works, the study authors said.

Of the 361 students in the new study, one-third went to schools that had a drug-testing policy. The researchers followed the students for a year and found that those in schools with drug testing were no less likely than other students to try marijuana, cigarettes or alcohol.

The findings are published in the January issue of the Journal of Studies on Alcohol and Drugs.

"Even though drug testing sounds good, based on the science, it's not working," study author Daniel Romer, of the University of Pennsylvania Annenberg Public Policy Center, said in a journal news release.

The students in the study were also asked about their school environment. Schools considered to have a positive environment had clear rules, and teachers and students treated each other with respect, the investigators found.

During the year of follow-up, students in schools with positive environments were about 20 percent less likely to try marijuana and 15 percent less likely to smoke cigarettes, compared to students in other schools.

However, a positive school environment did not seem to reduce the risk of student drinking. This may be due to the fact that drinking is considered more normal than drug use or smoking, Romer suggested.

"The whole culture uses alcohol," he said in the news release. "And you're fighting something that has widespread marketing behind it."

Tobacco Control Efforts Have Saved 8 Million Lives, Study Finds

A Yale study estimates that 8 million lives have been saved in the United States as a result of anti-smoking measures that began 50 years ago this month with the groundbreaking report from the Surgeon General outlining the deadly consequences of tobacco use. The Yale School of Public Health-led analysis is published in the Journal of the American Medical Association.

The study used mathematical models to calculate the long-term effect of the seminal report, and subsequent anti-smoking measures, over the past half-century. These cumulative efforts have significantly reshaped public attitudes and behaviors concerning cigarettes and other forms of tobacco, note the researchers.

First author Theodore R. Holford, professor of biostatistics and member of Yale Cancer Center, and six other researchers who are part of the National Cancer Institute's Cancer Intervention and Surveillance Modeling Network, found that while some 17.6 million Americans have died since 1964 due to smoking-related causes, 8 million lives have been saved as a result of increasingly stringent tobacco-control measures that commenced with the report's Jan. 11, 1964, release.

Of the lives saved, approximately 5.3 million were men and 2.7 million were women. The total number of saved lives translates into an estimated 157 million years of life, a mean of 19.6 years for each beneficiary, report the researchers.

"An estimated 31 percent of premature deaths were avoided by this effort, but even more encouraging is the steady progress that was achieved over the past half-century, beginning with a modest 11 percent in the first decade to 48 percent of the estimate what we would have seen from 2004 to 2012 in the absence of tobacco control," said Holford. "Today, a 40-year-old man can expect on average to live 7.8 years longer than he would have in 1964, and 30 percent of that improvement can be attributed to tobacco control. The gains for women have been slightly less, 5.4 years, but tobacco control accounts for 29 percent of that benefit." 

Using data collected by the National Center for Health Statistics from 1965 to 2009, the team recreated smoking life history summaries for groups born each year starting in 1890. These were used along with national mortality statistics and studies that followed large populations to calculate mortality rates by smoking status. This allowed them to estimate the impact of alternative scenarios for what might have occurred had the era of tobacco control never happened.

The tobacco warning was released by then-U.S. Surgeon General Luther Terry. It is seen by many as a pivotal moment in American public health and as the opening salvo in an ongoing effort to convince people to stop smoking.

Terry convened a committee of specialists who reviewed some 7,000 scientific articles and worked with more than 150 consultants to formulate the report's findings. It was released on a Saturday in order to generate maximum media coverage in Sunday's newspapers. Years after its publication, Terry referred to the report's release as a "bombshell."

The report has since spawned numerous other efforts at various levels of government to curb smoking. This has included the now-familiar Surgeon General's warning on the side of cigarette packages, as well as increased taxation, restrictions on advertising, and limiting public areas where people can smoke, along with programs and products to help people kick their smoking habit. 

While the number of smokers in the United States has decreased significantly over the past several decades, there are still an estimated 44 million Americans who smoke, or about 20 percent of the U.S. population. 

Today, smoking continues to claims hundreds of thousands of lives annually and is the single largest cause of preventable death in the United States. 

Related:

See Tripling Tobacco Taxes Worldwide Would Avoid 200 Million Tobacco Deaths. 
See Strategizer 56: Creating Healthy, Tobacco-Free Environments.